Medicine is primarily concerned with preventing and curing disease and relieving suffering. The Emergency Medical Service (EMS) is an important part of the health care system, especially for people who suffer sudden and unexpected emergencies. In most communities, EMS is regarded as a public good. There are myriad approaches to offering EMS: it may be provided by the fire department, by another agency within the local government, by private entities that provide care within a local geographic area, by volunteer organizations, or by any number of other configurations.
Emergency medical service is often regarded as including the full spectrum of emergency care from recognition of the emergency condition, requesting emergency medical aid, provision of prehospital care, through definitive care in the hospital. It may also include medical response to disasters, planning for and providing medical coverage at mass gatherings, and interfacility transfer of patients. However, for the purposes of this document, the examination of EMS is limited to the more traditional, colloquial definition: prehospital emergency care from the time of the request for medical aid until arrival at and transfer of care to the hospital.
EMS care is provided by a variety of personnel, both paid and volunteer, who are trained at various levels of sophistication including first responders, EMT-Basic, EMT-Intermediate, and EMT-Paramedic. Basic level providers, trained in as little as 110 hours, provide services such as first aid, cardiopulmonary resuscitation, and patient stabilization. At the other end of the training spectrum, paramedics, who have acquired up to thousands of hours of training, bring highly sophisticated medical interventions that require critical thinking, such as endotracheal intubation and intravenous medication administration, to patients in the prehospital setting. EMS agencies often employ physicians with the expertise to evaluate new treatments and with the ability to develop and improve protocols based on scientific findings.12