Talk:Emergency medical services

message: Having had a look at this content, it doesn't really fit into the Emergency medical services main page.  That's not to say that there isn't all sorts of good information...my feeling was that it would do better as its' own page, with plenty of room for expansion.  Rather than just deleting somebody's hard work, I've cut and pasted it here, so that when someone is ready to take a shot at doing a separate page, it's available:
===Rural EMS===
The face of rural/frontier EMS has changed dramatically since the 1966 National Academy of Sciences, National Research Council (NAS-NRC) white paper “Accidental Death and Disability: the Neglected Disease of Modern Society” marked the conception of modern EMS.
 Ambulance service of that era was more about a fast ride than medical care. It was provided as a low-investment by-product service of funeral homes and others whose primary business already had the requisite type of vehicle.
thumb|right
The NAS-NRC white paper revealed the ill-equipped, ill-trained nature of these services, as well as the potential to do more harm than good. Subsequent reforms led to the birth of modern EMS with the Emergency Medical Services Systems Act of 1973. As standards for training, equipment and care changed, so did the providers of rural/frontier EMS. Dedicated ambulance vehicles staffed by trained EMT's operated by independent volunteer organizations, volunteer fire departments, local hospitals, and others replaced hearses.
In the past three decades, the EMS field, with its capabilities and role as a unique discipline at the crossroads of medicine, public health and public safety, has matured dramatically. At a rural car crash, the gold standard medical response has gone from hearse to helicopter. The pressure to provide advanced life support (ALS), created at first by enthusiastic EMTs within EMS agencies themselves, has become compounded by media-generated public expectation. The drive to provide ALS has had an effect similar to that experienced by funeral home ambulance operators pressed to provide safe, basic care in the early 1970s. More workplace issues arose. The 1950s brought much needed emphasis on the physical and mental health of EMS providers.
EMS agencies dependent on volunteers for staffing and fund-raising for revenue, have found advancement difficult.
 Indeed, it is often a challenge to continue to assure the timely response of a basic life support ambulance in these settings. In the current era of preparing public safety for effective response to manage terrorist and other events, the reality of rural/frontier EMS is that the infrastructure upon which to build such a response is itself in jeopardy. The 1996 NHTSA “EMS Agenda for the Future,”41 the visionary guide upon which this document is based, states that “EMS of the future will be community-based health management which is fully integrated with the overall health care system.” A theme running through the Rural/Frontier EMS Agenda for the Future is that such EMS integration is not only a reasonable approach to making community health care more seamless and to meeting community health care needs that might not otherwise be met, but that providing a variety of EMS-based community health services may be crucial to the survival and advancement of many rural/frontier EMS agencies.
Another related theme is that EMS should not only weave itself into the local health care system but into the fabric of the community itself. Communities can objectively assess and publicly discuss the level and type of EMS care available, consider other options and accompanying costs, and then select a model to subsidize. Where this happens through a well-orchestrated and timely process of informed self-determination, community EMS can be preserved and advanced levels of care can be attained.
The National Rural Health Association National Rural and Frontier Emergency Medical Services
Agenda for the Future document suggests other means of maintaining an effective EMS presence as well such as alternative methods of delivering advanced life support back-up, and the formation of regional cooperatives for medical oversight, quality improvement, data collection and processing.
Emrgmgmtca (talk) 15:13, 15 September 2008 (UTC)
thread_title: Rural EMS

