Emergency medical services

1444:. In few jurisdictions, some EMTs are able to perform duties as IV and IO cannulation, administration of a limited number of drugs (including but not limited to Epinephrine, Narcan, Oxygen, Aspirin, Nitroglycerin - dependent on country, state, and medical direction), more advanced airway procedures, CPAP, and limited cardiac monitoring. Most advanced procedures and skills are not within the national scope of practice for an EMT. As such most states require additional training and certifications to perform above the national curriculum standards. In the United States, an EMT certification requires intense courses and training in field skills. A certification expires after two years and holds a requirement of taking 48 CEUs (continuing education credits). 24 of these credits must be in refresher courses while the other 24 can be taken in a variety ways such as emergency driving training, pediatric, geriatric, or bariatric care, specific traumas, etc. Is usually made up of 3 levels in the US. EMT-B, EMT-I (EMT-A in some states) and EMT-Paramedic. The National Registry of EMT New Educational Standards for EMS renamed the provider levels as follows: Emergency Medical Responder (EMR), Emergency Medical Technician (EMT-B), Advanced EMT (AEMT), and Paramedic (EMT-P). 371: 1510: 1223: 623: 293: 1118:

ambulances. Similar to online medical control, this practice allows paramedics to remotely transmit data such as vital signs and 12 and 15 lead ECGs to the hospital from the field. This allows the emergency department to prepare to treat patients prior to their arrival. This is allowing lower level providers (Such as EMT-B) in the United States to utilize these advanced technologies and have the doctor interpret them, thus bringing rapid identification of rhythms to areas where paramedics are stretched thin. While most insurance companies only reimburse EMS providers for transporting patients to 911 receiving facilities (e.g.

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ambulance crews are busy. This may mean that a government or other service provide the 'emergency' cover, whilst a private firm may be charged with 'minor injuries' such as cuts, bruises or even helping the mobility-impaired if they have for example fallen and simply need help to get up again, but do not need treatment. This system has the benefit of keeping emergency crews available at all times for genuine emergencies. These organisations may also provide services known as 'Stand-by' cover at industrial sites or at special events. In Latin America, private ambulance companies are often the only readily-available EMS service

1623:(RNs) in the pre-hospital setting is common in many countries in absence of paramedics. In some regions of the world nurses are the primary healthcare worker that provides emergency medical services. In European countries such as France or Italy, also use nurses as a means of providing ALS services. These nurses may work under the direct supervision of a physician, or, in rarer cases, independently. In some places in Europe, notably Norway, paramedics do exist, but the role of the 'ambulance nurse' continues to be developed, as it is felt that nurses may bring unique skills to some situations encountered by ambulance crews. 1272: 1214:, and the poorer the long-term prognosis for the patient. Current research in Canada has suggested that door to balloon times are significantly lower when appropriate patients are identified by paramedics in the field, instead of the emergency room, and then transported directly to a waiting PCI lab. The STEMI program has reduced STEMI deaths in the Ottawa region by 50 per cent. In a related program in Toronto, EMS has begun to use a procedure of 'rescuing' STEMI patients from the Emergency Rooms of hospitals without PCI labs, and transporting them, on an emergency basis, to waiting PCI labs in other hospitals. 944: 469: 1497:. The most important function of the paramedic is to identify and treat any life-threatening conditions and then to assess the patient carefully for other complaints or findings that may require emergency treatment. In many countries, this is a protected title, and use of it without the relevant qualification may result in criminal prosecution. In the United States, paramedics represent the highest licensure level of prehospital emergency care. In addition, several certifications exist for Paramedics such as Wilderness ALS Care, Flight Paramedic Certification ( 1627:

physician on emergency interfacility transports. In the United States, the most common uses of ambulance-based registered nurses is in the Critical Care/Mobile Intensive Care transport, and in Aeromedical EMS. Such nurses are normally required by their employers (in the US) to seek additional certifications beyond the primary nursing licensure. Four individual states have an Intensive Care or Prehospital Nurse licensure. Many states allow registered nurses to also become registered paramedics according to their role in the emergency medical services team. In

1689: 29: 220: 893: 736: 1458: 1643: 1639:, since 2005, all emergency ambulances should be staffed by at least one registered nurse since only nurses are allowed to administer drugs. And all Advanced Life Support Ambulances are staffed at least by a registered nurse in Spain. In France, since 1986, fire department-based rescue ambulances have had the option of providing resuscitation service (reanimation) using specially trained nurses, operating on protocols, while SAMU-SMUR units are staffed by physicians and nurses 43: 782: 1426: 6159: 571: 827: 289:, said "The curative process commences the instant the patient is put in to the carriage; time is saved which can be given to the care of the patient; the patient may be driven to the hospital so speedily that the hospitals may be less numerous and located at greater distances from each other". This tenet of ambulances providing instant care, allowing hospitals to be spaced further apart, displays itself in modern emergency medical planning. 1663:, as ALS is performed by physicians. In the German-speaking countries, paramedics are assistants to ambulance physicians (called Notarzt). In these countries, if a physician is present, paramedics require permission from the physician to administer treatments such as defibrillation and drugs. If there is no physician on scene and a life-threatening condition is present, they may administer treatments that follow the physician's instructions. 6171: 1606:. ECPs are university graduates in Emergency Medical Care or qualified paramedics who have undergone further training, and are authorized to perform specialized techniques. Additionally some may prescribe medicines for longer-term care, such as antibiotics and in the United Kingdom they can prescribe a broad range of medicines. With respect to a Primary Health Care setting, they are also educated in a range of Diagnostic techniques. 678: 1283: 1059: 1784: 1083: 773:.Their key feature is that all personnel are trained not only in ambulance (EMT) care, but as a firefighter and a peace officer (police function). They may be found in smaller towns and cities, where demand or budget is too low to support separate services. This multi-functionality allows to make the most of limited resource or budget, but having a single team respond to any emergency. 250:, and was distressed by the fact that wounded soldiers were not picked up by the numerous ambulances (which Napoleon required to be stationed two and half miles back from the scene of battle) until after hostilities had ceased, and set about developing a new ambulance system. Having decided against using the Norman system of horse litters, he settled on two- or four-wheeled 409:, taking delivery of the first automobile ambulance, donated by 500 prominent local businessmen, in February 1899. This was followed in 1900 by New York City, who extolled its virtues of greater speed, more safety for the patient, faster stopping and a smoother ride. These first two automobile ambulances were electrically powered with 2 hp motors on the rear axle. 1526:, which are more likely to be dispatched to emergencies requiring advanced care skills. They may also work on land ambulances. The training, permitted skills, and certification requirements vary from one jurisdiction to the next. It also varies to whether they are trained externally by a university or professional body or 'in house' by their EMS agency. 151:. Historically, ambulances only transported patients to care, and this remains the case in parts of the developing world. The term "emergency medical service" was popularised when these services began to emphasise emergency treatment at the scene. In some countries, a substantial portion of EMS calls do not result in a patient being taken to hospital. 528:. The report concluded that ambulance services in the US varied widely in quality and were often unregulated and unsatisfactory. These studies placed pressure on governments to improve emergency care in general, including the care provided by ambulance services. The government reports resulted in the creation of 1769:. Therefore, medical first responders in a helicopter can provide both a higher level of care at the scene, faster transport to a specialist hospital and critical care during the journey. A disadvantage is that it can be dangerous and potentially not possible for them to fly at night or in bad weather. 1834:

or the regional-responding Appalachian Search and Rescue Conference (USA based). Like traditional EMS providers, all wilderness emergency medical (WEM) providers must still operate under on-line or off-line medical oversight. To assist physicians in the skills necessary to provide this oversight, the

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Hospitals or larger hospital systems may provide their own ambulance service as a service to the community, or where ambulance care is unreliable or chargeable. Many hospital-based EMS departments operate solely with their hospital, though some operate more independently and can transport patients to

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Prior to World War II, hospitals provided ambulance service in many large cities. With the severe manpower shortages imposed by the war effort, it became difficult for many hospitals to maintain their ambulance operations. City governments in many cases turned ambulance services over to the police or

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and the National Association of EMS Physicians jointly supported the development in 2011 of a unique "Wilderness EMS Medical Director" certification course, which was cited by the Journal of EMS as one of the Top 10 EMS Innovations of 2011. Skills taught in WEMT courses exceeding the EMT-Basic scope

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are of a frontline under both emergency and non-emergency conditions to incidents. Their role is to assist the clinician that they are working with, either a Technician or Paramedic, in their duties, whether that be drawing up drugs, setting up fluids (but not attaching), doing basic observations or

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Ambulance personnel are generally professionals and in some countries their use is controlled through training and registration. While these job titles are protected by legislation in some countries, this protection is by no means universal, and anyone might, for example, call themselves an 'EMT' or

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The most basic emergency medical services are provided as a transport operation only, simply to take patients from their location to the nearest medical treatment. This was historically the case in all countries. It remains the case in much of the developing world, where operators as diverse as taxi

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In the United States, ambulance services provided by a local government are often referred to as "third service" EMS (the fire department, police department, and EMS department forming an emergency services trio) by the members of said service, as well as other city officials and residents. The most

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Depending on country, area within country, or clinical need, emergency medical services may be provided by one or more different types of organization. This variation may lead to large differences in levels of care and expected scope of practice. Some countries closely regulate the industry (and may

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The aim in "Scoop and Run" treatment is generally to transport the patient within ten minutes of arrival, hence the birth of the phrase, "the platinum ten minutes" (in addition to the "golden hour"), now commonly used in EMT training programs. The "Scoop and Run" is a method developed to deal with

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in this role. Additionally Advanced Life Support includes administering therapeutic doses of electrical shock to those who are in cardiac arrest or using drugs to stimulate the heart, Airway therapy, and so on and so forth. Most ambulances are equipped with advanced Life Support equipment and have

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in this model tend to be better equipped with more advanced medical devices, in essence, bringing the emergency department to the patient. High-speed transport to hospitals is considered, in most cases, to be unnecessarily unsafe, and the preference is to remain and provide definitive care to the

