International EMS Systems: Canada

A Descriptive Analysis of Emergency Medical Service Systems Participating in the Resuscitation Outcomes Consortium (ROC) Network

“…1,3,6,7,[9][10][11]14,[20][21][22][23][24][25][26][27] Although fire-based EMS is most common across the ROC sites, there is tremendous variability observed in agency configuration, provider level, and resource allocation. The recent Institute of Medicine report concerning the status of U.S. emergency medical care highlighted the lack of scientific evidence behind many prehospital interventions.…”

“…[1][2][3][4] Yet it was not until the second half of the 20th century that organized EMS systems began to appear throughout North America. A 1966 National Academy of Sciences article described the inadequacies of prehospital and emergency care in the United States and suggested guidelines for the training of prehospital emergency care providers and the development of EMS systems.…”

“…1 In Canada, substantial variability in EMS services existed from community to community until the mid-1970s. 3 with no federal or provincial funding. In 1975, the City of Toronto created the Department of Ambulance Services as the sole provider of EMS in Ontario's largest city, and in 1978 British Columbia legislated the creation of the British Columbia Ambulance Service as the sole provider of EMS within the entire province.…”

“…[6][7][8][9] Although initial legislative efforts encouraged communities to carefully consider the EMS systems under development, the absence of a standardized blueprint has resulted in multiple models for the delivery of EMS care. 1,3,[9][10][11][12][13][14][15] The Resuscitation Outcomes Consortium (ROC) was funded by the National Heart Lung and Blood Institute to create a network of premier regional centers with focus on EMS care delivery to evaluate the effectiveness of prehospital emergency care for patients with out-of-hospital cardiac arrest or life-threatening injury. ROC consists of 11 sites (8 in the United States and 3 in Canada), which provide the structure and resources necessary for conducting large-scale prehospital clinical research, and a data-coordinating center (DCC) that is separate from any of the clinical sites ( Figure 1).…”

Pre‐hospital cardiac arrest and induction of mild hypothermia: studies on epidemiology and feasibility

“…In most countries, the systems are based on basic life support (BLS)-level responders such as fire-fighters and emergency medical technicians (EMTs). Commonly, these responders provide BLS and automated external defibrillation (AED) but do not administrate medications or initiate thrombolysis (Campbell et al 2005;Ellis and Sorene 2008;Koichi and Keiichi 2006;Papaspyrou et al 2004;Roessler and Zuzan 2006;Symons and Shuster 2004).…”