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Section of Prehospital and Disaster Medicine

Emergency Medical Services (EMS) was recognized as a bona-fide subspecialty of emergency medicine in 2010. EMS encompasses a broad spectrum of emergency health care including: out of hospital medicine, emergency public heath, disaster medicine, mass gathering medicine, and critical care transport. EMS physicians at the Department of Emergency Medicine participate in a variety of roles including: 
  • Operational medical direction
  • Educational program direction
  • Emergency preparedness consulting
  • Emergency scene response
  • Tactical medical support
  • Critical care transport / special medical operations

The Section offers several educational experiences in emergency medical services including a medical student elective and a curriculum for emergency medicine residents. Explore the website to learn more about the clinical sites affiliated with the Department of Emergency Medicine. 

A sample curriculum in disaster medicine is also hosted on the webpage.




Overview of Emergency Medical Services

Scope and Mission

Emergency medical services (EMS)  rests at the intersection of public health and emergency medicine. Its breadth encompasses patients from all age groups, social strata, and geographic regions. The practice of EMS medicine is predicated upon an understanding of trends in resuscitation research, disaster medicine, and out of hospital care. EMS physicians work with fire departments, local governments, and hospitals to ensure that patients in need of assistance are transported safely and efficiently to definitive care. STEMI systems, trauma networks, and remotely located hospitals routinely depend upon the coordinated efforts of prehospital physicians, administrators, and other professionals. Given its "systematic" approach to illness and injury, EMS is well positioned to deal with mass casaulty events, mass gatherings, and disaster preperation. Triage and other elements of the National Incident Management System (NIMS) are embedded into the daily practice of prehospital medicine. One of the most clear cut functions of EMS is to provide immediate,  stabilizing assistance to ill and injured patients. The National Registy of Emergency Medical Technicians (NREMT) recognizes several basic levels of provider. EMS systems vary by state and region, but nationally recognized "levels" of EMS providers are described below. 


Emergency Medical Responder (EMR)


This professional possesses basic knowledge of patient assessment and first aid practices. EMRs are able to address life threatening hemorrhage and are trained in cardiopulmonary resuscitation. EMR training is commonly conducted at law enforcement and fire academies. 

Nationally Registered Emergency Medical Technician (EMT)


The EMT is the first level of certification and training that is found upon american ambulances. EMTs are skilled in oxygen administration and may assist patients with their own prescribed medication. EMTs can administer other life-saving medications such as epinephrine and are trained in basic principles of incident management and vehicle extrication. 


Nationally Registered Advanced Emergency Medical Technician (AEMT)

The AEMT possesses all of the skills and training of the EMT. In addition to the EMT scope of practice, AEMTs may insert laryngeal / supraglottic airways, initiate and administer intraveous fluids, and can provide cardioversion and defibrillation to victims of dysrhythmia. AEMTs have additional education in disease physiology and are often considered "advanced life support" providers. 


Nationally Registered Paramedic (NRP) 

The NRP possesses an in-depth understanding of anatomy and physiology. The paramedic typically completes an accredited program consisting of four semesters of college-level education. Paramedics can insert advanced airways, administer intravenous and intraosseous medications, and perform advanced patient assesments. 

Specialty Transport Providers

Other medical professionals participate in the delivery of prehospital emergency medical care. Paramedics with additional education are authorized to perform life saving treatments such as rapid sequence intubation. Critical care nurses are able to administer blood products and administer treatments outside of the usual scope of practice. State agencies regular the scope of prehospital provider practice. Maryland currently designated a "Specialty Care Transport" paramedic provider which incorporates specific treatments and medications outside of the usual advanced life support protocols. 




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