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Critical Care Transport (CCT), also known as medical retrieval or rendez vous MICU protocol in some countries (Australia, NZ, Great Britain, and Francophone Canada) refers to the critical care transport of patients between hospitals (as opposed to pre-hospital). Such services are a key element in

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acting as the most senior medical adviser to the ambulance service. In the United States, EMS became an officially recognized subspecialty by the American Board of Emergency Medicine in 2010, and the first examinations were held in 2013. Many states now recommend EMS board certifiction for newly

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In some areas, private companies may provide only the patient transport elements of ambulance care (i.e. non-urgent), but in some places, they are contracted to provide emergency care, or to form a 'second tier' response, where they only respond to emergencies when all of the full-time emergency

693:, though many also have paid personnel. These may be linked to a volunteer fire service, and some volunteers may provide both services. Some ambulance charities specialize in providing cover at public gatherings and events (e.g. sporting events), while others provide care to the wider community. 536:

In 1971 a progress report was published at the annual meeting, by the then president of American Association of Trauma, Sawnie R. Gaston M.D. Dr. Gaston reported the study was a "superb white paper" that "jolted and wakened the entire structure of organized medicine." This report is created as a

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In North America, and to a lesser extent elsewhere in the English-speaking world, some jurisdictions use specially trained nurses for medical transport work. These are mostly air-medical personnel or critical care transport providers, often working in conjunction with a technician, paramedic or

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may be an autonomous medical professional, and does not require the permission of a physician to administer interventions or medications from an agreed list, and can perform roles such as suturing or prescribing medication to the patient. Recently "Telemedicine" has been making an appearance in

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An emergency medical dispatcher is also called an EMD. An increasingly common addition to the EMS system is the use of highly trained dispatch personnel who can provide "pre-arrival" instructions to callers reporting medical emergencies. They use carefully structured questioning techniques and

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Many systems 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

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In the U.S., private ambulance companies provide emergency medical services in large cities and rural areas by contracting with local governments. In areas where the local county or city provide their own emergency services, private companies provide discharges and transfers from hospitals and

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Operating separately from (although alongside) the fire and police services of the area, these ambulances are funded by local, provincial or national governments. In some countries, these only tend to be found in big cities, whereas in countries such as the United Kingdom, almost all emergency

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In countries such as the United States, Japan, France, South Korea and parts of India, ambulances can be operated by the local fire or police services. Fire-based EMS is the most common model in the United States, where nearly all urban fire departments provide EMS and a majority of emergency

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Some agencies separate the 'driver' and 'attendant' functions, employing ambulance driving staff with no medical qualification (or just a first aid and CPR certificates), whose job is to drive ambulances. While this approach persists in some countries, such as India, it is generally becoming

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provide all medical interventions for the patient. Other ambulance personnel are not non-medically trained and only provide driving and heavy lifting. In other applications of this model, as in Germany, a paramedic equivalent does exist, but is an assistant to the physician with a restricted

1659:-led EMS model, such as France, Italy, the German-speaking countries (Germany, Switzerland, Austria), and Spain, physicians respond to all cases that require more than basic first aid. In some versions of this model (such as France, Italy, and Spain), there is no direct equivalent to a 1263:

patient until they are medically stable, and then accomplish transport. In this model, the physician and nurse may actually staff an ambulance along with a driver, or may staff a rapid response vehicle instead of an ambulance, providing medical support to multiple ambulances.

606:. Government ambulance services also have to take civil service exams just like government fire departments and police. In the United States, certain federal government agencies employ emergency medical technicians at the basic and advanced life support levels, such as the 158:

levels for members and employees of emergency medical services vary widely throughout the world. In some systems, members may be present who are qualified only to drive ambulances, with no medical training. In contrast, most systems have personnel who retain at least basic

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in 1794. Larrey subsequently entered Napoleon's service during the Italian campaigns in 1796, where his ambulances were used for the first time at Udine, Padua and Milan, and he adapted his ambulances to the conditions, even developing a litter which could be carried by a

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Many countries employ ambulance staff who only carry out non-emergency patient transport duties (which can include stretcher or wheelchair cases). Dependent on the provider (and resources available), they may be trained in first aid or extended skills such as use of an

1718:) often complement a land ambulance service. In some remote areas, they may even form the primary ambulance service. Like many innovations in EMS, medical aircraft were first used in the military. One of the first recorded aircraft rescues of a casualty was in 1917 in 537:"prime mover" and made the "single greatest contribution of its kind to the improvement of emergency medical services". Since this time a concerted effort has been undertaken to improve emergency medical care in the pre-hospital setting. Such advancements included Dr. 212:, in which a man who has been beaten is cared for by a passing Samaritan. Luke 10:34 (NIV) – "He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him." During the Middle Ages, the 1101:. They have specialized medical training, but not to the same level as a physician. In this model it is rare to find a physician actually working routinely in ambulances, although they may be deployed to major or complex cases. The physicians who work in EMS provide 1109:

or 'standing orders' (procedures for treatment). This may also include on-line medical control, in which the physician is contacted via radio or phone to provide advice and authorization for various medical interventions or for a patient's desire to refuse care.

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in ambulance construction concerning the internal height of the patient care area (to allow for an attendant to continue to care for the patient during transport), and the equipment (and thus weight) that an ambulance had to carry, and several other factors.

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that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other

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a 'paramedic', regardless of their training, or the lack of it. In some jurisdictions, both technicians and paramedics may be further defined by the environment in which they operate, including such designations as 'Wilderness', 'Tactical', and so on.

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Certified first responders may be sent to provide first aid, sometimes to an advanced level. Their duties include the provision of immediate life-saving care in the event of a medical emergency; commonly advanced first aid, oxygen administration,

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labs, suggests that time to treatment is a clinically significant factor in heart attacks, and that trauma patients may not be the only patients for whom 'load and go' is clinically appropriate. In such conditions, the gold standard is the

1010:(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. 1404:

skills. In some services, they may also provide emergency cover when other units are not available, or when accompanied by a fully qualified technician or paramedic. The role is known as an Ambulance Care Assistant in the United Kingdom.

996:, 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 members are known as 1238:. The physicians will attempt to treat casualties at the scene and will only transport them to hospital if it is deemed necessary. If patients are transported to hospital, they are more likely to go straight to a ward rather than to an 460:

fire department. No laws required minimal training for ambulance personnel and no training programs existed beyond basic first aid. In many fire departments, assignment to ambulance duty became an unofficial form of punishment.

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Physician-led EMS is also known as the Franco-German model, "stay and play", "stay and stabilize" or "delay and treat". In a physician-led system, doctors respond directly to all major emergencies requiring more than simple

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receive additional university education to become practitioners in their own right, which gives them absolute responsibility for their clinical judgement, including the ability to autonomously prescribe medications. An

3650: 1852:, and simple suturing; however, the scope of practice for the WEMT still falls under BLS level care. A multitude of organizations provide WEM training, including private schools, non-profit organizations such as the 757:

to/from other health related facilities and homes. In most areas private companies are part of the local government emergency disaster plan, and are relied upon for the overall EMS response, treatment and recovery.

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A critical care paramedic, also known as an advanced practice paramedic or specialist paramedic, is a paramedic with additional training to deal with critically ill patients. Critical care paramedics often work on

818:, have emergency medical services provided by employers as a means of protecting their interests and the welfare of their staff. These are often used as first response vehicles in the event of a fire or explosion. 720:, specialise in facilitating training medical professionals to volunteer to assist the statutory ambulance services in the care of patients, through their attendance at those with serious illnesses or injuries. 3931: 1316:

by a first responder measured in minutes, some medical emergencies evolve in seconds. Such a system provides, in essence, a "zero response time," and can have an enormous impact on positive patient outcomes.

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The developments were paralleled in other countries. In the United Kingdom, a 1973 law merged the municipal ambulance services into larger agencies and set national standards. In France, the first official

4466:"Real Decreto 836/2012, de 25 de mayo, por el que se establecen las características técnicas, el equipamiento sanitario y la dotación de personal de los vehículos de transporte sanitario por carretera" 753:

Some ambulances are operated by commercial companies with paid employees, usually on a contract to the local or national government, Hospital Networks, Health Care Facilities and Insurance Companies.

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provide scripted instructions to allow callers or bystanders to begin definitive care for such critical problems as airway obstructions, bleeding, childbirth, and cardiac arrest. Even with a fast

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patient. In France, fire service and private company ambulances provide basic care, while hospital-based ambulances with physicians on board provide advanced care. In many countries, an

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Wilderness EMS-like systems (WEMS) have been developed to provide medical responses in remote areas, which may have significantly different needs to an urban area. Examples include the

627: 1193:, rather than strictly medical situations (e.g. cardiac or respiratory emergencies), however, this may be changing. Increasingly, research into the management of S-T segment elevation 135:

When EMS is dispatched, they will initiate medical care upon arrival on scene. If it is deemed necessary or a patient requests transport, the unit is then tasked with transferring the

2935: 2890: 2583: 1344:. First responders are commonly dispatched by the ambulance service to arrive quickly and stabilize the patient before the ambulance arrives, and to then assist the ambulance crew. 723:

A few charities provide ambulances for taking patients on trips or vacations away from hospitals, hospices or care homes where they are in long-term care. Examples include the UK's

401:, reflecting the competing automotive technologies then in existence. However, the first motorized ambulance was brought into service in the last year of the 19th century, with the 4468:[Royal Decree 836/2012, of 25 May, which establishes the technical characteristics, the sanitary equipment and the staffing of the vehicles of sanitary transport by road]. 5163: 4716: 3570: 2779:

National Academy of Sciences (US) National Research Council (US) Committee on Trauma; National Academy of Sciences (US) National Research Council (US) Committee on Shock (1966).

