A Brief Analysis of Trends in Prehospital Care Services and a Vision for the Future

Introduction William Roush describes an Emergency Medical Service (EMS) system (ambulance service) as consisting of a “communications mechanism to initiate a response, a vehicle with personnel to provide treatment and transport, and a receiving facility to take the patient to.” This definition is one that may be largely valid today but may not be so in the future. Current influences on ambulance services as systems, and the role of the ambulance paramedic as a practitioner, are likely to result in a modification of this definition in this country in the future, based on the concept of the public health model. One such example is the provision of care without transport, or referral to an alternative primary care provider. This paper discusses the application of a framework for identifying and examining these influences.