message: The face of rural/frontier EMS has changed dramatically since the 1966 National Academy of Sciences, National Research Council (NAS-NRC) white paper “Accidental Death and Disability: the Neglected Disease of Modern Society” marked the conception of modern EMS.
 Ambulance service of that era was more about a fast ride than medical care. It was provided as a low-investment by-product service of funeral homes and others whose primary business already had the requisite type of vehicle.
thumb|right
The NAS-NRC white paper revealed the ill-equipped, ill-trained nature of these services, as well as the potential to do more harm than good. Subsequent reforms led to the birth of modern EMS with the Emergency Medical Services Systems Act of 1973. As standards for training, equipment and care changed, so did the providers of rural/frontier EMS. Dedicated ambulance vehicles staffed by trained EMT's operated by independent volunteer organizations, volunteer fire departments, local hospitals, and others replaced hearses.
In the past three decades, the EMS field, with its capabilities and role as a unique discipline at the crossroads of medicine, public health and public safety, has matured dramatically. At a rural car crash, the gold standard medical response has gone from hearse to helicopter. The pressure to provide advanced life support (ALS), created at first by enthusiastic EMTs within EMS agencies themselves, has become compounded by media-generated public expectation. The drive to provide ALS has had an effect similar to that experienced by funeral home ambulance operators pressed to provide safe, basic care in the early 1970s. More workplace issues arose. The 1950s brought much needed emphasis on the physical and mental health of EMS providers.
EMS agencies dependent on volunteers for staffing and fund-raising for revenue, have found advancement difficult.
 Indeed, it is often a challenge to continue to assure the timely response of a basic life support ambulance in these settings. In the current era of preparing public safety for effective response to manage terrorist and other events, the reality of rural/frontier EMS is that the infrastructure upon which to build such a response is itself in jeopardy. The 1996 NHTSA “EMS Agenda for the Future,”41 the visionary guide upon which this document is based, states that “EMS of the future will be community-based health management which is fully integrated with the overall health care system.” A theme running through the Rural/Frontier EMS Agenda for the Future is that such EMS integration is not only a reasonable approach to making community health care more seamless and to meeting community health care needs that might not otherwise be met, but that providing a variety of EMS-based community health services may be crucial to the survival and advancement of many rural/frontier EMS agencies.
Another related theme is that EMS should not only weave itself into the local health care system but into the fabric of the community itself. Communities can objectively assess and publicly discuss the level and type of EMS care available, consider other options and accompanying costs, and then select a model to subsidize. Where this happens through a well-orchestrated and timely process of informed self-determination, community EMS can be preserved and advanced levels of care can be attained.
The National Rural Health Association National Rural and Frontier Emergency Medical Services
Agenda for the Future document suggests other means of maintaining an effective EMS presence as well such as alternative methods of delivering advanced life support back-up, and the formation of regional cooperatives for medical oversight, quality improvement, data collection and processing.
Emrgmgmtca (talk) 15:13, 15 September 2008 (UTC)
thread_title: <span id="Rural"></span>Rural EMS

message: I have reviewed and either validated or invalidated all of the references and external links in the article.  Unfortunately, being relatively new to Wikipedia, I am unsure how to edit a reference list, as has been used here.  If someone could help out with this, the following was the result for the References section:  
Ref 1. Delete...no longer valid.
Ref 4. Delete...no longer valid.  Hijacks to another website.
Ref 10. Delete...no longer valid.
Ref 11. Delete...no longer valid.
Ref 13. Delete...no longer valid.
Ref 14. Delete...no longer valid.
Ref 20. Delete...no longer valid.
Ref 24. Delete...link to ISBN number, not reference source.
Ref 27. ???...Reference is valid and would be acceptable academically, but link doesn't work.
Ref 32. Delete...no longer valid.
Ref 35. Delete...no longer valid.
Ref 52. Delete...no longer valid.
The External Links (See Also) have all been validated.  Thanks for your help with this.  Emrgmgmtca (talk) 14:16, 12 September 2008 (UTC)
thread_title: References and External Links

message: I would strongly suggest that all of the content of this article be as generic as possible, without the loads of regional variations that are currently being presented as if they were universal.  As a result, I am proposing that all of the content on the various subspecialties (none of which are universal) be given their own separate articles, and linked to the main, generic article.  These would include all content related to Wilderness 'medics' (and I'm using that term interchangeably for paramedics, EMTs and other types of technicians in other jurisdictions), Fire-medics, Flight medics, tactical medics, critical care medics, paramedic practitioners, and the lot. The content is interesting and should be available, but it is by no means universal, and it creates erroneous impressions, particularly for Wiki users who are not actually involved in the field.  This would also elminate about eight of the items currently on the 'to do' list for this article, and move it a lot closer to completion.  I would welcome your comments on this proposal, and also some help in implementing it, if you agree.  Emrgmgmtca (talk) 12:49, 12 September 2008 (UTC)
thread_title: EMS Specialties in this article