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from 1947 to 1985, and is currently operated by the New Orleans Health Department and the New Orleans Office of Homeland Security and Emergency Preparedness, separate from the

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60% of ambulance teams are led by nurse. Ambulance nurses can do almost all emergency procedures and administer medicines pre-hospital such as physicians in Estonia. In the

712:, as well as small local volunteer/paid departments. In the United States, volunteer ambulances are rarer, but can still be seen in both metropolitan and rural areas (e.g. 5189: 3411:

Nallamothu BK, Bates ER (October 2003). "Percutaneous coronary intervention versus fibrinolytic therapy in acute myocardial infarction: is timing (almost) everything?".

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to name just a few. Some examples of skills include, but not limited to, life support systems normally restricted to the ICU or critical care hospital setting such as

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shown here, where each of the 'arms' to the star represent one of the six points, are used to represent the six stages of high quality pre-hospital care, which are:

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in Scotland. This level of care is likely to involve traditional healthcare professionals (in addition to or instead of critical care-trained paramedics), meaning

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is the largest charity in the world that provides emergency medicine. (in some countries, it operates as a private ambulance service). Other organisations include

4435: 1165:, especially penetrating trauma such as gunshot or stab wounds. Thus, minimal time is spent providing prehospital care (spine immobilization; "ABCs", i.e. ensure 871:– the emergency medical service provides appropriate and timely interventions to treat the patient at the scene of the incident without doing further harm. 649:

It is rare for a police department in the United States to provide EMS or ambulance services, although many police officers have basic medical training (such as

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Skandalakis PN, Lainas P, Zoras O, Skandalakis JE, Mirilas P (August 2006). "'To afford the wounded speedy assistance': Dominique Jean Larrey and Napoleon".

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In countries where EMS is led by paramedics, the ambulance service may still employ physicians. They may serve on specialist response vehicles, such as the

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A major advance was made (which in future years would come to shape policy on hospitals and ambulances) with the introduction of a transport carriage for

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In most places, EMS can be summoned by members of the public (as well as medical facilities, other emergency services, businesses and authorities) via an

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These are full service emergency service agencies, which may be found in places such as airports or large colleges and universities like for example the

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who are on duty for another emergency service may also be deployed in this role, though some firefighters are trained to a more advanced medical level.

877:-– the emergency medical service load the patient in to suitable transport and continue to provide appropriate medical care throughout the journey 4363: 2632: 2344: 3875: 2994: 2961: 1635:, all ambulances are staffed by a registered nurse with additional training in emergency nursing, anaesthesia or critical care, and a driver-EMT. In 1371: 1347:

Some EMS agencies have set up volunteer schemes, who can be dispatched to a medical emergency before the ambulance arrives. Examples of this include

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suggested that rapid transport was a better strategy for trauma cases, while stabilization at the scene was a better strategy for cardiac arrests.

4227: 5995: 5682: 3660: 3016: 2001: 591: 5999: 5530: 3341: 883:– the patient is handed over to an appropriate care setting, such as the emergency department at a hospital, in to the care of physicians 562:

require anyone working on an ambulance to be qualified to a set level), whereas others allow quite wide differences between types of operator.

992:(BLS) is often the lowest level of training that can be held by those who treat patients on an ambulance. Commonly, it includes administering 5622: 4931: 1936: 1041:

regionalized systems of hospital care where intensive care services are centralized to a few specialist hospitals. An example of this is the

859:– the first persons on scene make a call to the emergency medical services (911) and provide details to enable a response to be mounted 2939: 2606: 2531: 2256: 1856:

and the Wilderness EMS Institute, military branches, community colleges and universities, EMS-college-hospital collaborations, and others.

6015: 5759: 3743: 1340:(AED) usage. The first responder training is considered a bare minimum for emergency service workers who may be sent out in response to an 1355:

operated by the fire services in France. In some countries such as the US, there may be autonomous groups of volunteer responders such as

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paramedics on board. While some fire departments have ambulances, first aid and squads utilize ambulances for emergency medical services.

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increasingly rare. Ambulance drivers may be trained in radio communications, ambulance operations and emergency response driving skills.

1123: 355: 4708: 3600:"Bundesärztekammer - Notfall: Notkompetenz I (German Federal Board of Physicians: Directives regarding emergency powers for Paramedics)" 3574: 5662: 2446: 1981: 1853: 5073: 3969: 3495: 5987: 5627: 1941: 1161:, with the goal of having the patient in surgery within an hour of the traumatic event. This appears to be true in cases of internal 6005: 5209: 4301: 3696: 3599: 2101: 1147: 6201: 6025: 5667: 5637: 5597: 5562: 4688: 1986: 1906: 1871: 1794:

Some EMS agencies have set up specialist teams to help those injured in a major incident or a dangerous situation. These include

2557: 2038:, a programme that enables EMS workers to identify victims and contact their next of kin to obtain important medical information 1469:

has a high level of pre-hospital medical training and usually involves key skills not performed by technicians, often including

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approaches are used in the provision of EMS care around the world, they can generally be placed into one of two categories; one

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These providers have a vast array of and medications to handle complex medical and trauma patients. Examples of medication are

865:– the first professional (EMS) rescuers are dispatched and arrive on scene as quickly as possible, enabling care to begin 658: 599: 5672: 5602: 5592: 5582: 5567: 5557: 5294: 3270: 2798: 2515: 1991: 1966: 1911: 1901: 1891: 1876: 1866: 3401:

Accidental Death and Disability: The Neglected Disease of Modern Society, (1966), National Academy of Sciences (White Paper)

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Aircraft can travel faster and operate in a wider coverage area than a land ambulance. They have a particular advantage for

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Gaston, Sawnie R. (1971). "'Accidental death and disability: the neglected disease of modern society'. A progress report".

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In some cases in this model, such as France, there is no direct equivalent to a paramedic. Physicians and (in some cases)

6399: 6115: 6045: 6020: 5657: 5617: 5202: 2864: 1976: 1931: 1778: 1352: 1138:, or advanced care resources are taken to the patient where they lie. The "scoop and run" approach is exemplified by the 1042: 5048: 4327:

Melby V, Ryan A (October 2005). "Caring for older people in prehospital emergency care: can nurses make a difference?".

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Besides first responders who are deployed to an emergency, there are others who may be stationed at public events. The

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or paramedic practitioner is a position that is designed to bridge the link between ambulance care and the care of a

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is in the process of evaluating a payment model to enable reimbursement for patients evaluated and treated on-scene.

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The Anglo-American model is also known as "load and go" or "scoop and run". In this model, ambulances are staffed by

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Charities or non-profit ambulance departments operate some emergency medical services. They are primarily staffed by

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they had received early treatment in the field. Larrey's projects for 'flying ambulances' were first approved by the

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Studies have been inconclusive as to whether one model delivers better results than the other. A 2010 study in the

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the first experimental mobile coronary care ambulance successfully resuscitated patients using these technologies.

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monitoring. Depending on the service medical direction, these providers are trained on placement and use of UVCs (

92:) which puts them in contact with a dispatching centre, which will then dispatch suitable resources for the call. 6109: 6049: 5822: 5726: 5168: 4545: 1693: 508: 4890: 4013: 3996: 3906: 6097: 6091: 4523: 2230: 2178: 1921: 1509: 1333: 705: 643: 5572: 4864:

Meier, B, Saul, S. Fatal crashes provoke debate on safety of sky ambulances. New York Times, 28 February 2005.

1881: 1242:. Countries that use this model include Austria, France, Belgium, Luxembourg, Italy, Spain, Brazil and Chile. 204:

Emergency care in the field has been rendered in different forms since the beginning of recorded history. The

6378: 6174: 6079: 6062: 5516: 5027: 4197: 4065: 4036: 3956:

Editors of Salem Press (2008). Paramedics. Magill's Medical Guide, 4th Rev. ed.. Salem Press. Retrieved from

3826: 3068: 1841: 1787: 979: 662: 654: 639: 484: 209: 5131:, (Washington, D.C.: National Highway Traffic Safety Administration, US Department of Transportation, 1995). 4371: 2636: 2152: 351:

in 1881. Named the "Vienna Voluntary Rescue Society," it served as a model for similar societies worldwide.

6103: 6085: 6068: 5817: 5289: 5279: 1819: 1433: 1098: 997: 913: 622: 168: 2965: 638:

transport ambulance services in large cities are part of fire departments. Examples of this model are the

389:

was being developed, and in addition to horse-drawn models, early 20th century ambulances were powered by

6162: 5745: 5477: 5395: 5367: 5357: 5352: 5284: 5256: 5190:

World Health Organization: Department of Violence and Injury Prevention "Prehospital Trauma Care Systems"

4979: 3655: 1739: 1599: 666: 453: 97: 5177: 4935: 3098: 2320: 1473:(and with it the ability to use a range of drugs to relieve pain, correct cardiac problems, and perform 187:

may also provide pre-hospital care to varying degrees in certain countries, a model which is popular in

3448:"Applying the new STEMI guidelines: 1. Reperfusion in acute ST-segment elevation myocardial infarction" 1836: 1514: 1258:(ALS) procedures if authorized by the physician, or in cases of immediate life-threatening conditions. 259: 155: 85: 20: 3020: 1222: 440:, there were some areas where a modern ambulance carried advanced medical equipment, was staffed by a 6217: 5264: 1566: 1554: 1348: 1326: 1134:

The essential decision in prehospital care is whether the patient should be immediately taken to the

1007: 739: 611: 47: 2483: 1761:

injuries, especially when they occur in rural or isolated areas. The well-established theory of the

1032:

commonly provide ALS, but some countries require it to be a higher level of care and instead employ

292: 5335: 5274: 5005: 3625: 1413: 1313: 1001: 448:, the only available vehicle that could carry a recumbent patient, and were thus frequently run by 3682: 3626:"EMTs and Paramedics : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics" 2371: 2263: 1271: 1105:

for the work of the ambulance crews. This may include off-line medical control, where they devise

5701: 2535: 2046: 1814:. In the US, these are often known as Tactical EMS teams and are often deployed alongside police 1765:

suggests that major trauma patients should be transported as quickly as possible to a specialist

1574: 1562: 1474: 838:, which are to Preserve Life, Prevent Further Injury, and Promote Recovery. This common theme in 32: 3747: 5802: 5400: 2051: 1849: 1762: 1550: 1194: 1154: 905: 402: 113: 5508: 2508:

The ambulance: the story of emergency transportation of sick and wounded through the centuries

943: 853:– members of the public, or another agency, find the incident and understand the problem 6303: 6228: 6143: 5914: 5887: 5711: 5246: 3851: 2780: 2610: 2470: 1795: 1255: 1013: 607: 316:(now the Cincinnati General) by 1865. This was soon followed by other services, notably the 235: 176: 4783:

Branas CC, MacKenzie EJ, Williams JC, Schwab CW, Teter HM, Flanigan MC, et al. (2005).

