Acknowledgment

We extend our heartfelt thanks to everyone who contributed to this field report.

Firstly, I want to express special thanks to Kazi Iqramul Hoque sir,Assistant

Professor , Department of Law and Justice , Jaitya kabi Kazi Nazrul Islam
University ,for his unwavering guidance and support during our fieldwork. His
expertise and encouragement was indispensable.
Our gratitude also goes to Mymensingh Medical College Hospital and Sadar
hospitals communism for providing us with the platform and assisting in
coordinating our activities.
Lastly, I have immense appreciation for the community members and participants
who generously shared their time and knowledge. Your insights made this
task possible.
Thank you all for your invaluable contributions.
Yours Faithfully
Ashraful Islam
Id:21153507
Session :20-21
Department of Law and Justice
Jaitya Kabi Kazi Nazrul Islam University
Declaration

I, Ashraful Islam, declare that this research report titled “A study on Emergency
Service of Hospital in Mymensingh Sadar, ”is entirely my own work except where
otherwise acknowledged. I have cited all sources used in this Paper and have not
plagiarized any materials. Furthermore, any contributions from other to this work
have been duly acknowledged.

I also confirm that, the report is only prepared for my academic requirement not for
other purpose.

Ashraful Islam

Id:21153507

Session :20-21

Department of Law and Justice

Jaitya Kabi Kazi Nazrul Islam University

Abstract
The growth of emergency medicine around the globe has been tremendous, as expectation
regarding quality of life and healthcare improves worldwide. The emergence and recognition of
emergency medicine as a distinct discipline, with its own body of knowledge and skills, is a
relatively recent development dating back to the 1970s. Canada was one of the first countries to
recognize the uniqueness of EM and to develop formal training programs in the discipline. then
EM has evolved on a global level, and more than 18 countries have EM as a recognized specialty
with training programs. Thirteen countries have formal board certification, 4 have formal
fellowships in EM, 28 have national organizations and 27 are conducting research in the field .
Burgeoning events of the health sector in Bangladesh evidences the horrible chains of denial of
emergency medical care. The actors, both private and public, employed in the sector are performing
to provide health care to a huge number of populations with limited resources. Emergency
medical care is being subjected to limited resources or is sometimes being shifted to one actor from
another. The available instances offer a temporary sword to deal with cases of denial of
emergency medical care but not sufficiently. As a last resort, constitutional provisions then
remain as the only guardian that possesses the power to give redress in this regard. The
enforcement process further invites constitutional provisions to come into further debates, and
many of them are still under judicial discussion themselves. Harmonious construction bolstered by
liberal interpretation of the constitution upholding human rights in all cases is argued to be the
solution until effective legislation comes into effect.

1. Introduction

Emergency Medical Services provide out-of-hospital acute medical care to different types of
serious emergencies, such as life-threatening allergic reactions, poisoning due to ingestion of
drugs and chemicals, lethal venoms of snakes, accidents involving bones and skull fractures,
brain injuries, respiratory failure, blockade, cardiac arrest, febrile seizures, drug overdose, burns
and shocks and child abuse, in addition to transport of the patients to definitive care. The team of
EMS includes the emergency physicians who have additional expertise in EMS, the paramedics
(including the technicians), firefighters, and ambulance employees. The levels of services
available constitute three categories; Basic Life Support, Advanced Life Support and care by
traditional healthcare professionals (nurses and/or physicians) working in the pre-hospital setting
and even while on ambulances. While the physicians and nurses are rarely available for the pre-
hospital emergency care, most of the exigencies are managed by paramedics, including
technicians and the driver of the ambulance. A paramedic is a trained health professional who is
the first responder to the patient in medical emergency. The paramedics provide out of hospital
medical assessment, treatment, and care. There are varying levels of paramedic practice and the
employing authority determines their allotment to a specific level of care.