message: I moved EMS from Emergency medical service to Emergency Medical Service because in the US, at least, it is called the Emergency Medical Service, with all three words starting with consonants capitalized. --Tomtom 15:12, 19 Apr 2005 (UTC)
replies: text: This is incorrect: Emergency Medical ServiceS is the standard terminology worldwide.--Napthene 19:09, 22 July 2005 (UTC)
thread_title: I

message: Emergency Medical Services is the standard terminology, in worldwide use.--Napthene 19:09, 22 July 2005 (UTC)
replies: text: I really don't see why this article should use the Specifficaly US terminology. It talks about other countries at well. If there is something special about the EMS of the USA, start another, specific article, just like for SAMU, for instance. Rama 13:25, 23 July 2005 (UTC)
replies: text:  Yes this page should be all capitals it spelling a acronym and based on the other articles ATLS, ACLS, and PALS to name a few this page should be Emergency Medical Services Medicellis (talk) 16:39, 22 July 2008 (UTC)
replies: text: I believe this discussion was originally to rename "emergency medical service" to "emergency medical services".  As far as capitalization, it should be lowercase.  Basically all acronyms are written in caps, but that does not mean the individual words should be in all caps.  I raised this issue recently at Talk:Emergency medical technician#Capitalization of article titles.  According to the WP:MOS, article titles should be in sentence case.  When writing out mid sentence, you would use lowercase, not uppercase.  This article is for "emergency medical services" - not "EMS" spelled out.  PALS and ATLS should be capitalized, since they are copyrighted programs.  However, ACLS and CPR should not be capitalized, since they are generic terms (like EMS/EMT).  --Scott Alter 21:27, 22 July 2008 (UTC)
thread_title: Requested move

message: That said, I would support a move to emergency medical service--most of the hits in caps appear to be titles of articles/webpages or proper nouns (EG "Some County Emergency Medical Service"), while in-text usage is more likely all lowercase.[http://www.mishawakacity.com/ems.asp	 
"Mishawaka’s emergency medical service needs continue to grow."] Niteowlneils 07:29, 23 July 2005 (UTC)
replies: text: I really don't see why this article should use the Specifficaly US terminology. It talks about other countries at well. If there is something special about the EMS of the USA, start another, specific article, just like for SAMU, for instance. Rama 13:25, 23 July 2005 (UTC)
replies: text:  Yes this page should be all capitals it spelling a acronym and based on the other articles ATLS, ACLS, and PALS to name a few this page should be Emergency Medical Services Medicellis (talk) 16:39, 22 July 2008 (UTC)
replies: text: I believe this discussion was originally to rename "emergency medical service" to "emergency medical services".  As far as capitalization, it should be lowercase.  Basically all acronyms are written in caps, but that does not mean the individual words should be in all caps.  I raised this issue recently at Talk:Emergency medical technician#Capitalization of article titles.  According to the WP:MOS, article titles should be in sentence case.  When writing out mid sentence, you would use lowercase, not uppercase.  This article is for "emergency medical services" - not "EMS" spelled out.  PALS and ATLS should be capitalized, since they are copyrighted programs.  However, ACLS and CPR should not be capitalized, since they are generic terms (like EMS/EMT).  --Scott Alter 21:27, 22 July 2008 (UTC)
thread_title: Discussion

message: It seems to me that play and run is no different from scoop and run. Although it is not explicitely mentioned, if a patient needs to be stabilized before moving, they usually are unless it is known they can be stabilized en route, or an ER/medic can be reached within a short period of time. This is particularly true of codes. Of course, perhaps there is a slight distinction between these two care strategies, but I don't think it is portrayed very strongly.Shaggorama 07:46, 5 January 2006 (UTC)
thread_title:  Play and run 