3722: 3603: 6318: 6298: 5920: 5797: 5782: 5706: 5362: 5325: 5077: 4873:

Levin, A, Davis, R. Surge in crashes scars air ambulance industry. USA Today, 18 July 2005.

3973: 3499: 2056: 2035: 2014: 1723: 1709: 1697: 1603: 1523: 1239: 1119: 1087: 1063: 965: 932: 743: 476: 468: 433: 144: 105: 101: 3795: 1201:) occurring outside of the hospital, or even inside community hospitals without their own 339:

Another early ambulance service was founded by Jaromir V. Mundy, Count J. N. Wilczek, and

254:-drawn wagons, which were used to transport fallen soldiers from the (active) battlefield 8: 6404: 6368: 6333: 6253: 5899: 5893: 5881: 5497: 5304: 4598: 2733: 2067: 2024: 1831: 1470: 1017: 213: 5129:

Planning Emergency Medical Communications: Volume 2, Local/Regional Level Planning Guide

4305: 3997:"Advanced life support in the wilderness: 5-year experience of the Reach and Treat team" 3700: 2454: 2105: 6073: 5977: 5768: 5487: 5415: 5241: 4685: 4668: 4465: 3335: 3203: 3178: 3148: 2761: 2420: 2030: 1715: 1478: 989: 511:

was the first civilian emergency medical service in the United States to be staffed by

239: 230:

The first use of the ambulance as a specialized vehicle, in battle came about with the

164: 4842: 4825: 3995:

Schmidt TA, Federiuk CS, Zechnich A, Forsythe M, Christie M, Andrews C (August 1996).

3547: 3522: 3472: 3447: 3424: 3123:

Dick WF (2003). "Anglo-American vs. Franco-German emergency medical services system".

308:

The first known hospital-based ambulance service operated out of Commercial Hospital,

23:, also known as the Emergency Medical Service, which operated in World War II Britain. 6358: 6283: 6248: 6238: 5972: 5807: 5792: 5492: 5472: 5456: 5446: 5387: 5021: 4847: 4806: 4763: 4738: 4660: 4617: 4416: 4411: 4394: 4344: 4340: 4018: 3552: 3477: 3428: 3323: 3313: 3266: 3243: 3208: 3140: 2846: 2842: 2804: 2794: 2753: 2749: 2667: 2511: 2412: 1620: 1578: 1436:

are usually able to perform a wide range of emergency care skills, such as automated

1375: 1295: 1251: 1106: 1025: 701: 325: 321: 297: 129: 117: 73: 5139: 4672: 4279: 3152: 2424: 1840:

of practice include catheterization, antibiotic administration, use of intermediate

1153:

The strategy developed for prehospital trauma care in North America is based on the

978:

consists of basic skills that are commonly taught to members of the public, such as

6343: 6258: 5382: 5309: 4837: 4796: 4650: 4406: 4336: 4008: 3542: 3534: 3467: 3459: 3420: 3377: 3235: 3226:

BS Roudsari (2007). "International comparison of prehospital trauma care systems".

3198: 3190: 3132: 2838: 2786: 2765: 2745: 2404: 1811: 1727: 1671: 1670:

in the UK. They may also provide advice and devise protocols for treatment, with a

504: 317: 125: 51: 4092: 1688: 6293: 6233: 5482: 5425: 5410: 5372: 5184: 5158: 4720: 4692: 3239: 2558:"How EMS Services Including Ambulances Went from Punishment to Prestige - IA MED" 1807: 1207: 1190: 952: 717: 529: 417: 109: 4957: 4639:"The First Recorded Aeromedical Evacuation in the British Army - the True Story" 4575: 3773: 3286: 479:

ambulance. Note the raised roof, with more room for the attendants and patients.

358:

was established to provide first aid and ambulance services at public events in

5904: 5866: 5855: 1845: 1799: 1746:, when time to reach a medical facility was reduced from 8 hours to 3 hours in 1570: 1546: 1494: 1441: 1437: 1360: 1341: 1227: 1158: 1021: 993: 948: 807: 803: 786: 747: 538: 496: 492: 488: 420:

were introduced during the war and were found to have a positive effect on the

3136: 2868: 2408: 1294:

A unique aspect of EMS is that there are two hierarchies of authority, as the

432:

became available shortly after World War I, enabling for more efficient radio

283:

patients in London during 1832. The statement on the carriage, as printed in

219: 6393: 6353: 6308: 6288: 5832: 5342: 5194: 5153: 4826:"Variation in air medical outcomes by crew composition: a two-year follow-up" 4801: 4784: 3327: 1766: 1667: 1276: 1182: 1049:

and/or physicians working in the pre-hospital setting and even on ambulances.

892: 735: 603: 429: 301: 205: 140: 89: 6186: 4655: 4638: 3378:"Emergency Triage, Treat, and Transport (ET3) Model | CMS Innovation Center" 1457: 416:, further advances were made in providing care before and during transport; 216:

were known for rendering assistance to wounded soldiers in the battlefield.

6363: 6338: 6313: 6273: 5827: 5451: 5405: 5269: 5236: 4810: 4420: 4348: 4022: 3556: 3481: 3432: 3247: 3212: 3144: 2808: 2757: 2710: 2671: 2416: 2062: 1758: 1747: 1701: 1642: 1490: 1356: 843: 815: 690: 631: 449: 444:, and was dispatched by radio. In many locations, however, ambulances were 437: 121: 4851: 4664: 2850: 2317:"Motorcycle Ambulance Trailer Project Gets Off The Ground With MAN ERF UK" 2289: 781: 324:

which started in 1869 with ambulances carrying medical equipment, such as

242:'s chief surgeon. Larrey was present at the battle of Spires, between the 42: 28: 6373: 5962: 5926: 5103: 4912:

Hawkins, SC (21 January 2012). "Wilderness EMS Medical Director Course".

3538: 3463: 1751: 1632: 1425: 1364: 1067: 1028:. The scope of this higher tier response varies considerably by country. 413: 398: 379: 348: 3446:

Bogaty P, Buller CE, Dorian P, O'Neill BJ, Armstrong PW (October 2004).

3194: 3046: 2782:

Accidental Death and Disability: The Neglected Disease of Modern Society

2208: 1501:), and Critical Care Emergency Medical Transport Program certification. 565: 521:

Accidental Death and Disability: The Neglected Disease of Modern Society

362:. It was modelled on a military-style command and discipline structure. 116:, and others may be used. EMS agencies may also operate a non-emergency 6348: 6138: 5947: 5861: 5347: 4253: 1743: 1582: 1530: 1486: 1482: 1401: 1259: 1211: 1178: 1157:

theory, i.e., that a trauma victim's best chance for survival is in an

1146:, whereas the "stay and play" is exemplified by the French and Belgian 1143: 1102: 724: 570: 512: 386: 375: 309: 4549: 4395:"A new profession in the pre-hospital care field: the ambulance nurse" 3263:

The Emergency Medical Responder: Training and Succeeding as an EMT/EMR

6328: 6323: 6263: 6243: 6057: 5942: 5909: 5737: 5692: 5420: 5330: 5299: 4149:. The Board for Critical Care Transport Certification. Archived from 4144:"Report of a National Study of the Certified Critical Care Paramedic" 3072: 2087: 1731: 1660: 1656: 1594: 1558: 1466: 1235: 1114: 1094: 1033: 1029: 975: 917: 909: 835: 834:

Emergency medical services exists to fulfill the basic principles of

826: 811: 441: 421: 285: 180: 172: 160: 93: 36: 2234: 2182: 661:, which was formed as a hospital-based service, was operated by the 5967: 5957: 5952: 5430: 2127: 2019: 1538: 1534: 1282: 1162: 1135: 912:-led and the other led by pre-hospital allied health staff such as 839: 770: 713: 709: 677: 650: 628:

District of Columbia Fire and Emergency Medical Services Department

542: 473: 394: 329: 148: 4201: 4069: 4040: 2790: 2658:

Bledsoe, B.; Barnes, D. (2004). "Traction splint. An EMS relic?".

1210:

time. The longer the time interval, the greater the damage to the

1150:

or the German "Notarzt"-System (preclinical emergency physician).

1058: 452:. These vehicles, which could serve either purpose, were known as 6278: 3312:. Zigmont, Jason J. (Third ed.). Burlington, Massachusetts. 3179:"Models of International Emergency Medical Service (EMS) Systems" 2394: 2156: 1735: 1730:. In 1928, the first civilian air medical service was founded in 1628: 1139: 983: 956: 897: 579: 500: 406: 280: 247: 136: 78: 4114:. International Association Of Flight Paramedics. Archived from 1113:

In some cases, such as in the UK, South Africa and Australia, a

5837: 5538: 5172: 3994: 3957: 2027:, a rapid-response emergency unit in Chicago disbanded in 2005. 1783: 1719: 1636: 1246: 1046: 682: 445: 359: 344: 333: 243: 188: 4760:

International Trauma Life Support for Emergency Care Providers

1734:

to provide healthcare to people living in remote parts of the

1609: 5716: 5607: 4983: 4782: 3445: 1542: 1198: 1082: 425: 390: 268: 264: 251: 184: 4732: 2731: 2345:"Do not take all your patients to hospital, paramedics told" 1700:

often have staff who are specially trained for dealing with

4014:

10.1580/1080-6032(1996)007[0208:ALSITW]2.3.CO;2

3261:

Ventura, Christian (20 January 2021). "1: The EMS System".

