Emergency Medical Services

An Introduction

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EMS Documents

Listed below are selected documents to expand your knowledge of EMS. Each document title is followed by a brief description of its content. Documents that are in Portable Document Format (PDF) will require the Adobe Acrobat Reader for access. If you do not have the Reader currently installed on your computer, you can download one here.

Areas covered include:

  • EMS History
  • EMS System
  • Indian Health Service EMS
  • Rural EMS
  • Ambulance Equipment
  • Medical Oversight


EMS History

  • Accidental Death and Disability: The Neglected Disease of Modern Society, 1966.

Read from the National Academy Press this White Paper that recognized a need to improve EMS: "In 1965, 52 million accidental injuries killed 107,000, temporarily disabled over 10 million and permanently impaired 400,000 American citizens at a cost of approximately $18 billion. This neglected epidemic of modern society is the nation's most important environmental health problem. It is the leading cause of death in the first half of life's span."

This document is several years old but provides historical information on EMS in the IHS until approximately the mid 1990’s.

EMS System

“The National Association of State EMS Directors (NASEMSD) and the National Association of EMS Physicians (NAEMSP) represent EMS professionals who are involved centrally in the planning, development, and day-to-day direction of EMS systems. The NASEMSD and NAEMSP embrace the concept of comprehensive and integrated EMS SYSTEM planning and implementation. Accordingly, it is the purpose of this joint position statement to encourage the use of the following . . .”

“The EMS Agenda for the Future provides an opportunity to examine what has been learned during America's EMS experience of the past three decades, and create a vision for the future. This opportunity comes at an important time, when those agencies, organizations and individuals that affect EMS are evaluating its role in the context of a changing health care system.” For a summary of the recommendations from the Agenda go here.

Indian Health Service EMS

This chapter provides historical background, reference information, guidelines, and suggested resources for the provision of high quality emergency medical care to American Indian/Alaska Native (AI/AN) people. This chapter revises Indian Health Service (IHS) policy regarding Emergency Medical Services (EMS). The chapter may serve as an administrative handbook for individuals and organizations seeking to provide EMS services. The actual provision of clinical care is not discussed in this chapter.

“The purpose of this report is to present data collected from Tribal Emergency Medical Services (EMS) programs, report their unmet needs, and make suggestions for future resource allocation by the Indian Health Service (IHS). “ 76 pages in length.

The purpose of the Technical Assistance Team developed by NHTSA is to evaluate the status of state EMS systems and then make recommendations for improvement. In 1993 the IHS was the first non-state entity to request a review. Important recommendations were made as a result of this assessment. Although the assessment and recommendations were made in 1993, the recommendations still stand today as a worthy goal for IHS EMS.

Rural EMS

“This paper will address rural emergency preparedness by describing: Rural public health infrastructure and an overview of rural emergency preparedness; and Perspectives and experiences of State Offices of Rural Health in responding to emergencies and in enhancing responsiveness in their States’ rural communities.“

"Rural/frontier EMS providers are acutely aware of the challenges that they face. This document is intended to arm them with information about future directions in which their services and systems might best head to assure their survival, advancement and growth. It is also, more importantly, targeted to local, state and national makers of policy and funding decisions to underscore the fragility of rural/frontier EMS, identify the barriers to success, and propose solutions and highlight successful practices that they must consider in their spheres of influence."

Ambulance Equipment

“The guidelines list the supplies and equipment that should be stocked on ambulances to provide patient care. Previous documents regarding ambulance equipment have referred to essential or minimal equipment necessary to adequately equip an ambulance. However, very little scientific evidence supports requirements for specific equipment and supplies. Equipment requirements will vary, depending on the certification levels of the providers, population densities, geographic and economic conditions of the region, and other factors.”

Medical Oversight

Out-of-Hospital Medical Direction, 1997

A brief introduction to medical oversight, a key component for any EMS system.