سیستم های EMS بین المللی : ایالات متحده آمریکا : گذشته، حال و آینده

Emergency medical services (EMS) is an organised system designed to transport sick or injured patients to the hospital. Though EMS system configurations can be quite varied in design depending on locale, we provide an overview of EMS as it has evolved and is currently modelled in the US. We outline the history of EMS in the US, including the major events and legislation that shaped the current models that are in existence. We provide an overview of provider training, system design, system funding, and dispatch issues. The concepts of medical direction for physician surrogates, as well as EMS as it relates to specialty care are also elucidated.

While EMS care in the US has a long and rich history, it continues to evolve and adapt to changing times. Many EMS systems are continuing to expand the scope of practice of all levels of providers. One such example involves paramedics performing a 12-lead electrocardiogram (ECG) on patients complaining of chest pain while enroute to the hospital [33]. The paramedics relay the findings of the ECG to the receiving hospital, which can potentially decrease the time to perform angioplasty or initiate thrombolysis upon arrival in the hospital. Some studies have even permitted the paramedic to initiate thrombolytic therapy to a patient suffering from a myocardial infarction, after discussing the ECG with a physician. Thus, while the “golden era” for EMS has passed, many new and exciting changes will continue in future years.