2831:

The Journal of Trauma: Injury, Infection, and Critical Care

1815: 1803: 1498: 802:

Many large factories and other industrial centers, such as

672: 575: 313: 2447:"The Revolutionary Flying Ambulance of Napoleon's Surgeon" 2257:"EU document on European adoption of 112 emergency number" 1726:

who had been shot in the ankle was flown to hospital in a

1074:

drivers and undertakers may transport people to hospital.

1016:(ALS) has a considerably expanded range of skills such as 968:

provides a higher level of care than a regular ambulance.

785:

An ambulance belonging to the Ogawa Red Cross Hospital in

4200:. University Of Maryland Baltimore County. Archived from 4175: 3651:"Fire/EMS Merger: An Examination of Cultural Differences" 1181:) and the victim is transported as fast as possible to a 590:

notable examples of this model in the United States are

167:(BLS). In English-speaking countries, they are known as 4823: 2732:

Kouwenhoven WB, Jude JR, Knickerbocker GG (July 1960).

2582:. West Virginia Department of Education. Archived from 1400:, oxygen therapy, pain relief and other live-saving or 541:

creating the country's first statewide EMS program, in

4735:

Atls, Advanced Trauma Life Support Program for Doctors

2962:"IAFC Position: Fire-based Emergency Medical Services" 1859: 730: 5136:

Medicine at the Margins: EMS Workers in Urban America

4178:. The Board for Critical Care Transport Certification 3970:"HPC - Health Professions Council - Protected titles" 2319:. Transport News Network. 4 July 2006. Archived from 1593:

In the United Kingdom and South Africa, some serving

518:

One well-known report in the US during that time was

483:

Advances in the 1960s, especially the development of

175:, with the latter having additional training such as 3287:"What Does a Super Paramedic Do? (BBC News website)" 1818:

teams. The equivalent in UK ambulance services is a

499:, led to changes in the tasks of the ambulances. In 96:

are the primary vehicles for delivering EMS, though

2059:, a model for organizing Emergency Medical Services 5074:"University of Utah Wilderness and EMS Fellowship" 4094:The Feasibility of the Advanced Practice Paramedic 3602:(in German). Bundesaerztekammer.de. Archived from 2505: 2343: 4599:"EMS officially recognized as an EM subspecialty" 4488:"Infermier Sapeur-Pompiers (French govt website)" 2919: 2891:"Royal Commission on the National Health Service" 1493:, and other skills such as performing a surgical 1372:International Red Cross and Red Crescent Movement 887: 698:International Red Cross and Red Crescent Movement 617: 586:ambulances are part of a national health system. 491:as the standard form of care for out-of-hospital 6391: 4881: 4879: 3176: 3095:"Design, Origin and Meaning of the Star of Life" 3019:. Order of Malta Ambulance Corps. Archived from 2633:"St John Ambulance in the Industrial Revolution" 1997:Emergency medical services in the United Kingdom 50:emergency medical services unit responding to a 5996:International Federation for Emergency Medicine 4824:Burney RE, Hubert D, Passini L, Maio R (1995). 4785:"Access to trauma centers in the United States" 3410: 2580:"A Brief History of Emergency Medical Services" 2445:Ortiz, Captain Jose M (October–December 1998). 2002:Emergency medical services in the United States 1420: 1306: 1086:Ambulances parked outside an emergency room in 920:. These models are commonly referred to as the 592:Pittsburgh Bureau of Emergency Medical Services 6000:International Conference on Emergency Medicine 5224: 3520: 2604: 1742:. The use of helicopters was pioneered in the 1588: 1447: 6216: 6202: 5753: 5524: 5210: 5008:. Archived from the original on 15 April 2012 4876: 4709:40 Years Retrospective: It's Been a Wild Ride 2920:Geneviève Barrier (1992). Odile Jacob (ed.). 2657: 1937:Emergency medical services in the Netherlands 1351:schemes run by ambulance services the UK and 794:whichever hospital may be needed or desired. 764: 6016:Canadian Association of Emergency Physicians 4980:"Appalachian Center for Wilderness Medicine" 4776: 4762:(8th Global ed.). Pearson. p. 12. 4622:: CS1 maint: multiple names: authors list ( 4361: 4176:"Board Of Critical Care Transport Paramedic" 3172: 3170: 3168: 3166: 3164: 3162: 2501: 2499: 2497: 2495: 2493: 2311: 2309: 2307: 1772: 274: 6122:Care of the Critically Ill Surgical Patient 6011:Australasian College for Emergency Medicine 4911: 4817: 4302:"South Western Ambulance Service NHS Trust" 3358: 3344:) CS1 maint: multiple names: authors list ( 3225: 1610:Traditional healthcare professionals in EMS 1408: 1301: 982:, bandaging wounds and saving someone from 842:is demonstrated by the "star of life". The 566:Municipal "third service" ambulance service 6209: 6195: 5760: 5746: 5531: 5517: 5217: 5203: 3340:: CS1 maint: location missing publisher ( 3035: 1982:Emergency medical services in South Africa 1854:Appalachian Center for Wilderness Medicine 1810:situations, building collapses, fires and 1504: 1390: 1378:both provide first aiders in these roles. 4841: 4800: 4654: 4436:"International EMS system Design: Sweden" 4410: 4392: 4326: 4138: 4136: 4060: 4058: 4012: 3546: 3471: 3202: 3159: 3045:. Jumbulance Travel Trust. Archived from 2686:Prehospital Systems and Medical Oversight 2490: 2304: 1942:Emergency medical services in New Zealand 1675:hired medical directors of EMS agencies. 1077: 776: 6006:American College of Emergency Physicians 5162:) is being considered for deletion. See 5042:"Roane State Wilderness First Responder" 4958:"WILDERNESS EMT: TO TAKE OR NOT TO TAKE" 4757: 4751: 4364:"EMS in the Netherlands: A Dutch Treat?" 4109:"Critical Care Paramedic Position Paper" 4097:(MPH thesis). University of Connecticut. 4090: 2341: 1782: 1687: 1641: 1508: 1456: 1429:EMTs loading a patient into an ambulance 1424: 1281: 1270: 1221: 1148:SMUR emergency mobile resuscitation unit 1124:Center to Medicare and Medicaid Services 1081: 1057: 942: 891: 825: 780: 734: 676: 673:Charity/not-for-profit ambulance service 621: 569: 467: 369: 291: 218: 41: 27: 6026:European Society for Emergency Medicine 4643:Journal of the Royal Army Medical Corps 4001:Wilderness & Environmental Medicine 3260: 3122: 2985: 2983: 2913: 2440: 2438: 2436: 2434: 2390: 2388: 1987:Emergency medical services in Sri Lanka 1907:Emergency medical services in Hong Kong 1872:Emergency medical services in Australia 1177:irculation; external bleeding control; 35:paramedics transporting a patient on a 6392: 6036:American Academy of Emergency Medicine 5767: 4715:, August 2007. Accessed: 8 June 2014. 4133: 4055: 3820:"North Dakota EMT-B Scope of Practice" 3087: 2936:"UK NHS Ambulance Service Information" 2828: 2690:National Association of EMS Physicians 2635:. St John Ambulance UK. Archived from 1962:Emergency medical services in Portugal 1952:Emergency medical services in Pakistan 797: 659:New Orleans Emergency Medical Services 600:New Orleans Emergency Medical Services 436:of ambulances in some areas. Prior to 6190: 5741: 5512: 5295:Advanced emergency medical technician 5198: 4733:American College of Surgeons (2008). 4636: 4597:PA-C, Fred Wu, MHS (5 October 2010). 4433: 4368:Journal of Emergency Medical Services 3594: 3592: 3265:. Springer International Publishing. 3118: 3116: 2678: 2660:Journal of Emergency Medical Services 2444: 2288:. Town of Colonie EMS. Archived from 1992:Emergency medical services in Ukraine 1967:Emergency medical services in Romania 1922:Emergency medical services in Ireland 1912:Emergency medical services in Iceland 1902:Emergency medical services in Germany 1892:Emergency medical services in Finland 1877:Emergency medical services in Belgium 1867:Emergency medical services in Austria 1489:, pericardiocentesis, cardioversion, 1254:. They are only permitted to perform 515:, all of whom were African-American. 463: 16:Services providing acute medical care 6031:Asian Society for Emergency Medicine 5100:"Carolina Wilderness EMS Externship" 4596: 3770:"Dept. of Labor EMT Job Description" 3308:J., Walz, Bruce (2 September 2016). 3071:. First Aid Services. Archived from 2980: 2883: 2625: 2431: 2385: 2352:from the original on 12 January 2022 2342:Donnelly, Laura (10 November 2013). 2205:"Valhalla Volunteer Ambulance Corps" 2102:"Long Hill Township First Aid Squad" 1972:Emergency medical services in Russia 1957:Emergency medical services in Poland 1947:Emergency medical services in Norway 1927:Emergency medical services in Israel 1897:Emergency medical services in France 1887:Emergency medical services in Canada 1882:Emergency medical services in Brazil 1614: 1417:performing 12 lead ECG assessments. 1217: 640:New York City Fire Department (FDNY) 336:, reflecting contemporary medicine. 6116:Advanced Life Support in Obstetrics 6021:Royal College of Emergency Medicine 3521:Cantor WJ, Morrison LJ (May 2005). 3361:"CT Statewide EMS Protocols 2017.2" 2993:. British Red Cross. Archived from 2991:"BritishRedCross Ambulance Support" 2605:Nicholas Genes (2 September 2005). 1977:Emergency medical services in Spain 1932:Emergency medical services in Italy 1860:Organization in different countries 1779:Tactical emergency medical services 1381: 1043:Emergency Medical Retrieval Service 971:Examples of level of care include: 731:Private/corporate ambulance service 385:Also in the late 19th century, the 13: 5122: 3659:. 1 September 1998. Archived from 3589: 3413:The American Journal of Cardiology 3307: 3113: 2607:"Disasters and Emergency Medicine" 1917:Emergency medical services in Iran 1320: 1298:is separate to medical authority. 1275:EMT staff at an emergency call in 14: 6416: 5166:to help reach a consensus. › 5145: 5138:(Fordham University Press, 2022) 3900:"Colorado EMT-B IV Certification" 3125:Prehospital and Disaster Medicine 2153:"Hennepin County Emergency Squad" 1683: 1678: 1053: 938: 347:after the disastrous fire at the 6169: 6158: 6157: 5813:International emergency medicine 5092: 5066: 5034: 4998: 4972: 4950: 4934:. Journal of EMS. Archived from 4924: 4412:10.1111/j.1362-1017.2005.00129.x 4362:Wulterkens D (6 December 2005). 4341:10.1111/j.1365-2702.2005.01222.x 4037:"Flight Paramedic Certification" 3498:. Ottawaheart.ca. Archived from 3017:"Order of Malta Ambulance Corps" 2901:from the original on 21 May 2015 2843:10.1097/00005373-197103000-00001 2750:10.1001/jama.1960.03020280004002 2042:List of EMS provider credentials 1646:Prehospital anaesthesia training 1338:automated external defibrillator 1286:A patient arriving at a hospital 904:Although a variety of differing 574:A government-owned ambulance in 428:of patients with leg fractures. 6170: 6110:Pediatric Advanced Life Support 5823:Pre-hospital emergency medicine 4905: 4867: 4858: 4726: 4701: 4679: 4630: 4590: 4564: 4538: 4512: 4480: 4458: 4427: 4386: 4355: 4320: 4294: 4268: 4242: 4224:"Cleveland Clinic CICP program" 4216: 4190: 4168: 4101: 4091:Paquette, Anthony John (2005). 4084: 4029: 3988: 3962: 3950: 3924: 3892: 3868: 3852:"NHTSA EMT-B Scope of Practice" 3844: 3812: 3788: 3762: 3736: 3715: 3689: 3675: 3643: 3618: 3563: 3533:(11): 1425, author reply 1426. 3514: 3488: 3439: 3404: 3395: 3370: 3352: 3301: 3279: 3254: 3219: 3061: 3009: 2954: 2928: 2857: 2822: 2772: 2725: 2695: 2651: 2609:. Medgadget.com. Archived from 2598: 2572: 2550: 2524: 2364: 2335: 1129: 556: 509:Freedom House Ambulance Service 365: 6098:Acute Care of at-Risk Newborns 6092:Neonatal Resuscitation Program 4889:. 31 July 2013. Archived from 4686:"Royal Flying Doctor Service." 2734:"Closed-chest cardiac massage" 2510:. New York: Exposition Press. 2278: 2249: 2223: 2197: 2171: 2145: 2128:"FAST Squad | Town of Lyme NH" 2120: 2094: 2080: 1842:Blind Insertion Airway Devices 1750:, and again to 2 hours by the 1714:Air ambulances (also known as 1481:, 12-lead ECG interpretation, 1440:, care of spinal injuries and 1334:cardio-pulmonary resuscitation 888:Strategies for delivering care 830:Six points on the Star of Life 706:Order of Malta Ambulance Corps 681:A volunteer ambulance crew in 644:Baltimore City Fire Department 618:Fire- or police-linked service 1: 6080:Advanced cardiac life support 6063:Cardiopulmonary resuscitation 5151: 4843:10.1016/s0196-0644(95)70322-5 3425:10.1016/S0002-9149(03)00891-9 3131:(1): 29–35, discussion 35–7. 