Although the paramedics are not medically qualified, they get adequate training in the tasks they
have to carry out. Nevertheless, they face several barriers and obstacles in the discharge of their
duties, in addition to humiliation and dishonor. There are many barriers and obstacles, including
traffic congestion, nuisance by bystanders and family members, incompetence of doctors and the
administration, lack of trust and confidence bestowed on them, lack of independence given,
patient's resistance, interference of legal issues and litigation proceedings, impression of people,
and the family of the patients about the paramedics. These obstacles interfere with the
performance and efficiency of paramedics. In view of a paucity literature on the subject, it was
found worthwhile to investigate the views of the paramedics by constituting a questionnaire, in
order to understand their working and finding means and ways to improve their environment
1.1 What is the meaning of Emergency medical service?
Medical Services, more commonly known as EMS, is a system that provides emergency medical
care. Once it is activated by an incident that causes serious illness or injury, the focus of EMS is
emergency medical care of the patient(s).meaning of emergency medical service

EMS is most easily recognized when emergency vehicles or helicopters are seen responding to
emergency incidents. But EMS is much more than a ride to the hospital. It is a system of
coordinated response and emergency medical care, involving multiple people and agencies. A
comprehensive EMS system is ready every day for every kind of emergency.
1.2 Speciality of emergency medical service

EMS is an intricate system, and each component of this system has an essential role to perform
as part of a coordinated and seamless system of emergency medical care. Here in Maine, EMS
clinicians are more than what is seen "in the movies" (and EMS is rarely like what is on Tv). In
fact, EMS is less about "emergency" and more about "medical service

Emergency Medical Services (EMS) specialize in providing critical care and transportation to
patients in urgent medical situations. Here's what makes EMS unique and essential:

 Rapid Response

 Speed: EMS teams are trained to respond quickly to emergencies,

often arriving at the scene within minutes of receiving a call. Time is
critical in emergencies, and EMS is structured to minimize delays.
 24/7 Availability: EMS operates around the clock, ensuring that help
is always available, regardless of the time or location.

 Pre-Hospital Care

 On-Scene Medical Treatment: EMS professionals provide immediate

care at the scene of an emergency, stabilizing patients and addressing
life-threatening conditions before they reach the hospital. This includes
administering medications, performing CPR, stopping bleeding, and
more.
 Advanced Life Support (ALS): Paramedics in EMS teams are trained
to provide advanced medical interventions, such as intubation,
intravenous therapy, and defibrillation, often in challenging
environments.

 Transport to Appropriate Facilities

 Safe Transport: EMS ensures that patients are safely transported to

the nearest or most appropriate medical facility, continuing to provide
care on route.
  Specialized Transport Units: Some EMS systems have specialized
units like air ambulances or neonatal transport teams, designed for
specific types of emergencies or patients requiring specialized care.

 Coordination with Emergency Departments

 Communication: EMS teams communicate with hospital emergency

departments while en route, providing updates on the patient's
condition and preparing the hospital staff for the patient’s arrival.
 Triage and Handoff: Upon arrival, EMS teams work with hospital staff
to ensure a smooth transfer of care, providing critical information and
assisting with triage.

 Diverse Skill Set

 Versatile Training: EMS professionals are trained to handle a wide

range of emergencies, from trauma and cardiac events to obstetric
emergencies and hazardous materials incidents.
 Problem Solving in Dynamic Environments: EMS teams often work in
unpredictable and challenging environments, requiring quick thinking,
adaptability, and effective decision-making under pressure.

 Public Health and Safety Role

 Community Outreach and Education: EMS often participates in

community education programs, teaching CPR, first aid, and injury
prevention.
 Disaster Response: EMS is a critical component of the response to
large-scale disasters, providing immediate care and assisting in the
coordination of emergency services.

1.3 Necessity of the Emergency of Medical service

Emergency medical services exists to fulfill the basic principles of first aid, which are to
Preserve Life, prevent Further Injury, and Promote Recovery. This common theme in medicine is
demonstrated the "star of life". The Star of Life shown here, where each of the 'arms' to the star

represent one of the six points, are used to represent the six stages

 Early detection - members of the public, or another agency, find the incident and
understand the problem

 Early reporting - the first persons on scene make a call to the emergency medical
services (911) and provide details to enable a response to be mounted

 Early response - the first professional (EMS) rescuers are dispatched and arrive on scene
as quickly as possible, enabling care to begin Good on-scene/field care the emergency
medical service provides appropriate and timely interventions to treat the patient at the
scene of the incident without doing further harm.

