What is Emergency Medical Service (EMS) ?

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Kunle Emmanuel
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What is Emergency Medical Service (EMS) ?

Unread post by Kunle Emmanuel » Tue May 28, 2013 1:02 pm

Emergency Medical Services is an exciting and rewarding medical career field. There is a need nationwide for Paramedics to provide emergency care for the sick and injured. They were dedicated to providing out-of-hospital acute medical care, transport to definitive care, and other medical transport to patients with illnesses and injuries which prevent the patient from transporting themselves.

Emergency Medical Services

Emergency medical services may also be locally known as a first aid squad, emergency squad, rescue squad,ambulance service, ambulance corps, or life squad.

Prehospital care is a relatively young profession. Over nearly 4 decades, the profession has evolved from what was a transportation service provided by First Aiders and Rescuers with limited training or none at all, to specially trained professionals ranging from First Responders, EMT- Basic, EMT- Intermediate and EMT- Paramedic level.


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Re: What is Emergency Medical Service (EMS) ?

Unread post by Kunle Emmanuel » Tue May 28, 2013 1:13 pm

Goals of EMS:

The goal of most emergency medical services is to either provide treatment to those in need of urgent medical care, with the goal of satisfactorily treating the presenting conditions, or arranging for timely removal of the patient to the next point of definitive care. This is most likely an emergency department at a hospital. The term emergency medical service evolved to reflect a change from a simple system of ambulances providing only transportation, to a system in which actual medical care is given on scene and during transport. In some developing regions, the term is not used, or may be used inaccurately, since the service in question does not provide treatment to the patients, but only the provision of transport to the point of care.




History

Emergency care in the field has been rendered in different forms since the beginning of recorded history. The New Testament contains the parable of the Good Samaritan, where a man who was beaten is cared for by a Samaritan. Luke 10:34 (NIV) - "He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him."



The first use of the ambulance as a specialized vehicle, in battle came about with the ambulances volantes designed by Dominique Jean Larrey (1766–1842), Napoleon Bonaparte's chief physician. Larrey was present at the battle of Spires, between the Frenchand Prussians, and was distressed by the fact that wounded soldiers were not picked up by the numerous ambulances (which Napoleon required to be stationed two and half miles back from the scene of battle) until after hostilities had ceased, and set about developing a new ambulance system. Having decided against using the Norman system of horse litters, he settled on two- or four-wheeledhorse-drawn wagons, which were used to transport fallen soldiers from the (active) battlefield after they had received early treatment in the field. These 'flying ambulances' were first used by Napoleon's Army of the Rhine is 1793. Larrey subsequently developed similar services for Napoleon's other armies, and adapted his ambulances to the conditions, including developing a litter which could be carried by a camel for a campaign in Egypt.



A major transformation of how ambulances were used in battle was instituted by Dominique Jean Larrey, Napolean Bonaparte’s chief physician. After witnessing so many soldiers die on the battle field because of their wounds, Larrey set out to make it easier for the ambulances to reach and assist the wounded soldiers. He designed a two- and four-wheel wagon pulled by horses. After the soldiers received initial medical attention on the field, they were transported to the hospital.
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Re: What is Emergency Medical Service (EMS) ?

Unread post by Kunle Emmanuel » Tue May 28, 2013 1:48 pm

Health Care System:

An Emergency Medical Services is a part of health care system that includes trauma centers, burn centers, pediatric centers, poison centers, and other specialty centers. It is important that as EMT, you must understand and follow your local protocols in determining which facility to transport your patient to in an emergency. You may also be involved in non emergency transport of transfers of patients in between these facilities or in patient's homes.


Health care professionals include:
  • Physicians
    Nurses
    Allied health providers
    EMS providers
    Support personnel


911 Systems:


Public information and Education is the most important component of an EMS system. The community served by EMS must understand what the system is designed to do, how it is used appropriately, and how it serves the community.



Access to EMS across is through the local Emergency hotline number. Like in the United States, 911 is used to call for help. Callers into 911 systems have the potential for important information stored within the system to be available to responders dispatch centers, and they may still use conventional phone numbers to access EMT's for response. An important part of educating your community will be orienting them to the communication and dispatch system that covers them.
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Re: What is Emergency Medical Service (EMS) ?