2073: 1825: 1788:New York City Fire Department 1461:A girl treated by a paramedic 1434:Emergency medical technicians 1099:emergency medical technicians 998:emergency medical technicians 980:cardiopulmonary resuscitation 947:Bags of medical supplies and 914:emergency medical technicians 663:New Orleans Police Department 223:A drawing of one of Larrey's 210:parable of the Good Samaritan 199: 169:emergency medical technicians 6104:Pediatric basic life support 6086:Advanced trauma life support 6069:Mouth-to-mouth resuscitation 5818:Pediatric emergency medicine 5290:Emergency medical technician 5280:Emergency medical dispatcher 4737:. Amer College of Surgeons. 3958:http://elibrary.bigchalk.com 3932:"Paramedic: Job description" 3240:10.1016/j.injury.2007.03.028 2938:. NHS Direct. Archived from 2895:Socialist Health Association 2179:"Nottingham Ambulance Squad" 1820:Hazardous Area Response Team 1650: 1452: 1421:Emergency medical technician 1307:Emergency medical dispatcher 1266: 7: 5478:Critical emergency medicine 5396:Kendrick extrication device 5368:Nontransporting EMS vehicle 5358:Light horse field ambulance 5285:Emergency medical responder 4887:"Tactical EMS: an overview" 4698:Retrieved: 4 December 2010. 4493:(in French). Archived from 4476:: 41589–41595. 8 June 2012. 4329:Journal of Clinical Nursing 3796:"NYS EMT-B Job Description" 2684:Kuehl, Alexander E. (Ed.). 2506:Barkley, Katherine (1978). 2008: 1740:Royal Flying Doctor Service 1600:emergency care practitioner 1589:Emergency care practitioner 1567:Umbilical Arterial Catheter 1448:Advanced life support (ALS) 881:Transfer to definitive care 667:New Orleans Fire Department 553:were founded in the 1970s. 10: 6421: 6400:Emergency medical services 6269:Emergency medical services 5788:Emergency medical services 5549:Emergency medical services 5540:Emergency medical services 5226:Emergency medical services 5169:Emergency Medical Services 5006:"Wilderness EMS Institute" 4470:Boletín Oficial del Estado 3310:Foundations of EMS systems 2560:. IA MED. 22 February 2021 1837:Wilderness Medical Society 1796:tactical police operations 1776: 1738:. This service became the 1707: 1515:Toronto Paramedic Services 1324: 955:Logistics Headquarters in 821: 765:Combined emergency service 657:). One notable example is 260:Committee of Public Safety 194: 86:emergency telephone number 58:Emergency medical services 21:Emergency Hospital Service 18: 6224: 6218:Allied health professions 6152: 6131: 6044: 5986: 5935: 5846: 5775: 5691: 5547: 5465: 5439: 5381: 5318: 5265:Certified first responder 5255: 5232: 5026:: CS1 maint: unfit URL ( 3876:"EMT-B additional skills" 3177:Sultan Al-Shaqsi (2010). 3137:10.1017/s1049023x00000650 2924:(in French). p. 141. 2867:. Umm.edu. Archived from 2409:10.1007/s00268-005-0436-8 1773:Tactical (hazardous area) 1563:Umbilical Venous Catheter 1555:Intra-aortic balloon pump 1414:Emergency care assistants 1353:similar volunteer schemes 1349:Community First Responder 1327:Certified first responder 1008:Intermediate Life Support 1002:emergency care assistants 740:American Medical Response 612:Federal Bureau of Prisons 356:St John Ambulance Brigade 275:Early civilian ambulances 48:New South Wales Ambulance 6309:Music and arts therapist 5963:Epinephrine / Adrenaline 5275:Emergency care assistant 5164:templates for discussion 4802:10.1001/jama.293.21.2626 4399:Nursing in Critical Care 3571:"SAMU de France website" 2397:World Journal of Surgery 2286:"EMS Special Operations" 1722:, when a soldier in the 1409:Emergency care assistant 1302:Basic life support (BLS) 869:Good on-scene/field care 320:service provided out of 163:certifications, such as 19:Not to be confused with 6274:Hemodialysis technician 4758:Campbell, John (2018). 4656:10.1136/jramc-132-01-08 4546:"Londons Air Ambulance" 4434:Bom A (February 2012). 3097:. NHTSA. Archived from 3043:"Questions and Answers" 2703:"Miller-Meteor History" 2453:: 17–25. Archived from 2372:"Knights Hospitaller's" 2047:Mass Gathering Medicine 1517:Critical Care ambulance 1505:Critical care paramedic 1475:endotracheal intubation 1391:Non-emergency attendant 1179:endotracheal intubation 1142:aeromedical evacuation 120:service, and some have 81:such as EMAS or EMARS. 33:Chicago Fire Department 6319:Occupational therapist 5134:Prener, Christopher. 4707:Kay, Marcia Hillary. " 4572:"Surrey Air Ambulance" 3523:"Guidelines for STEMI" 2922:La vie entre les mains 2897:. HMSO. 17 July 1979. 2478:Cite journal requires 2052:Medical amnesty policy 1850:Nasogastric Intubation 1791: 1705: 1696:helicopter ambulance. 1647: 1551:mechanical ventilators 1518: 1462: 1430: 1287: 1279: 1230: 1195:myocardial infarctions 1090: 1078:Transport-centered EMS 1070: 960: 901: 831: 790: 777:Hospital-based service 750: 742:ambulances staging in 686: 634: 582: 480: 403:Michael Reese Hospital 382: 305: 227: 54: 39: 6369:Respiratory therapist 6304:Medical transcription 6254:Clinical psychologist 6229:Anesthesia technician 6144:Injury Severity Score 5915:Nasopharyngeal airway 5888:Intraosseous infusion 5247:Advanced life support 3744:"ACA job description" 3496:"UOHI - Heart Attack" 2231:"Sardinia Life Squad" 1786: 1691: 1645: 1512: 1460: 1428: 1285: 1274: 1256:Advanced Life Support 1225: 1120:Emergency Departments 1085: 1061: 1014:Advanced Life Support 946: 895: 829: 784: 738: 716:). Charities such as 680: 625: 608:National Park Service 573: 471: 373: 341:Eduard Lamezan-Salins 295: 236:Dominique Jean Larrey 222: 177:advanced life support 45: 31: 6299:Medical technologist 6249:Cardiac physiologist 5921:Oropharyngeal airway 5798:Emergency psychiatry 5783:Emergency department 5363:Motorcycle ambulance 5326:Air medical services 3703:on 29 September 2008 3539:10.1503/cmaj.1041728 3464:10.1503/cmaj.1041417 3183:Oman Medical Journal 3069:"First Aid Services" 2323:on 22 September 2008 2185:on 26 September 2007 2057:Public utility model 2036:In case of emergency 2015:Battlefield medicine 1710:Air medical services 1655:In countries with a 1604:general practitioner 1557:(IABP) and external 1240:emergency department 1088:Binghamton, New York 1064:motorcycle ambulance 1024:and interpreting an 933:Oman Medical Journal 926:Anglo-American model 896:Training for EMS in 744:Tallahassee, Florida 626:An ambulance of the 145:emergency department 88:(such as 911 in the 6359:Radiation therapist 6334:Pharmacy technician 5900:Tracheal intubation 5894:Intravenous therapy 5498:Wilderness medicine 5305:Emergency physician 5183:24 May 2011 at the 4914:Wilderness Medicine 4719:8 June 2014 at the 4374:on 17 February 2015 3750:on 11 February 2009 3606:on 20 November 2010 3577:on 14 November 2008 3195:10.5001/omj.2010.92 2871:on 24 December 2005 2532:"Cholera carriages" 2108:on 22 December 2005 2068:Wilderness medicine 2025:First Aid Care Team 1846:King Laryngeal Tube 1832:National Ski Patrol 1018:intravenous therapy 922:Franco-German model 798:Internal ambulances 232:ambulances volantes 225:ambulances volantes 214:Knights Hospitaller 6074:Basic life support 5978:Sodium bicarbonate 5776:Emergency medicine 5769:Emergency medicine 5488:Emergency medicine 5416:Spinal precautions 5242:Basic life support 5054:on 7 November 2012 4691:2010-05-04 at the 4637:Dolev, E. (1986). 4578:on 10 October 2017 4520:"The SMUR of Nice" 4393:Suserud B (2005). 4282:on 20 October 2013 4156:on 19 January 2012 4121:on 11 January 2012 3976:on 7 November 2018 3938:on 2 February 2009 3382:innovation.cms.gov 3101:on 15 October 2008 3075:on 22 October 2008 2997:on 10 October 2017 2942:on 6 November 2009 2586:on 1 February 2023 2031:Good Samaritan law 1792: 1706: 1648: 1519: 1479:cardiac monitoring 1463: 1431: 1288: 1280: 1231: 1091: 1071: 990:Basic Life Support 961: 902: 832: 791: 751: 687: 635: 583: 481: 464:Rise of modern EMS 383: 349:Vienna Ringtheater 328:, a stomach pump, 306: 267:for a campaign in 240:Napoleon Bonaparte 228: 165:basic life support 74:emergency services 70:paramedic services 66:ambulance services 55: 40: 6387: 6386: 6294:Medical physicist 6284:Medical assistant 6279:Massage therapist 6234:Aquatic therapist 6184: 6183: 5973:Magnesium sulfate 5882:Electrocardiogram 5808:Medical emergency 5793:Emergency nursing 5735: 5734: 5506: 5505: 5493:Military medicine 5473:Aviation medicine 5457:Search and rescue 5447:Ambulance station 4960:. 15 October 2013 4932:"Blazing a Trail" 4696:flyingdoctor.net. 4250:"Wake County EMS" 4230:on 22 August 2011 4204:on 11 August 2011 3912:on 24 August 2008 3683:"Free Dictionary" 3663:on 29 August 2018 3359:CT DPH and OEMS. 3272:978-3-030-64395-9 3023:on 9 October 2007 2800:978-0-309-07532-9 2517:978-0-682-48983-6 2292:on 8 January 2008 1812:natural disasters 1790:Haz-Tac Ambulance 1621:registered nurses 1615:Registered nurses 1376:St John Ambulance 1252:scope of practice 1226:Ambulance in the 1218:Physician-led EMS 1026:electrocardiogram 702:St John Ambulance 495:, along with new 378:ambulance during 354:In June 1887 the 322:Bellevue Hospital 298:Bellevue Hospital 130:search and rescue 118:patient transport 64:), also known as 6412: 6379:Speech therapist 6259:Dental hygienist 6239:Athletic trainer 6211: 6204: 6197: 6188: 6187: 6173: 6172: 6161: 6160: 5762: 5755: 5748: 5739: 5738: 5542:around the world 5533: 5526: 5519: 5510: 5509: 5383:Casualty lifting 5310:Medical director 5219: 5212: 5205: 5196: 5195: 5116: 5115: 5113: 5111: 5102:. Archived from 5096: 5090: 5089: 5087: 5085: 5080:on 7 August 2019 5076:. Archived from 5070: 5064: 5063: 5061: 5059: 5053: 5047:. Archived from 5046: 5038: 5032: 5031: 5025: 5017: 5015: 5013: 5002: 4996: 4995: 4993: 4991: 4986:on 7 August 2019 4982:. Archived from 4976: 4970: 4969: 4967: 4965: 4954: 4948: 4947: 4945: 4943: 4928: 4922: 4921: 4909: 4903: 4902: 4900: 4898: 4893:on 7 August 2019 4883: 4874: 4871: 4865: 4862: 4856: 4855: 4845: 4821: 4815: 4814: 4804: 4780: 4774: 4773: 4769:978-1292-17084-8 4755: 4749: 4748: 4730: 4724: 4713:Rotor & Wing 4705: 4699: 4683: 4677: 4676: 4658: 4634: 4628: 4627: 4621: 4613: 4611: 4609: 4594: 4588: 4587: 4585: 4583: 4574:. Archived from 4568: 4562: 4561: 4559: 4557: 4548:. Archived from 4542: 4536: 4535: 4533: 4531: 4526:on 15 April 2013 4522:. Archived from 4516: 4510: 4509: 4507: 4505: 4499: 4492: 4484: 4478: 4477: 4462: 4456: 4455: 4453: 4451: 4446:on 30 March 2014 4442:. 