A Defining Moment for EMS
In the July issue, Skip Kirkwood, president of the National EMS Management Association (NEMSMA), penned a column titled, “What Is EMS, Anyway?” Some may think the whole discussion surrounding the definition of EMS is an academic exercise, but it has real value in terms of the industry’s basic identity (health care vs. public safety) and also how it is viewed by others, which has practical implications in terms of legislation and funding. (It’s interesting how EMS has sometimes been assumed to include care in hospitals, especially when grants are involved.)
A few months later, Skip put his money where his mouth is and worked with the NEMSMA board to develop a position paper outlining their take on what EMS is—and, just as important, what it isn’t. The effort was sparked by a definition of EMS issued by the National Association of EMS Officials (NASEMSO) and a robust discussion that touched on many of the key points raised by Skip in his original essay. NEMSMA’s definition substantially agreed with NASEMSO’s but was expanded and modified to read as what follows below.
What do you think? Did NEMSMA get it right?
Definition of EMS
“Emergency Medical Services (EMS) is the integrated system of medical response established and designed to respond, assess, treat, and facilitate the disposition of victims of acute injury or illness and those in need of medically safe transportation. The EMS System includes the full spectrum of response from recognition of the emergency to access of the healthcare system, dispatch of an appropriate response, pre-arrival instructions, direct patient care by trained personnel, and appropriate transport or disposition. A provider participating in any component of this response system is practicing EMS. EMS also includes medical response provided in hazardous environments, rescue situations, disasters and mass casualties, mass gathering events, as well as interfacility transfer of patients and participation in community health activities.
EMS does not include the following:
- Care rendered by professionals within an established healthcare facility.
- Good Samaritan care: emergency care provided by someone regardless of their level of training and experience outside of an established and organized response and the individual is not receiving any type of compensation for care rendered.
- Basic first aid, CPR, and public access defibrillator use provided outside the established EMS system.
- Public health programs and home health care programs unaffiliated with the EMS system.
It should be noted that this definition is not intended to exclude any aspects of EMS not formally described (e.g., oversight, administration, education and research). In addition, EMS is an evolving discipline that is maturing as a partner in the healthcare system. As such, EMS must be flexible enough to accommodate new roles.
NEMSMA further defines the following additional elements that comprise EMS:
Paramedic Service is the deployment of vehicles, equipment and personnel that respond to requests for EMS within a community. Paramedic service may be provided by governmental and/or non-governmental agencies and may include transport and non-transport components. This definition is intended to conform to internationally adopted usage of the term paramedic which includes basic and advanced life support response and transport by EMTs (international equivalent: primary care paramedic),
AEMTs (intermediate care paramedic) and paramedics (advanced care paramedic).
Emergency Medical Dispatch refers to the elements of the EMS system that receive requests for service, provide medical instructions to callers, dispatch resources and serve as controllers of deployed resources.
Ambulance Service is defined as the provision of ground or air ambulance transportation in conjunction with emergency response or interfacility medical transportation.
Medical First Response is defined as the provision of EMS response that arrives on scene in a manner that does not have capability to transport (on foot, bicycle, Segway, automobile, fire apparatus etc.). The intent of medical first response is to provide rapid lifesaving interventions for patients who require immediate medical attention and to provide additional resources on an EMS scene when needed. Medical first response may be provided by one or more organizations in the context of an EMS system.”
Adopted by NEMSMA, July 13, 2012.