 Care in transit -- the emergency medical service load the patient in to suitable transport
and continue to provide appropriate medical care throughout the journey

 Transfer to definitive care-- the patient is handed over to an appropriate care setting,
such as the emergency department at a hospital, in to the care of physicians
2. Purposes of the study

The objects of the study are as follows:

 Assess the Quality and Efficiency of EMS

o Evaluate Response Times

o Patient Care Quality
o Patient Outcomes
o Service Availability

 Identify Challenges Faced by Healthcare Providers

o Resource Constraints
o Training and Expertise
o Infrastructure Issues
o Operational Challenges
o Psychological and Physical Stress

 Provide Recommendations for Improvement

o Training Programs
o Resource Allocation
o Infrastructure Development
o Policy and Governance
o Community Involvement

 What is the reliability of emergency medical services in the current hospitals?

 Are there emergency medical services in government hospitals and private hospitals? If
yes, is it properly given?
 Usually, What kind of services are offered?
 Why Private hospitals in most of the time transferred the patients to government Hospital?
 If we call the number 999 for ambulance in case of emergency, it is available one the
other hand it is official Ambulances are not available.
 In the emergency department, the patient is under pressure and the doctors have
  to do their duty for a long time. Is there any change in mental behavior due to work
pressure?
 Emergency medical services are a little critical. Are nurses trained differently for work?
 At present people tend to given service more from private. Most of the private
emergency medical service is missing. If any private hospital exist emergency medical
service most of the time they are also handed over to the government hospital

3. Methodology

We usually do our field visits in groups. Our team consists of seven members and one sir is our
moderator. We carry out our field inspection work based on research and data. Generally, there
are no specific rules in the law regarding emergency medical services, but currently, if you want
to establish a private health complex, you must register and renew the registration after a certain
period, which is mentioned in the registration law. Our field visit was Sadar Hospital in
Mymensingh. We visit 15 private hospitals and one government hospital in Mymensingh.
Among them, the government one is Mymensingh Medical College Hospital. The private 15 are
respectively Lab Aid, Edge, Rajdhani, Union, Popular, Delta, sayem, Swadesh, Universal,
Liberty, Nexus, Alchemy, Serum Hospital. We found that most of the private hospitals do not
have emergency medical services, there are only three private hospitals which account for only
20% of the total. Here are some questions we ask service receivers and service providers:

 Research Design

 The research design for this study is a mixed-methods approach, combining both
qualitative and quantitative techniques to provide a comprehensive understanding of the
emergency medical services (EMS) at Mymensingh Sadar Hospital. The study utilizes a
cross-sectional design to capture a snapshot of the current state of EMS, examining
various aspects such as infrastructure, staffing, response times, and patient outcomes. The
qualitative component includes interviews and observations, while the quantitative
component focuses on data from surveys and hospital records.

 Study Area: Mymensingh Sadar Hospital

 Mymensingh Sadar Hospital, located in the Mymensingh district of Bangladesh, serves as

the primary study area. This hospital is a key healthcare facility in the region, offering a
wide range of medical services, including emergency care. The study area is chosen due
to its significant role in providing EMS in a densely populated area with diverse
healthcare needs. The hospital's emergency department is the focal point of the study, as
it is critical in understanding the effectiveness and challenges of EMS delivery.
  Data Collection Methods

 The study employs both primary and secondary data collection methods to gather
comprehensive information on EMS at Mymensingh Sadar Hospital.

 Primary Data

 Surveys: Structured questionnaires will be administered to EMS personnel, patients, and

their families to gather quantitative data on their experiences, perceptions, and
satisfaction with the services provided.
 Interviews: In-depth, semi-structured interviews will be conducted with key
stakeholders, including hospital administrators, emergency department staff, and patients,
to gain qualitative insights into the challenges and operational aspects of EMS.
 Observations: Non-participant observations will be carried out in the emergency
department to document real-time practices, staff-patient interactions, and the overall
environment, providing contextual understanding.