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Archived from 2149: 2143: 2142: 2140: 2138: 2124: 2118: 2117: 2115: 2113: 2104:. Archived from 2098: 2092: 2091: 2084: 1728:de Havilland DH9 1672:medical director 1571:surgical airways 1382:Ambulance driver 1296:chain of command 875:Care in transit 524:, also known as 505:Northern Ireland 454:combination cars 418:traction splints 126:technical rescue 52:call for service 6420: 6419: 6415: 6414: 6413: 6411: 6410: 6409: 6390: 6389: 6388: 6383: 6344:Physiotherapist 6220: 6215: 6185: 6180: 6148: 6132:Scoring systems 6127: 6040: 5982: 5931: 5842: 5771: 5766: 5736: 5731: 5687: 5543: 5537: 5507: 5502: 5483:Diving medicine 5461: 5435: 5426:Vacuum mattress 5411:Scoop stretcher 5385: 5377: 5373:Water ambulance 5353:Combination car 5314: 5251: 5228: 5223: 5185:Wayback Machine 5167: 5148: 5125: 5123:Further reading 5120: 5119: 5109: 5107: 5106:on 2 April 2012 5098: 5097: 5093: 5083: 5081: 5072: 5071: 5067: 5057: 5055: 5051: 5044: 5040: 5039: 5035: 5019: 5018: 5011: 5009: 5004: 5003: 4999: 4989: 4987: 4978: 4977: 4973: 4963: 4961: 4956: 4955: 4951: 4941: 4939: 4938:on 18 July 2012 4930: 4929: 4925: 4910: 4906: 4896: 4894: 4885: 4884: 4877: 4872: 4868: 4863: 4859: 4822: 4818: 4795:(21): 2626–33. 4781: 4777: 4770: 4756: 4752: 4745: 4731: 4727: 4721:Wayback Machine 4706: 4702: 4693:Wayback Machine 4684: 4680: 4635: 4631: 4615: 4614: 4607: 4605: 4595: 4591: 4581: 4579: 4570: 4569: 4565: 4555: 4553: 4552:on 23 July 2008 4544: 4543: 4539: 4529: 4527: 4518: 4517: 4513: 4503: 4501: 4500:on 6 March 2012 4497: 4490: 4486: 4485: 4481: 4464: 4463: 4459: 4449: 4447: 4432: 4428: 4391: 4387: 4377: 4375: 4360: 4356: 4325: 4321: 4311: 4309: 4300: 4299: 4295: 4285: 4283: 4274: 4273: 4269: 4259: 4257: 4248: 4247: 4243: 4233: 4231: 4222: 4221: 4217: 4207: 4205: 4198:"CCEMTP Course" 4196: 4195: 4191: 4181: 4179: 4174: 4173: 4169: 4159: 4157: 4153: 4146: 4142: 4141: 4134: 4124: 4122: 4118: 4111: 4107: 4106: 4102: 4089: 4085: 4075: 4073: 4072:on 21 June 2008 4064: 4063: 4056: 4046: 4044: 4043:on 19 July 2012 4035: 4034: 4030: 3993: 3989: 3979: 3977: 3968: 3967: 3963: 3955: 3951: 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2933: 2929: 2918: 2914: 2904: 2902: 2889: 2888: 2884: 2874: 2872: 2863: 2862: 2858: 2827: 2823: 2813: 2811: 2801: 2777: 2773: 2744:(10): 1064–67. 2730: 2726: 2716: 2714: 2701: 2700: 2696: 2688:, 3rd edition. 2683: 2679: 2656: 2652: 2642: 2640: 2639:on 26 June 2007 2631: 2630: 2626: 2616: 2614: 2613:on 12 June 2009 2603: 2599: 2589: 2587: 2578: 2577: 2573: 2563: 2561: 2556: 2555: 2551: 2541: 2539: 2538:on 22 June 2008 2530: 2529: 2525: 2518: 2504: 2491: 2479: 2477: 2468: 2467: 2460: 2458: 2443: 2432: 2393: 2386: 2376: 2374: 2370: 2369: 2365: 2355: 2353: 2340: 2336: 2326: 2324: 2315: 2314: 2305: 2295: 2293: 2284: 2283: 2279: 2269: 2267: 2266:on 20 July 2008 2259: 2255: 2254: 2250: 2240: 2238: 2237:on 22 June 2007 2229: 2228: 2224: 2214: 2212: 2203: 2202: 2198: 2188: 2186: 2177: 2176: 2172: 2162: 2160: 2159:on 15 June 2007 2151: 2150: 2146: 2136: 2134: 2126: 2125: 2121: 2111: 2109: 2100: 2099: 2095: 2086: 2085: 2081: 2076: 2011: 2006: 1862: 1828: 1800:active shooters 1781: 1775: 1712: 1686: 1681: 1653: 1617: 1612: 1591: 1507: 1455: 1450: 1423: 1411: 1393: 1384: 1361:Police officers 1329: 1323: 1321:First responder 1309: 1304: 1269: 1220: 1208:door to balloon 1132: 1080: 1056: 953:York Region EMS 941: 890: 857:Early reporting 851:Early detection 824: 804:chemical plants 800: 779: 767: 733: 718:BASICS Scotland 675: 620: 568: 559: 526:The White Paper 497:pharmaceuticals 466: 368: 277: 202: 197: 143:, typically an 24: 17: 12: 11: 5: 6418: 6408: 6407: 6402: 6385: 6384: 6382: 6381: 6376: 6371: 6366: 6361: 6356: 6351: 6346: 6341: 6336: 6331: 6326: 6321: 6316: 6311: 6306: 6301: 6296: 6291: 6286: 6281: 6276: 6271: 6266: 6261: 6256: 6251: 6246: 6241: 6236: 6231: 6225: 6222: 6221: 6214: 6213: 6206: 6199: 6191: 6182: 6181: 6179: 6178: 6166: 6153: 6150: 6149: 6147: 6146: 6141: 6135: 6133: 6129: 6128: 6126: 6125: 6119: 6113: 6107: 6101: 6095: 6089: 6083: 6077: 6071: 6066: 6060: 6054: 6052: 6042: 6041: 6039: 6038: 6033: 6028: 6023: 6018: 6013: 6008: 6003: 5992: 5990: 5984: 5983: 5981: 5980: 5975: 5970: 5965: 5960: 5955: 5950: 5945: 5939: 5937: 5933: 5932: 5930: 5929: 5924: 5918: 5912: 5907: 5905:Laryngeal tube 5902: 5897: 5891: 5885: 5879: 5873: 5867:Defibrillation 5864: 5859: 5856:Bag valve mask 5852: 5850: 5844: 5843: 5841: 5840: 5835: 5830: 5825: 5820: 5815: 5810: 5805: 5800: 5795: 5790: 5785: 5779: 5777: 5773: 5772: 5765: 5764: 5757: 5750: 5742: 5733: 5732: 5730: 5729: 5724: 5722:United Kingdom 5719: 5714: 5709: 5704: 5698: 5696: 5689: 5688: 5686: 5685: 5680: 5678:United Kingdom 5675: 5670: 5665: 5660: 5655: 5650: 5645: 5640: 5635: 5630: 5625: 5620: 5615: 5610: 5605: 5600: 5595: 5590: 5585: 5580: 5575: 5570: 5565: 5560: 5554: 5552: 5545: 5544: 5536: 5535: 5528: 5521: 5513: 5504: 5503: 5501: 5500: 5495: 5490: 5485: 5480: 5475: 5469: 5467: 5466:Related fields 5463: 5462: 5460: 5459: 5454: 5449: 5443: 5441: 5437: 5436: 5434: 5433: 5428: 5423: 5418: 5413: 5408: 5403: 5398: 5392: 5390: 5379: 5378: 5376: 5375: 5370: 5365: 5360: 5355: 5350: 5345: 5340: 5339: 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2694: 2677: 2650: 2624: 2597: 2571: 2549: 2523: 2516: 2489: 2480:|journal= 2457:on 14 May 2008 2430: 2403:(8): 1392–99. 2384: 2363: 2334: 2303: 2277: 2248: 2222: 2211:on 6 July 2008 2196: 2170: 2144: 2132:www.lymenh.gov 2119: 2093: 2088:"What is EMS?" 2078: 2077: 2075: 2072: 2071: 2070: 2065: 2060: 2054: 2049: 2044: 2039: 2033: 2028: 2022: 2017: 2010: 2007: 2005: 2004: 1999: 1994: 1989: 1984: 1979: 1974: 1969: 1964: 1959: 1954: 1949: 1944: 1939: 1934: 1929: 1924: 1919: 1914: 1909: 1904: 1899: 1894: 1889: 1884: 1879: 1874: 1869: 1863: 1861: 1858: 1827: 1824: 1774: 1771: 1698:Air ambulances 1685: 1684:Air ambulances 1682: 1680: 1679:Specialist EMS 1677: 1668:air ambulances 1652: 1649: 1616: 1613: 1611: 1608: 1590: 1587: 1579:arterial lines 1547:blood products 1524:air ambulances 1506: 1503: 1495:cricothyrotomy 1454: 1451: 1449: 1446: 1442:oxygen therapy 1438:defibrillation 1422: 1419: 1410: 1407: 1392: 1389: 1383: 1380: 1342:emergency call 1322: 1319: 1308: 1305: 1303: 1300: 1268: 1265: 1228:Czech Republic 1219: 1216: 1159:operating room 1131: 1128: 1079: 1076: 1055: 1054:Transport-only 1052: 1051: 1050: 1038: 1022:cricothyrotomy 1011: 1005: 994:oxygen therapy 987: 949:defibrillators 940: 939:Levels of care 937: 889: 886: 885: 884: 878: 872: 866: 863:Early response 860: 854: 823: 820: 808:oil refineries 799: 796: 787:Ogawa, Saitama 778: 775: 766: 763: 748:Hurricane Irma 732: 729: 674: 671: 619: 616: 567: 564: 558: 555: 539:R Adams Cowley 493:cardiac arrest 489:defibrillation 465: 462: 430:Two-way radios 367: 364: 296:A horse-drawn 276: 273: 201: 198: 196: 193: 179:(ALS) skills. 114:fire apparatus 15: 9: 6: 4: 3: 2: 6417: 6406: 6403: 6401: 6398: 6397: 6395: 6380: 6377: 6375: 6374:Social worker 6372: 6370: 6367: 6365: 6362: 6360: 6357: 6355: 6354:Public health 6352: 6350: 6347: 6345: 6342: 6340: 6337: 6335: 6332: 6330: 6327: 6325: 6322: 6320: 6317: 6315: 6312: 6310: 6307: 6305: 6302: 6300: 6297: 6295: 6292: 6290: 6289:Medical coder 6287: 6285: 6282: 6280: 6277: 6275: 6272: 6270: 6267: 6265: 6262: 6260: 6257: 6255: 6252: 6250: 6247: 6245: 6242: 6240: 6237: 6235: 6232: 6230: 6227: 6226: 6223: 6219: 6212: 6207: 6205: 6200: 6198: 6193: 6192: 6189: 6177: 6176: 6167: 6165: 6164: 6155: 6154: 6151: 6145: 6142: 6140: 6137: 6136: 6134: 6130: 6123: 6120: 6117: 6114: 6111: 6108: 6105: 6102: 6099: 6096: 6093: 6090: 6087: 6084: 6081: 6078: 6075: 6072: 6070: 6067: 6064: 6061: 6059: 6056: 6055: 6053: 6051: 6047: 6043: 6037: 6034: 6032: 6029: 6027: 6024: 6022: 6019: 6017: 6014: 6012: 6009: 6007: 6004: 6001: 5997: 5994: 5993: 5991: 5989: 5988:Organisations 5985: 5979: 5976: 5974: 5971: 5969: 5966: 5964: 5961: 5959: 5956: 5954: 5951: 5949: 5946: 5944: 5941: 5940: 5938: 5934: 5928: 5925: 5922: 5919: 5916: 5913: 5911: 5908: 5906: 5903: 5901: 5898: 5895: 5892: 5889: 5886: 5883: 5880: 5877: 5874: 5872: 5868: 5865: 5863: 5860: 5857: 5854: 5853: 5851: 5849: 5845: 5839: 5836: 5834: 5833:Trauma center 5831: 5829: 5826: 5824: 5821: 5819: 5816: 5814: 5811: 5809: 5806: 5804: 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5343:Ambulance bus 5341: 5337: 5334: 5333: 5332: 5329: 5327: 5324: 5323: 5321: 5317: 5311: 5308: 5306: 5303: 5301: 5298: 5296: 5293: 5291: 5288: 5286: 5283: 5281: 5278: 5276: 5273: 5271: 5268: 5266: 5263: 5262: 5260: 5258: 5254: 5248: 5245: 5243: 5240: 5238: 5235: 5234: 5231: 5227: 5220: 5215: 5213: 5208: 5206: 5201: 5200: 5197: 5191: 5188: 5186: 5182: 5179: 5176: 5174: 5170: 5165: 5161: 5160: 5155: 5150: 5149: 5141: 5140:online review 5137: 5133: 5130: 5127: 5126: 5105: 5101: 5095: 5079: 5075: 5069: 5050: 5043: 5037: 5029: 5023: 5007: 5001: 4985: 4981: 4975: 4959: 4953: 4937: 4933: 4927: 4919: 4915: 4908: 4892: 4888: 4882: 4880: 4870: 4861: 4853: 4849: 4844: 4839: 4836:(2): 187–92. 4835: 4831: 4830:Ann Emerg Med 4827: 4820: 4812: 4808: 4803: 4798: 4794: 4790: 4786: 4779: 4771: 4765: 4761: 4754: 4746: 4740: 4736: 4729: 4722: 4718: 4714: 4710: 4704: 4697: 4694: 4690: 4687: 4682: 4674: 4670: 4666: 4662: 4657: 4652: 4648: 4644: 4640: 4633: 4625: 4619: 4604: 4600: 4593: 4577: 4573: 4567: 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