Emergency Medicine in America: Fact Sheet

Pre-hospital Medicine

In the United States prehospital medicine is provided by three different levels of providers: first responders, Emergency Medical Technicians (EMT’s), and paramedics. There are national standardized curriculums for all three levels of providers. However, each individual state has the authority to add requirements for providers in this state. An example is that a state like New Jersey requires some of its EMT’s and paramedics who work in cities with many chemical companies have additional certification in hazardous materials.

EMS Models:

• City contracts private company
• City provides EMS using Fire Service
• City contracts with volunteer ambulance organization

Emergency Medicine

• Emergency Medicine became a medical specialty in 1980
• There are 3 levels of Emergency Departments.
  1. Level 1
  2. Level 2
  3. Level 3
• Emergency Medicine Residency is 3-4 years after completing medical school.
• The emergency department has become the “medical safety net” for the US healthcare system.
• Most emergency department visits are medical problems that could have been managed in a family doctors office.
• You may assume that because the US doesn’t have universal coverage it is the reason there are over 100 million emergency department visits a year instead of going to a primary care physician.
• Scotland saw a 50% rise in emergency department visits between 1981 and 1994 even though it has a well developed primary care system.
• Some reasons for rising emergency department visits: expectations of the public, defensive medicine, increased morbidity, primary care factors, changing household structure, aging population, and revolving door admissions.