EMS From Around the Globe
Across the United States, it's safe to say that every EMS service is unique. Each township/village/city/district has its own jurisdiction and delivers care in its own way. The people and protocols can differ vastly -- even among neighboring entities. Additionally, not all ambulances are created equal. Some services operate with vans, others operate with truck chassis connected to a box, while others operate spacious heavy duty Freightliner units. The items mentioned above are not only applicable to North America. Patients can and do present themselves all of the world and they have come to expect high quality care delivery outside of a hospital setting. This blog will be centered around some cool, unusual, and interesting facts from EMS services around the globe, because if you've seen one agency, you've only seen one agency.
In the United States, ALS corresponds to the scope of practice of paramedics, and BLS corresponds to that of EMTs. This distinction is conserved between many countries, such as Canada, the United Kingdom, all Nordic countries, Japan, and Greece. According to some scholarly articles published in Resuscitation recently, in other countries, certification systems and scopes of practice differ so it is difficult to precisely compare levels between two countries. Many countries with less funding for public safety rely solely on BLS services for their EMS systems such as much of South Africa, China, and many countries in South and Central America. Another distinction of EMS systems internationally is whether a Franco-German model or an Anglo-American model is utilized. Systems using the Franco-German model depend on ambulance practitioners with more advanced training, often using physicians deployed to the field where more people are treated at the scene of dispatch, and only the sickest patients are brought to the hospital. The Anglo-American model is more focused on quickly bringing patients to the hospital, and fewer patients are treated at the scene of dispatch. This system likely sounds more familiar to us in the United States because it has applied to even the earliest American prehospital efforts in the late 19th century. However, EMS physicians are beginning to show up in some larger metro areas. Austin-Travis County (TX) is one such example of positive change from historical norms.
Australia - there is generally just one agency for emergency services in each state/territory.
Brazil - there are still high rates of transport to hospitals via private vehicle.
China - the number to call for an ambulance in "120".
England - in the past few years a mass exodus has created shortages.
France - one of the most sophisticated in the world, many ambulances are staffed by physicians and nurses.
Greece - nearly 1 out of 5 calls come from the Athens metro alone.
Kenya - St. John Ambulance frequently sets up medical tents where thousands receive basic medical care and food.
Lebanon - the EMS system is primarily volunteer based and run by the Lebanese Red Cross, it's still very fragmented and can be unreliable.
Russia - old Soviet standards have held it back, but reform is happening now.