 Secondary Data

 Hospital Records: Data from hospital records will be reviewed to analyze patient
demographics, types of emergencies handled, response times, and patient outcomes.
 Government Reports: Relevant government publications and reports on healthcare,
EMS policies, and hospital performance will be examined to contextualize the findings
within broader regional and national frameworks.

 Sample Selection

The study will use purposive sampling to select participants for interviews and surveys,
ensuring that a diverse range of perspectives is captured. This includes:

 EMS Personnel: Doctors, nurses, and paramedics working in the emergency department.
 Patients: Individuals who have received emergency care at Mymensingh Sadar Hospital
within the last six months.
 Hospital Administrators: Senior staff involved in the management and oversight of the
emergency department.
 Sample Size: The sample size for surveys will aim for 100-150 respondents to ensure
statistical validity, while interviews will include 15-20 participants for in-depth
qualitative analysis.

 Data Analysis Techniques

The study will employ various data analysis techniques to interpret the collected data:
  Quantitative Data: Survey data will be analyzed using statistical software (e.g., SPSS)
to calculate descriptive statistics (mean, median, mode) and inferential statistics (e.g., chi-
square tests, regression analysis) to identify patterns and relationships.
 Qualitative Data: Interview transcripts and observation notes will be analyzed using
thematic analysis to identify recurring themes, patterns, and insights. Coding will be used
to categorize data, and NVivo software may be employed for more systematic analysis.
 Triangulation: To enhance the validity of the findings, data from different sources
(surveys, interviews, observations, and records) will be cross-verified through
triangulation, ensuring a robust and comprehensive understanding of EMS at
Mymensingh Sadar Hospital.

After our investigation we have asked service provider ( means authority) some specific
questions write the below:

 Does your hospital have an emergency medical service?

 Are there enough authorities to provide emergency services?

(Ambulance, Basic Life Support, Advance Life Support Electrocardiogram)

 Are there any grounds for an eligible EMS are they appropriate? (Problem identification,
early reporting, emergency response, transfer to specific care)

 Is EMS 24/7 available in your medical? Is there proper service? Is There Enough Stuff?
Weekend crisis or not?

 Is there a medicine specialist to manage emergency services? How is the appointment

process of Stuff? Is there any training e course to enhance their skills?

 Do you follow the rules of 2018 regarding emergency medical services? (specific rules,
regulations)

 Registration is required to fulfill all the conditions to be registered in a hospital, have

you fulfilled them? (Emergency Service) is not there

 How effective is the Helpline Service?

Next, we asked service receiver some specific question write the below:

 Have you ever taken emergency services at Mymensingh Sadar; Where did you take it?

 How quickly did you get emergency services? Have you encountered any delays or
difficulties?
 How did you get the ambulance service? What does the hotline do?

 Is the doctor available 24/7? Did you go on holiday or at night?

  Where did the emergency examination? Medicines/ blood have been found or not.

 How is the behavior of doctors and staff? Is it available when needed?

 How is the experience of going to the private hospital

4. Overview of Emergency Medical Services (EMS)

Emergency Medical Services (EMS) are crucial for providing urgent medical care and transport
to individuals experiencing acute health emergencies. EMS systems are designed to deliver
prompt and effective medical intervention, stabilize patients, and transport them to appropriate
medical facilities for further treatment. Here’s an overview of EMS:

 Components of EMS:

 Emergency Medical Dispatch (EMD):

o Role: Coordinates and manages emergency calls, provides pre-arrival instructions
to callers, and dispatches appropriate emergency units.
o Features: Use of advanced call-taker protocols and computer-aided dispatch
systems to assess and prioritize calls.
 Emergency Medical Services (EMS) Providers:
o Paramedics and EMTs (Emergency Medical Technicians):
 Role: Provide pre-hospital emergency medical care, including assessment,
treatment, and transport.
 Levels of Care:
 Basic Life Support (BLS): Provided by EMTs, includes basic
medical care and patient stabilization.
 Advanced Life Support (ALS): Provided by paramedics, includes
advanced medical procedures and medication administration.
 Ambulance Services:
o Types:
 Basic Ambulances: Equipped for standard emergency medical care.
 Advanced Life Support Ambulances: Equipped with advanced medical
equipment and staffed by paramedics.
 Emergency Departments (ED):
o Role: Provide immediate medical care for patients brought in by EMS, including
diagnostic tests, treatment, and stabilization.
o Features: May include specialized units such as trauma centers, pediatric
emergency care, and critical care units.
 Integration with Other Services:
o Hospital Systems: Coordination with hospitals for patient handover and
continuity of care.
o Public Health and Safety Agencies: Collaboration with police, fire services, and
disaster response teams for comprehensive emergency management.
  Key Functions of EMS:

