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• W76300242 abstract "he provision of emergency medical services (EMS) is a practice of medicine. Although it has been present in various forms since the days of Napoleon, the currently utilized EMS system in the United States began in 1966 with the publication of the EMS “White Paper” from the Institute of Medicine of the National Academies (IOM) and the passage of the Highway Safety Act. 1,2 Over the past 4 decades, the public and members of the medical community have come to rely upon the prompt, professional response of the EMS system, summoning ambulances over one million times per year in North Carolina alone. 3 Indeed, the EMS practice of medicine is one of the largest in every community because all citizens are potential patients. On an annual basis, between 7% and 9% of the population become actual patients and summon EMS via 9-1-1. Unfortunately, these have not been 4 decades of clinical progress in EMS. There are shining examples of clinical success, but we often fail to dedicate sufficient resources to the prehospital medical effort. As the recent IOM report confirms, the federal government has not provided sufficient funding in the areas of research or disaster preparedness, with EMS receiving less than 5% of the preparedness funding since the attacks of September 11, 2001. 4 The medical community remains uncertain of exactly how to incorporate EMS physicians, for while the number of EMS fellowships continues to grow, the American Board of Medical Specialties has yet to incorporate the subspecialty of EMS into the formal board structure. Finally, the IOM report calls for a new federal agency to oversee EMS, indicating that EMS neither belongs exclusively in the National Highway and Traffic and Safety Administration (the current federal oversight agency for EMS) nor exclusively in the areas of public health or homeland security. 4 From the local to the federal level, EMS is truly at the crossroads, and leadership from physicians and the broader medical community is now urgently needed to guide us through this transition. What is an EMS Physician? The EMS physician divides clinical activities into two spheres: the traditional, direct care activities in the emergency department and the less traditional, indirect patient care that is delegated to EMS providers in the community. In the latter role, the EMS physician is responsible for all medical components of the prehospital encounter, including dispatch algorithms for the 9-1-1 center, development and revision of patient care protocols, education for all providers, and remediation of providers when necessary. Gone are the days when the EMS physician could create protocols once every few years and meet with paramedics only when they violated these protocols. The practice of EMS medicine is truly a partnership between receiving hospitals, public health, emergency medical dispatchers, basic life support first responders, and, in most communities, advanced life support providers. This partnership requires intensive and frequent interaction with the EMS physician in order for it to function in the patient’s best interest. For maximum patient benefit," @default.
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• W76300242 date "2007-07-01" @default.
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• W76300242 title "Medical Oversight for Emergency Medical Services: Defining Success" @default.
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• W76300242 doi "https://doi.org/10.18043/ncm.68.4.268" @default.
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