Models of International Emergency Medical Service (EMS) Systems

Abstract

An Emergency Medical Service (EMS) can be defined as “a comprehensive system which provides the arrangements of personnel, facilities and equipment for the effective, coordinated and timely delivery of health and safety services to victims of sudden illness or injury.” 1 The aim of EMS focuses on providing timely care to victims of sudden and life-threatening injuries or emergencies in order to prevent needless mortality or long-term morbidity. The function of EMS can be simplified into four main components; accessing emergency care, care in the community, care en route, and care upon arrival to receiving care at the health care facility. 2 Today’s global EMS has advanced so much that it contributes widely to the overall function of health care systems. The World Health Organization regards EMS systems as an integral part of any effective and functional health care system. 3 It is the first point of contact for the majority of people to health care services during emergencies and life-threatening injuries and act as a gate-keeping step for accessing secondary and tertiary services. Emergency medical providers around the world have developed an extended role to deal with medical and trauma emergencies utilizing advanced clinical technology. In many countries where proper EMS system exists, providers can administer controlled medications such morphine and epinephrine, perform invasive procedures for instance, endotracheal intubation and placement of intravenous line, and make complex clinical judgment or even pronounce death. 4,5 The rapid development of medical technology has also reformed the international EMS systems with the introduction of multifunctional compact monitoring systems making the task of monitoring patients manageable in an uncontrolled environment of pre-hospital settings. Since 1970s, the mode of emergency health care delivery in pre-hospital environment evolved around two main models of EMS with distinct features. These are the Anglo-American and the Franco-German model. These categorical distinctions were obvious during the 1970s until the end of the 20th century. Today, most EMS systems around the world have varied compositions from each model. The delivery of emergency medical services in pre-hospital settings can be categorized broadly into Franco-German or Anglo