Published online by Cambridge University Press: 28 June 2012
The growth and development of emergency medical services (EMS) has been both impressive and extensive since the late 1960s. Since that time, there has been much discussion and debate regarding the level and quality of care that patients receive from the EMS system. In the United States, this has resulted in a wide variety of emergency medical technician (EMT) certification levels that determine which personnel administer an extensive range of medications, procedures, and medical protocols. Because of these differences, the care a patient receives varies not only from state to state but from community to community. Even though there are many different EMS system configurations, EMS professionals generally believe die level of care they provide in their local community is effective. It is unfortunate that very often, opinions about EMS system effectiveness are not based on studies of EMS system performance or patient outcome data, but upon subjective assessments of ongoing activities by those individuals providing the services.