 Assessment and Triage:

o Role: Quickly assess the severity of a patient's condition, prioritize treatment
based on urgency, and determine the appropriate level of care needed.
 Treatment and Stabilization:
o Role: Administer medical interventions, manage life-threatening conditions, and
stabilize patients for transport.
 Transport:
o Role: Safely transport patients to medical facilities, ensuring continuous
monitoring and care during transit.
 Communication and Coordination:
o Role: Maintain effective communication with dispatch centers, hospitals, and
other emergency services to coordinate patient care and response efforts.

 Challenges and Considerations:

 Response Times: Ensuring prompt arrival at the scene is critical for effective emergency
care.
 Resource Allocation: Balancing the availability of equipment, medication, and
personnel to meet varying demands.
 Staff Training and Retention: Maintaining high standards of training and addressing
staff shortages and burnout.
 Patient Outcomes and Satisfaction: Ensuring quality care and addressing patient
feedback to improve service delivery.

 Importance of EMS:

 Timely Care: Provides crucial medical interventions in critical situations, potentially

saving lives and improving outcomes.
 Accessibility: Ensures that emergency medical care is accessible to individuals
regardless of location, especially in underserved or remote areas.
 Community Support: Plays a vital role in community health and safety by responding to
a wide range of emergencies, from accidents to medical crises

5. condition of emergency medical service in Mymensingh sadar hospitals

5.1 Case study : perspective of service receiver

Going into a data collection we found some notable points, for Example :
Our survey focuses on emergency services at public and private medical hospitals in
Mymensingh Sadar. My team members and I collect data through both in-person and online
surveys.
Case study 1 : Abrir Chandra pine:Emergency services are somewhat available, the behavior
is not bad, and 24/7 service is provided. Does not listen to problems, advises to visit their private
chambers, and displays rude behavior.

Case study 2: Selim Reza: Emergency Services are mismanagement, Doctor’s behavior is
pretty, and 24/7 service is not provided, Patients are not satisfied. More staff and doctors are
needed.

Case study 3 : Zia Uddin Khan:Emergency Services are Somewhat slow,the behavior is so
good, and 24/7 service is provided, Patients are satisfied. Better measures need to be taken for
improvement.

Case study 3: Nayeem There have been difficulties in accessing emergency services, and 24/7
service is not provided, Most of the behavior is good. I am not satisfied; I have observed many
irregularities. Legal action needs to be taken to address these issues.

Case study 5 : MD. Akib Rayhan, Emergency services are good, 24/7 service is provided and
Doctor’s behavior is good. The country is a hub of corruption, so the medical ward helpers don’t
directly ask for money, but if you don’t give them any, they hover around. They indirectly imply
that they want something.
Example 6 : Ridwan, Emergency services are somewhat satisfactory, It is somewhat satisfactory,
but there is room for improvement and 24/7 service available. I am not fully satisfied. I want the
issue of the brokerage networks to be resolved first, as otherwise, patients face a lot of
difficulties. Also, prompt service needs to be ensured.

Case study 6: Jinnat,:There have been difficulties in accessing emergency services, Behavior is
very poor, and 24/7 is not provided. Especially during the night and early morning hours, doctors
are not available at specific times, and patients have to wait in the corridors. On holidays, doctors
are not present, and even when they are, they do not spend sufficient time with patients.
Addressing these issues is crucial.

Case study 8 : Emam Hosen: Mismanagement of emergency services, the behavior is not bad,
and Yes, but it needs to be improved further. More doctors and staff are needed, along with
improved management and equipment.

