Emergency Medical Service (EMS) is urgent treatment for a medical problem or condition that requires immediate attention although may not pose a serious health threat at that particular moment. The federal government regulates Emergency Medical Service, and federal guidelines are followed to ensure the same quality and level of care to every individual requiring it. However, due to a number of factors, Emergency Medical Service available in different states may be different. There are publicly operated Emergency Medical Services and private Emergency Medical Services. The first one is far more common and usually operated by the municipality, funded by service fees and property taxes. Publicly operated EMS is usually a part of the local public health department and often does not have enough funding to operate unless the help of volunteers is used. In many communities, relying on the services of volunteer EMS staff is what allows the people to get medical care they urgently need without driving hundreds of miles. Private EMS is not that common but still available in some states, offering emergency transport with a certain fee or providing contracted emergency services to some municipalities.
Emergency Medical Service system accepted in the United States involves patients being transported to the hospital. EMS staff members are trained to provide basic first aid to the patient, checking the vitals and doing simple procedures to keep the patient alive or stable until the unit arrives at the hospital. An ambulance, according to the standards, must be staffed with at least 2 people. One of the staff members would typically be providing patient care, the other one would be responsible for driving the ambulance and providing necessary assistance.
Advanced Life Support staff member may be summoned to assist while the ambulance is making its way to the hospital, but this happens in some cases only and is not a common practice. Emergency physicians may be called on field for specialty situations, such as mass casualties that require massive amputations or other complex procedures, cardiac bypass transports and some other ones. Except for large cities, EMS providers are usually volunteers, but these days many universities have collegiate EMS programs that extend services to the community.
Emergency Medical Technicians can perform certain procedures, which may vary from state to state, from defibrillation to intravenous therapy. EMS staff can be allowed to perform certain procedures (such as an IV therapy) after completing an add-on course and getting the training required. EMS professionals are required to follow the so-called protocol – a decision tree that allows making a decision in any situation no matter how unusual. Response time standards vary from city to city and from state to state, being anywhere from 10 to 15 minutes: an objective difficult to achieve in large cities due to traffic and other factors.