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Category: EMS Operations

Topic: EMS Systems

Level: EMR

Next Unit: Quality Improvement

11 minute read

Components of EMS systems and their roles:

  • Dispatch centers - These centers receive emergency calls from the public and dispatch appropriate resources to respond to the call. They are responsible for prioritizing calls based on the severity of the situation and ensuring that the appropriate resources are sent to the scene.
  • Response units - These units include ambulances, fire departments, and other emergency response vehicles that provide on-site emergency care and transportation to healthcare facilities. EMS providers must be knowledgeable about the equipment and resources available on these vehicles and know how to use them properly.
  • Healthcare facilities - These facilities include hospitals, urgent care centers, and other healthcare facilities where patients may be transported for further treatment. EMS providers must be familiar with the different types of healthcare facilities in their service area and know which facilities are best suited to handle certain types of medical emergencies.
  • EMS personnel - These are the individuals who provide emergency medical care to patients. EMS providers must be knowledgeable about their own roles and responsibilities within the EMS system, as well as the roles and responsibilities of other EMS personnel. They must also understand the importance of working together as a team to provide the best possible care to patients.
  • Medical oversight - Medical oversight includes medical directors, physicians, and other healthcare professionals who oversee the quality of care provided by EMS providers. EMS providers must understand the role of medical oversight in guiding patient care and ensuring that high standards of care are maintained within the EMS system.

In addition to understanding the components of EMS systems, EMS providers should be familiar with the roles and responsibilities of EMS personnel, including their own. This includes understanding the importance of professionalism and ethical behavior, as well as the need for ongoing education and training to maintain the highest standards of care.

To illustrate the importance of EMS systems, consider the example of a patient experiencing a heart attack. EMS providers must be able to quickly and accurately assess the situation, coordinate with dispatch centers, and provide appropriate prehospital care to stabilize the patient before transport to a healthcare facility for definitive treatment. This requires a deep understanding of the EMS system and the roles of different personnel involved.

Therefore, it is critical for EMS providers to receive comprehensive education and training in EMS systems, including the various components, roles, and responsibilities of EMS personnel, and the importance of maintaining professionalism and ethical behavior. By doing so, EMS providers can ensure they are equipped to provide the highest level of emergency medical care possible.

  The three most common types of EMS service are:

  1. Municipal-based (fire service EMS falls under this, such as FDNY EMS),
  2. Health System or hospital-based, and
  3. Private service.

They have the same goal but provide service in different ways, based on the needs and resources of the community.

NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION (NHTSA): the Lead Coordinating Agency in the national EMS system.

PUBLIC-SAFETY ANSWERING POINT (PSAP): a call center responsible for answering calls to an emergency telephone number, usually 911.

NATIONAL SCOPE OF PRACTICE MODEL: divides prehospital care into provider levels.

NATIONAL EMS EDUCATION STANDARDS: dictates to what extent each provider level must know the given material.


Authorization to Practice

Authorization to practice medicine is issued via coordinated efforts between:  

  1. State EMS offices determine the state scope of practice and actively regulate the licensure of prehospital personnel.
  2. Medical oversight is a system by which the quality of calls can be administratively systemized into protocols that are iterated upon using quality improvement programs.

    Protocols can be online (direct communication with the physician) or offline (written protocols and standing orders.)
  3. County, city, metro, or other local credentialing agencies. These agencies may provide additional credentialing requirements for EMS providers beyond state requirements. This may include additional training, certifications, or other qualifications.
  4. Employer policies and procedures. EMS providers may also be subject to policies and procedures established by their employer. These policies may relate to patient care, vehicle operations, or other aspects of EMS practice. They ensure that EMS providers are operating within the scope of their employer's expectations and standards.