The Emergency Medical Services (EMS) aim to provide medical care to patients who need urgent medical intervention and cannot wait until a scheduled appointment with doctors. Except for acute medical help, EMS Systems are simply providing transportation services to patients from their places to hospitals. These systems can be different depending on the countries where they are implemented. Each state has its rules and regulations of the basic duties of EMS systems. There are two primary modes of EMS in pre-hospital health care delivery that are involved since the 1970s, namely, Anglo-American AAS) and Franco-German (FGS).
The Anglo-American system works in close collaboration with various public safety services, such as police or fire departments. The primary professionals who work within this system and control it with clinical oversight are emergency medical technicians and trained paramedics. EMS employees who are in charge of transportation also play a significant role in the process of providing medical care for patients.
They are trained by a special Emergency Department, which develops the main rules, regulations, as well as plans of actions needed for delivering care to the population. Before transportation, patients are seen by the attending crew, who treat people and do everything that is possible to bring relief to those who suffer from pain. Paramedics also take part in the process, as it is assumed that they should alleviate patients. Also, paramedics are involved in the process in order to reduce expenses that cover education and training for staff. It is more expensive to educate and hire doctors than paramedics. It does not mean that paramedics are not qualified enough to provide health care to people. In fact, they are well-trained and have many treatment options available due to their extensive working practice.
Even though the EMS system helps to provide patients with pre-hospital care, sometimes, it is not enough as the EMS performs only minimal actions needed to carry patients to hospitals. The reason for that is the fact that, in most cases, it is necessary to make a diagnosis in order to provide appropriate treatment. However, for the EMS system, it is not always possible as there are many types of medical equipment that are necessary for diagnostics, which are usually available only in hospitals.
In the Anglo-American system, the patients with less severe diseases are provided with services by First Responder Units (FRU) and the Emergency Responder (ER). These providers are equipped with modern technologies and high-qualified professionals. This system is used in the USA, Canada, the United Kingdom, Ireland, Australia, Hong Kong, Mexico, South Korea, and Iran (National Center for Biotechnology Information. U.S. National Library of Medicine). The AAS often relies on land ambulance rather than on an aeromedical ambulance.
The Franco-German system is an entirely different model compared to the one discussed above. This system brings hospitals to the patients instead of transferring them to medical institutions. The hospitals have advanced technology and experienced healthcare professionals.
The Franco-German model was invented by a German surgeon, Mertin Kirschner, in 1938. In the 1950s, the system was further developed in order to improve the quality of medical care provided to emergency patients. The main purpose of this model is to treat patients effectively both during transportation and in the hospital. This system helps to help patients with life-threatening diseases or injuries in prehospital conditions and is mostly used in European countries. Unlike the AAS, the FGS uses both the land and air ambulance.
The comparative differences between AAS and FGS are provided in table 1 below.
Table 1. Franco-German and Anglo-American Model (National Center for Biotechnology).
In the Franco-German system, the emergency physicians, who attend patients on scene, have an opportunity to provide effective treatment making complex clinical examinations. In some situations, however, patients are still transported to hospitals by an emergency physician bypassing the emergency departments. This system is used in such countries as Germany, France, Austria, Russia, Ukraine, Italy, Spain, Poland, Estonia, Hungary, Switzerland, Portugal, and more (National Center for Biotechnology Information. U.S. National Library of Medicine [71]).
Therefore, there are more countries in the world that use the Franco-German system rather than the Anglo-American one. Both models have their advantages and disadvantages, so it would not be correct to conclude what system is more beneficial. Each case is unique as it is connected with humans’ health, and every individual has his or her specific circumstances, health conditions, and peculiarities.