Unread post by Kunle Emmanuel » Thu Sep 12, 2019 10:09 am

EMS in Lagos

There are about 20 ambulance points (stations) for the Lagos State Ambulance Services (LASAMBUS), one in each of the 20 local government areas in the state. Built in shady locations along major roads or intersections, each station is designed to house a single ambulance equipped with a radio phone and deployable to scenes by the LASAMBUS dispatch coordinator, who sits in the state’s PSAP. Most of the LASAMBUS fleet are Type II vehicles.

At maximum efficiency—that is, each station having an ambulance as designed—about a million Lagosians will depend on each ambulance for emergency transportation. This number is grossly inadequate to meet the population’s needs, and it is even more disturbing to note that at any point in time, fewer than 10 ambulances are generally at full working capacity. Whenever one breaks down, there’s usually no organized effort to immediately get it fixed. Many times that is the end of that ambulance, which may remain grounded forever.

When calls come in to the PSAP within the state emergency command center, the dispatcher transmits the information to the required emergency response agency—generally one or a combination of fire, ambulance, and police. Each of these agencies is represented within the command center. The agency representative sends a radio message to the nearest field responder(s) to the scene. Backups and additional resources are mobilized based on proximity. For lack of tracking devices on each responding vehicle, the closest vehicle or team to the scene responds to the call. Fleet-monitoring devices are among the tools needed by the state to enhance response efficiency.

There are multiple agencies in Lagos state that have similar names and functions. These are the Lagos State Emergency Management Agency (LASEMA); LASEMA Response Unit (LRU); LASAMBUS; and Lagos Emergency Medical Services (LASEMS).

LASEMA is the state’s emergency management agency. This is the body charged by law to coordinate all responses to emergencies within the state. LRU, on the other hand, provides personnel and response assets as response capacity. LASAMBUS fields the ambulances that provide prehospital care, while LASEMS provides emergency care within the hospital.

There are ambulances branded LRU and others branded LASAMBUS. Dispatching ambulances to scenes with overlapping responsibilities like this may result in gaps in effectively managing an incident. If these agencies could be consolidated to one or two, their efficiency would improve and duplication of assignments could be better avoided.

Varying Competencies

There is an incorrect use of the term paramedic within Nigeria, and the ignorance is based on the national EMS gap. Most people think anyone attached to an ambulance is a paramedic, so whether or not you’re a paramedic by training, Nigerians don’t see you as less qualified as long as you wear the uniform and work on the ambulance.

Nearly all the staff attached to the LRU ambulances are paramedics by training, but those attached to LASAMBUS are often nurses converted into ambulance staff. These nurses are not always subjected to organized trainings like Basic Life Support and Advanced Cardiac Life Support to enhance their skills. This means at accident scenes with both LRU and LASAMBUS ambulances, responders’ competencies may vary, and that’s a potential cause of conflict.

Traffic Accidents

For many years road traffic accidents have been a leading cause of preventable death in Nigeria. The WHO records that 90% of deaths from road traffic accidents occur in sub-Saharan Africa.

As the most populated country on the continent, it is safe to assume Nigeria ranks high globally in fatalities from traffic accidents. Apart from unimaginably bad roads, driver recklessness and lack of a system to ensure vehicle roadworthiness keep the numbers high.

When accidents occur, especially outside Lagos, there is no emergency number to call. Victims are either left to the mercies of other road users or take care of themselves. If they are lucky enough to have officers of the Federal Road Safety Corps make it to the scene, their lack of first aid kits and training may leave victims helpless still. These FRSC officials often end up taking patients to the nearest hospital in their patrol truck.

Upon getting to the hospital, which is often understaffed and unequipped, arriving accident victims are often not attended to with any sense of urgency. That they are carried without immobilizing injured body parts may leave them with permanent disability.

Future of EMS in Nigeria

There are essential steps required, mainly by the various levels of government, to fix Nigeria's EMS gaps. First would be to fix the country’s roads and make them safe for travel and accessible to emergency medical transport.

In addition, efforts will be required to add PSAPs, build infrastructure like helipads, establish state EMS systems, and recruit people with required qualifications for the job. This will improve response to medical emergencies across the nation.

Abiodun Awoyemi is managing director of TNN Emergency Management Services Ltd. in Lagos, Nigeria.
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