Page 10 - Hassan Nasser Moafa
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Chapter 1



                 Introduction


                 Emergency medical services (EMS) are comprehensive and integrated medical systems
                 that take care of patients exposed to different types of emergencies.[1,2] According to the
                 WHO, a healthcare system is not considered integrated without effective and efficient EMS.
                 [3,4] Providing emergency healthcare is not limited to indoor locations such as hospitals
                 and primary healthcare centers but rather extend to dispatch crews for people in need of
                 medical aid at emergency locations. EMS responds to medical emergencies, tragedies and
                 situations where life is at imminent risk.[5,6] Well-developed EMS provide patient-centered
                 healthcare after the patients, their relatives, bystanders, or other emergency services
                 personnel like police or firefighters contact the call center through a national designated
                 telephone number. Call receivers in the call center put the caller through to dispatchers
                 in the Dispatching Center (DC) for further information that is required to dispatch the
                 appropriate crew(s) to the patients’ location. The role of the DC is to assign the right
                 resources to the right patients in the appropriate amount of time via up-to-date triaging
                 software.[7] Ambulances are the means of transportation that can comprise different type
                 and size. For example, according to European Union standards, ambulances in Europe can
                 be one of three types, called A, B, and C. Each one has its specification and indication for
                 use according to the urgency and severity of the emergency patient.[8] In several states
                 of the US, medical physicians are assigned online to monitor performance and support
                 emergency providers at the scene and resolve conflict related to any unexpected pattern
                 that affects the ambulance run.[9]



                  A Brief History of EMS Around the World


                 EMS has gone through several stages of development.[10] During the early 20th  century,
                 most EMS were realized from war experiences as an integral part of military operations to
                 preserve soldiers and minimize casualties. Historically, the Greeks and Romans were the first
                 who provided EMS to injured soldiers at the battle in ancient times.[11] During the revolution
                 of prophet Mohammed in Madinah city, located in Saudi Arabia (SA), 620 AD (9 AH)  a
                 group of Arabian Muslim women led by the famous first nurse called Rufaida bint Saad Al-
                 Aslameya voluntarily provided rescue services for injured soldiers.[12] Nevertheless, several
                 historians attribute the first organized EMS to the era of Napoleon by Baron Dominique Jean
                 Larrey (1766 – 1842).[13] Larrey was a French surgeon and military doctor in the French army
                 during the Napoleonic war (1803–1815), where he observed a high mortality rate due to
                 keeping soldiers untreated at the scene.[14,15] Figure 1 shows the invention of Larry and
                 his team. They implemented EMS and provided rapid evacuation of soldiers to be treated by
                 medical personnel.[13] [14] On the other hand, EMS during that period was not provided for
                 civilians during the peacetime period.



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