In times of emergencies and incidents where human life is in danger, services that transport the victim from the scene to the treatment unit are critical. Every state has an emergency medical service called Emergency Medical Service (EMS). Many factors determine the correct and efficient operation of EMS. When designing the infrastructure, it is crucial to consider the aspects that affect the efficient operation of the service. Modern engineers create circuits that allow for the establishment and optimisation of medical ambulance operations. The purpose of this research paper is to identify urban environmental factors that have the most significant impact on the management of the EMS transport system, as well as to analyse the essential operation of the Emergency Medical Service Unit.
Before determining the main influencing factors, special attention should be paid to the evolution of EMS at different stages of human development. It is believed that the history of emergency medical service begins long before the peak of the ancient Greek and Roman epochs (Bucher and Zaidi, 2018). At that time, the service only transported wounded warriors from the endless wars of antiquity to the infirmary. Along with the development of human society, the idea underlying the medical service also changed (Kellermann et al., 2013). Only in the last century, namely in 1972, the priority of EMS changed from transporting patients to providing primary health care. Thus, the service ceased to act as a mediator, becoming a fully-fledged paramedic.
It is wrong to think that with the emergence of the role of paramedic, corpsman and emergency medical rescue service has changed everywhere. An analysis of the scientific literature shows that the work of the EMS is directly dependent on the level of income of the country where the service operates. For example, according to Mehmood et al. (2018), Emergency Medical Service has only transport competence if the country’s income level is low. As the state’s economic system grows, EMS functions increase, and may include emergency assistance on the spot.
It is important to note that regardless of the country’s financial support, the EMS will aim to help those in urgent need. The tasks to be performed by the service include either on-site treatment or the organization of the transfer of the patient to the point of care. For this reason, the design of the leading vehicle, which serves as the essential tool in the professional activities of EMS staff, may vary. Generally, there are four main types of vehicles:
- vehicles that provide only transport services;
- vehicles that have a basic set of medical services;
- machines that have the equipment to perform operations;
- machines capable of providing ALS.
It is noteworthy that the latter category of vehicles may include not only vehicles but also helicopters designed for a more rapid transfer of patients from one location to another.
In emergencies, it is essential to ensure that EMS is strictly organized in order to prevent further harm to the affected person. Healthcare systems in countries are striving to improve EMS activities and are creating specific models to reflect potential factors that affect the speed and quality of work. However, real-life conditions are not always met by mathematical modelling, as in reality, a greater variety of factors affect the performance of EMS (Ebrahimian et al., 2014). For example, the improvement of Emergency Medical Service within a region must consider the level of industrialization, current service location and availability, degree of contamination and quality of pavements. The design of an EMS system is inextricably linked to financial factors that affect the ability of a service to be economically viable. Of course, an increase in the number of emergency vehicles serving the area will have a positive impact on the survival factor of the population. However, on the other hand, such an increase requires a significant investment both in the purchase of machines and staff salaries. Furthermore, it is possible that the increase in the number of vehicles may not be justified by the number of medical personnel providing care in clinics and medical centres. Therefore, the design of EMS systems is continuously faced with compromises to optimize management processes. Furthermore, the most significant factor contributing to increased survival among patients is the response time, which should not exceed twenty minutes (McCoy et al., 2013). The integration of these aspects into the design of the EMS infrastructure favours positive service performance and the prevention of deaths due to emergencies.
It is essential to understand that EMS cannot exist in isolation without communicating with other health services. While in developed countries, emergency services are a complete health care structure; their original purpose is to prevent deaths and provide care. As noted above, assistance generally consists of the transfer of a victim from one place to another and, if necessary, the provision of medical assistance on-site or on the move. It is difficult to imagine that EMS services would regularly perform open-heart surgeries or prevent stroke in patients – instead, they would work in a way that would allow time to transfer patients to medical staff and follow other victims. EMS is, therefore integrated with other services and systems designed to maintain and promote public health and safety.
Reference List
Bucher, J. and Zaidi, H.Q. (2018) ‘A brief history of emergency medical services in the United States’, in Rogers L., Arshad F. and Lenz T. (eds.) EMS essentials: a resident’s guide to prehospital care. Texas: Emergency Medicine Residents’ Association, pp. 1-6.
Ebrahimian, A. et al. (2014) Exploring factors affecting emergency medical services staffs’ decision about transporting medical patients to medical facilities. Web.
Kellermann, A.L. et al. (2013) ‘Emergency care: then, now, and next’, Health Affairs, 32(12), pp. 2069-2074.
McCoy, C.E. et al. (2013) ‘Emergency medical services out-of-hospital scene and transport times and their association with mortality in trauma patients presenting to an urban Level I trauma center’, Annals of Emergency Medicine, 61(2), pp. 167-174.
Mehmood, A. et al. (2018) ‘Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach’, International Journal of Emergency Medicine, 11(1), p. 53-63.