Emergency Medical Services

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EMS Tutorial: The EMS Response

At this point, it may be instructional to look at the stages of an EMS Response. Using the stages outlined by the Joint Position Statement on Emergency Medical Services and Emergency Medical Services Systems, we will briefly define the scope of an EMS system. These thirteen stages include:

  • Prevention
  • Detection
  • Notification
  • Dispatch
  • Pre-arrival
  • On-scene
  • Transport and Facility Notification
  • Emergency Department/Receiving Facility
  • Interfacility Transport
  • Critical Care
  • Inpatient Care
  • Rehabilitation
  • Follow-up

Now with a little more detail.

  • Prevention: Everyone should be involved; it is more efficient to prevent illness and injury in terms of decreased human suffering and conservation of health care dollars.
  • Detection: We can't fix'em if we can't find'em. This is more of a problem in rural/frontier environments due to the sparsely populated, wide open spaces. Technology may help in the future as devices such as automated crash detectors are installed on more and more vehicles.
  • Notification: Who you gonna call? Not all areas are covered by 911 and must use a seven digit emergency number.
  • Dispatch: The dispatcher is responsible for getting information about the emergency and notifying the right emergency provider in a timely manner. The equipment they use can range from a simple radio system to the latest computer assisted communication devices. Rural dispatchers often suffer from low pay, little training, and high stress.
  • Pre-arrival: Once the EMS Providers receive a call, they must begin to think about what they may need once they get on scene of the medical emergency. Fire suppression? Law enforcement? Hazardous material expertise? Extrication equipment? More medical personnel? They must then activate available resources to maximze care at the scene.
  • On-scene: The number 1 priority is scene safety. This must be accomplished before patient care can begin. All EMS Providers must protect themselves and assist with maintaining the safety of other emergency personnel or bystanders present on scene. The injury of one emergency provider by a scene hazard decreases available resources and increases the number of patients requiring care.
  • Transport and Facility Notification: Transport the patient to the most appropriate available healthcare facility by the most appropriate available transport mode. Receiving facility notification from the field providers should be early and contain information that can be used by the receiving facility to prepare for continued care of the patient.
  • Emergency Department/Receiving Facility: Rural receiving facilities are often clinics or small hospitals with limited resources. Those illnesses or injuries that cannot be treated locally are stabilized and transported to a larger facility.
  • Interfacility Transport: Patients can be transported from one healthcare facility to the next by various methods depending on local availability. To determine the most appropriate method, at least three questions must be answered: 1. How fast do I need to get the patient to the next level of care? 2. What is the type of care needed during transport (basic vs advanced and/or specialty care such as neonatal)? 3. What transport options are available in my area?
  • Critical Care: What are the local capabilities to care for the severely ill or injured? Where is the nearest specialty care ie: trauma center, interventional cardiology (balloon, bypass), stroke team, burn care, etc.
  • Inpatient Care: Again, what are the local capabilites and what is the access to specialty care.
  • Rehabilitation: The process to regain function lost as a result of injury or illness. The goal is a return to pre-illness/injury functional status.
  • Follow-up: Most patients seen in the emergency department are treated and returned to the community within a brief time period. Patients with severe illness or injury may require prolonged hospitalization and will need reassessment once they return to the community to determine any ongoing needs.
  • Next lets look at the responders who provide care during the out-of-hospital phase of our EMS response.

EMS Tutorial Content



The EMS Response

The EMS Responder


EMS Summary

Medical Oversight Tutorial