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Emergency medical services (EMS) is the broad name for a wide range of people who help citizens in any type of emergency. Many emergency medical services personnel work in hospitals, where people come for care, but they also include the personnel involved in search and rescue, fire and rescue, law enforcement, dispatch, and ambulance services, who save, transport, and care for emergency victims on the spot and as they travel to hospital settings.
Depending on the circumstances, people may use their local emergency number, for example, 911, in which case the first emergency medical services employee that they are in contact with is likely to be a dispatcher, sometimes called a public safety dispatcher or a 911 operator. The dispatcher, sometimes an Emergency Medical Technician (EMT) assesses the situation and performs triage to separate true emergency calls from calls that do not require emergency medical services to respond.
When there is a true emergency, the dispatcher contacts law enforcement, fire departments, or medical units to respond, all the while keeping track of the locations of EMS personnel. Dispatchers may also provide instructions, such as first-aid, until emergency personnel arrive on the scene and provide a link between the caller and ambulance EMT and/or between the EMT in the ambulance and the hospital staff.
Just which personnel are sent to the scene will depend on the type of emergency. In some cases, such as an avalanche, a burning building, a car crash in which the doors are damaged, or some kind of structure collapse, the first thing that is needed on the scene may be rescue, which could be the local fire department or the ski patrol. In a situation that requires crisis intervention, such as a case in which someone has been taken hostage or someone is threatening suicide, a certified crisis intervener or other expert in negotiation or intervention may be the most needed EMS personnel.
In many cases, the caller needs to be medically stabilized and transported to the closest emergency or trauma unit. In this case, an ambulance team, characteristically made up of an EMT and a paramedic—an EMT with the highest level of training—can usually provide both services. Paramedics are often the ones to begin the emergency medical care of the patient both on the scene and in transit to a hospital. It the nearest available ambulance is at a distance, other personnel, such as law enforcement, may arrive to provide assistance and oversee the situation until the ambulance can reach the scene.
Transport options may also include medical evacuation, sometimes called MEDEVAC or medivac, which uses specially equipped ground or air ambulances. Medivac is used for trauma patients or if the patient’s location is remote or difficult to reach by standard means. At least one EMS ambulance service, Tri-State Ambulance in Wisconsin, has inaugurated a bike response team for responding to emergencies during special community events when crowds and closed off streets may prevent more traditional responders from reaching an emergent situation in a timely way.
At a hospital, emergency services are provided by all the emergency room personnel, including emergency nurses, emergency room physicians, and others. Emergency medicine is a specialty, just as endocrinology or neurology, and the emergency room personnel have specific training to deal with injuries due to accidents and quick-onset illness, such as a heart attack. Patients who enter the emergency room may receive service there and go home from there, or they may be admitted to the hospital if the situation warrants.