Not all Ambulances are Created Equal

Not all Ambulances are Created Equal

Unless you work in Emergency Medical Services (EMS) you are probably not aware that ambulances are not created equal. Activation of the emergency response system and advanced resuscitation by EMS are two of the components of the Chain of Survival (American Heart Association, 2023) making EMS response times and service level crucial factors of patient outcome.

The socio-ecological model (SEM) of heath care encompasses Individual, family organization, community and societal factors that influence mental health and well-being. (University of Minnesota, 2023) In additional to political influences all components of the SEM factor into EMS service delivery.

EMS services are regulated provincially, with professional licensing requirements unique to each province and not easily transferrable. Paramedics provide patient care following medical control protocols with medical direction provide by a physician meaning care can differ between each service, even within the same province.

In Alberta, there are three levels of EMS service. Non-emergent transport (NET) is for stable, ambulatory patient transport and is not an emergency level of care. Basic Life Support (BLS) and Advanced Life Support (ALS) are the two levels of emergency response. The difference between these two is the training level of the highest member of the ambulance crew. ALS is the highest level of service providing advanced life support skills including advanced and surgical airways, medication administration, 12-lead ECGs, pacing and cardioversion. Service level is determined by contractual agreements with municipalities and can be impacted by geographical location.

Your geographical location impacts EMS response time, which in a life-threatening emergency can negatively impact patient outcome. In Alberta, if you live in a metro or urban community the response time standard is eight minutes. That increases to 10 minutes in you live in a community of less than 3000 people, 20 minutes if you live rural and 40 minutes if you live remote. (Alberta Health Services. 2022)

The province and community you choose to live in, the service level that supports your community, and the training of the responding crew are all contributing factors to the EMS experience you will receive if you ever find yourself requiring prehospital care.

References

Alberta Health Services. (2022, October 20). Quarterly Emergency Medical Services Dashboard. https://www.albertahealthservices.ca/assets/info/ems/if-ems-dashboard.pdf

American Heart Association. (2023). Out of Hospital Chain of Survival. https://cpr.heart.org/en/resources/cpr-facts-and-stats/out-of-hospital-chain-of-survival

University of Minnesota. (2023). Mental Health and Well-being Ecological Model. https://mch.umn.edu/resources/mhecomodel/