5.2 Case study : perspective of service provider

Case study :1 kamrul Hasan: He is a senior executive IBM of Delta hospital. There is no
ambulance service. Training service available for stuff and nurce.they are provided primary
treatment not long time treatment. Most of the time they are transfer patients to govt. hospital

Case study :2 Mahfuzur Rahman mukta : He is a assistant manager of Sadesh private

hospital. Outdoor system available 10 :00 am from 4:00 pm only 100 tk.here including NICU,
ICU,CCU,SDU etc. Primary treatment available 24 ours. If any patients critical situation when
they transfer to Mymensingh medical College Hospital. If incase of police case, its depend the
condition of patients they taken to admit. Training facilities must including 3 years of diploma
must to be stuff.

Case study :3 Mustafa khaled Ripon: He is a AGM of Sayem private hospital. Including
consultancy is diagnostics,this diagnostics to made up for commercial tendency. Service 24 ours
available but Consultancy is limited

6. Limitations and challenges

6.1 Regarding govt.hospital:

 Shortage of ambulances in government hospitals: Mymensingh Medical

College Hospital receives more than 2000 thousand patients daily which is much
more than the capacity of the hospital. The number of ambulances in the hospital
is 9 where the number of patients is very high for which not everyone can get the
government
 ambulance. Number of doctors and nurses less than required: Where the number
of patients is high, there are fewer doctors and nurses. The number of doctors and
nurses are appointed according to the capacity of the hospital but the number of
patients the greater number is their number need to grow more.

 Long Duty: Due to the large number of patients, doctors and nurses have to
perform extra duty due to which they get tired. Since this is an emergency
medical service, doctors should be given a chance to calm down and rest,
otherwise there will be big consequences for any mistake. Accidents can happen

 Instrumental error :High number of patients there are various types of tests to
be done. But due to the inadequacy and crudity of the equipment, it is not possible
to do all the tests.

 Issues with Response Times:

Delay in Ambulance Arrival: Delays in dispatching and arriving at the emergency scene can
critically impact patient outcomes.

Traffic Congestion: High traffic volumes and road conditions can prolong response times.
Geographic Constraints: Remote or underserved areas may experience longer response times due
to distance and accessibility issues.

Coordination Issues: Inefficiencies in communication between dispatch centers, ambulance

crews, and hospitals can contribute to delays.

 Resource Limitations:

Limited Medication Supplies: Inadequate stock of essential medications can impact the ability
to manage emergencies effectively.

Facility Constraints: Emergency departments may be constrained by limited space, outdated

infrastructure, or insufficient technology.

Financial Constraints: Budget limitations can affect the acquisition of necessary resources and
maintenance of equipment.
Staff Shortages:

Insufficient Personnel: A shortage of trained medical staff, including doctors, nurses, and
paramedics, can lead to increased workload and decreased quality of care.
High Turnover Rates: Frequent staff turnover can result in a lack of continuity in patient care
and increased training requirements.
Burnout and Stress: High-stress environments and long working hours can contribute to
burnout among EMS staff, affecting their performance and well-being.

Training Gaps: Inadequate training for handling specific emergency situations or new medical
technologies can impact staff effectiveness.

 Patient Satisfaction and Feedback:

Delayed Care: Extended wait times for treatment or transport can lead to dissatisfaction among
patients and their families.

Communication Issues: Poor communication between EMS personnel and patients or their
families can result in misunderstandings and dissatisfaction.

Quality of Interaction: The demeanor and professionalism of EMS staff can affect patient
perceptions and overall satisfaction with the service.

Follow-Up Care: Lack of adequate follow-up or continuity of care post-emergency can lead to
patient concerns and lower satisfaction levels.

6.2 Regarding Private Hospitals:

Based on our field visit, most of the hospitals do not have emergency medical services. The
reason behind this is that it is very expensive due to which the common people are not interested
in taking the service and the money that the owners get from doctors, nurses and equipment and
other expenses and medical services is disproportionate. And in some cases, the condition of the
road accident patient is very critical, so the patient does not want to be admitted for fear of
lawsuits.

7. Recommendations

 Enhance EMS Infrastructure and Resources

Upgrade Emergency Facilities: Invest in modernizing emergency departments with

updated medical equipment, improved triage areas, and expanded patient care
spaces to accommodate high patient volumes.
Increase Ambulance Availability: Expand the fleet of ambulances equipped with life-
support systems and trained paramedics to reduce response times and improve
patient outcomes.

