Emergency Medical ServicesThe world is an unpredictable place. You never know when you may become an accident victim. Some accidents are more serious than others but many will benefit from quick help or medical service.

Now, other than hospitals and doctors, Emergency Medical Services (EMS) are often the first to respond. Of course that’s the purpose of EMS.

Professionally trained personnel, called Emergency Medical Technicians (EMT), serve their community by being on call 24 hours a day. Their job is to reach accident sites as fast as possible, to treat people rapidly and get them to a more comprehensive medical facility as quickly as they can.

If you aspire to become a firefighter, you may be required to get EMS training. In some cities, all professional firefighters are required to be certified EMTs.

EMS Fundamentals

In brief, Emergency Medical Technicians are an integral part of the Emergency Medical Services. They assess the medical needs of patients who are sick or injured and then provide immediate care to aid their recovery or save their lives. From a car accident to a dog bite, heart attack, violent encounter or a fire, the EMS are expected to cover it all.

EMS Certifications

Training and qualification levels for EMS members and employees vary widely throughout the world. In some agencies, certain members may be qualified only to drive ambulances (no medical training).

However, most EMT personnel maintain at least rudimentary first aid certifications, such as Basic Life Support (BLS).

In English-speaking countries, they are known as paramedics and EMTs, with the former having additional training such as Advanced Life Support (ALS). Physicians and nurses also provide pre-hospital care to varying degrees in different countries.

Levels of Care

Most EMS systems around the world have tiers of response for medical emergencies.  For example, a common arrangement in the United States is that fire engines or volunteers are sent to provide a rapid initial response to a medical emergency, while an ambulance is sent to provide advanced treatment and transport the patient.  In many countries, an air ambulance provides a higher level of care than regular ambulances.

Examples of Level of Care Include:

  • First aid consists of basic skills that are commonly taught to members of the public, such as cardiopulmonary resuscitation (an emergency procedure that combines chest compressions often with artificial ventilation), bandaging wounds and saving someone from choking.
  • Basic Life Support (BLS) is often the lowest level of training that can be held by those who treat patients on an ambulance. Commonly, it includes administering some drugs and a few invasive treatments. BLS personnel may either operate a BLS ambulance on their own, or assist a higher qualified crewmate on an ALS ambulance. In English-speaking countries, BLS ambulance crew are known as EMTs.
  • Intermediate Life Support (ILS), also known as Limited Advanced Life Support (LALS), is positioned between BLS and ALS, but is less common than both. It is commonly a BLS provider with a moderately expanded skill set, but where it is present it usually replaces BLS.
  • Advanced Life Support (ALS) has a considerably expanded range of skills such as intravenous therapy, cricothyrotomy (emergency incision for relief of an obstructed airway) and interpreting an electrocardiogram (ECG or EKG). The scope of this higher tier response varies considerably by country. Paramedics commonly provide ALS, but some countries require it to be a higher level of care and instead employ physicians in this role.
  • Critical Care Transport (CCT) refers to the critical care transport of patients between hospitals (as opposed to pre-hospital). Such services are a key element in regionalized systems of hospital care where intensive care services are centralized to a few specialist hospitals. This level of care is likely to involve traditional healthcare professionals, meaning nurses and/or physicians working in the pre-hospital setting and even on ambulances.


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Basics of Emergency Medical Services (EMS)
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