Improve Medical Supplies Management: Establish a robust inventory management

system to ensure the availability of critical supplies such as medications, diagnostic
tools, and emergency kits.

 Strengthen Workforce Capacity and Training

Regular Training Programs: Conduct ongoing training sessions for EMS staff on
advanced life-saving techniques, emergency triage protocols, and crisis
management skills to enhance their ability to respond effectively.

Capacity Building for Non-Clinical Staff: Provide training for administrative and
support staff on emergency department workflow, patient coordination, and
communication skills to support clinical teams.

Address Staffing Shortages: Hire additional qualified medical professionals,

including doctors, nurses, and paramedics, to reduce the workload on existing staff
and prevent burnout.

 Optimize Operational Processes

Implement Efficient Triage Protocols: Develop clear and standardized triage protocols
to prioritize patients based on the severity of their conditions, ensuring timely care
for critical cases.

Streamline Patient Admission and Discharge: Introduce digital systems for faster
patient registration, tracking, and discharge to minimize delays and reduce
overcrowding in emergency areas.

Improve Communication Systems: Establish better communication channels between

EMS teams, hospital departments, and external emergency services (e.g., police,
fire services) to enhance coordination.

 Improve Community Awareness and Engagement

Public Awareness Campaigns: Conduct community education programs to raise
awareness about emergency services, how to access them, and the importance of
timely medical intervention in emergencies.

Promote First Aid Training: Offer first aid and basic life support (BLS) training to
the public, empowering them to provide initial assistance in emergencies before
professional help arrives.

 Establish Monitoring and Evaluation Systems

Performance Monitoring: Implement regular monitoring and evaluation of EMS

performance using key performance indicators (KPIs) such as response times,
patient outcomes, and service efficiency.

Feedback Mechanisms: Create channels for patient and staff feedback on EMS
services, using the insights gained to identify areas for improvement and to
implement changes.

 Implement Stress Management and Support Programs for EMS Staff

Mental Health Support: Provide mental health support services, including counseling
and stress management workshops, to help EMS staff cope with the high-stress
nature of their work.

Shift Management: Introduce effective shift management practices to balance

workloads, ensure adequate rest periods, and prevent burnout among emergency
staff.

 Address Technological Barriers

Improve Internet Connectivity: Ensure reliable internet access in emergency

departments to facilitate the use of digital tools for patient management and real-
time communication with external services.

Deploy Mobile Health Apps: Utilize mobile apps to streamline EMS operations, such
as for ambulance dispatch, patient monitoring, and real-time data sharing among
medical teams.

 Enhance Safety and Security Measures

Improve Security in Emergency Departments: Deploy security personnel and
monitoring systems to maintain order in busy emergency areas, protecting both
staff and patients.

Establish Infection Control Protocols: Implement stringent infection prevention and

control measures, especially in high-risk emergency settings, to safeguard the
health of patients and staff.

Conclusion

Emergency medical service is the umbrella term to describe all the working parts that make of
prehospital medicine. It is incorporated into almost all aspects of healthcare and continues to be
an important part of the medical field. The field is ever evolving and changing to reflect a more
evidenced based approach to medical care and a desire of a national standard for
providers. Nonetheless, it is a crucial part of the delivery of healthcare to the population at large
and the safety net for many.

Reference

 Medical Journals:

Journal of Emergency Medical Services (JEMS). (n.d.). JEMS: A Journal of EMS Leadership.
Retrieved from https://www.jems.com/

 Government and Professional Organizations:

World Health Organization. (2017). Emergency Care Systems for Universal Health Coverage:
Ensuring Timely Care for the Acutely Ill and Injured. WHO Press. Retrieved from
https://www.who.int/publications/i/item/9789241511260

 Textbooks:

Mistovich, J., Karren, K., & Hafen, B. (2017). Prehospital Emergency Care (11th ed.). Pearson.

 Guidelines and Protocols:

American Heart Association. (2020). 2020 American Heart Association Guidelines for CPR and
Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S337-S357.
https://doi.org/10.1161/CIR.000000000