message: I think that we should include certain select subspecialties in this article. ie EMT-T (tactical medics), Fire-Medics, etc. At least the tactical medics for sure, since they are a unique and interesting branch of the EMS services.
:: the only thing about this is that while there are subspecialty certifications such as Wilderness EMT/P, Flight Paramedic-Certified, and EMT-Tactical, they are not recognized as a licensure level. They should have their own section in the article, seperate of levels of provider because of this. Someone may be a Flight Paramedic, but they are still required to act in accordance with their state's definition of a Paramedic - I.E. a PAramedic cannot just off of classroom perform a surgical airway in Tennessee, but can with special licensure and training every six months. Fire-Medic is NOT an additional certification, but rather a job description. The training for Firefighter only intersects with EMS in that NFPA requires that Firefighter 1s have AT LEAST Basic First Aid and CPR/AED Training, some states make them achieve First Responder. A Fire-Medic is a Paramedic or Firefighter that has been crosstrained in both EMS and Fire. Our job is to give a basic, World-Wide overview of EMS in this article. Maybe this would be better in the Emergency Medical Technician Article. 75.64.179.85 (talk) 04:44, 21 May 2008 (UTC)
replies: text: I agree, the whole point of this article is a generic, worldwide view.  That's the reason why the EMS by country pages have been established, to provide local specifics independent of the generic article.  All of the groups that you have referred to are of potential interest, and each deserves its own specific page, if you have the ambition to create them. One word of caution though; be careful about what you refer to each as...try to keep it to a generic description of the role, rather than jargon.  In a great many places, particularly worldwide, while the roles you are referring to may exist in some form, they are often not referred to by the titles that you are using.  In EMS, we tend to love our jargon and acronyms, and far too often, we develop an assumption that just because we do things a certain way at a local level, or call things by a certain title, that the rest of the world is exactly the same, and guess what?  It JUST ISN'T TRUE!!!  I work in an EMS system in a major metropolitan area in Canada, and we certainly have highly skilled and trained tactical medics (indeed, we had the first in our country), but we have NEVER used the term EMT-T!  In fact, most of the paramedics assigned to our Tactical Unit would probably object to being referred to as EMTs, period.  Emrgmgmtca (talk) 10:30, 12 September 2008 (UTC)
thread_title:  EMS Specialties 

message: In looking over this and other EMS related articles (consider ambulance, for example) I'm seeing a lot of information that is country-specific.  I also note that some articles are becoming lengthy, in part due to the inclusion of country-specific information, but fail to adequately cover common aspects of their subjects.  What do people think about culling the country-specific information from the EMS, EMT, ambulance &c articles and placing this info in country-specific emergency_medicine/ EMS/ title to-be-determined articles? --Badger151 17:01, 1 December 2006 (UTC)
replies: text: No one else seems to have any opinion on this one way or another, so, seeing as a month and a half has gone by without comment, I have moved large blocks of US-focussed info to Emergency Medical Services in the United States.  As time permits, I hope to move more info over, and produce a less US-centric article here. --Badger151 02:47, 26 January 2007 (UTC)
replies: text: Just come across this. Even now it is far too US-centric. If all such material is moved there will be nothing left! Clearly a major re-write is needed. I don't know about others, but I find this sort of thing most annoying. Much of this article has been written as though there is no world at all outside of the USA. Might it just have been better to rename this entire article and use it as a source for a new, non-country-specific article? Arcturus 20:39, 7 February 2007 (UTC)
replies: text: Yes, the US is the country that many love to hate. So much so that it's become fashionable to bash the US on so many talk pages. But it's getting to the point that it reminds me of the reductio ad hitlerum. This is the English Wikipedia, and more primary English speakers live in the US than all other countries combined, so of course there are many English speaking editors from the US. It would be helpful if you would either edit the parts you have a problem with, or offer some constructive criticism. The demonizing isn't helpful (on this or any other talk page). MoodyGroove 22:18, 7 February 2007 (UTC)
replies: text: Nobody is knocking America. It's the writing and editing that's the problem. The subject of this article is clearly relevant across the world but it's written as though it's only relevant to the US - that's bad writing and editing. I'm not knowledgeable enough about the subject to deal with the problem, but many of the editors of this article obviously are, and I would encourage them to do something about it. I think it's preferable not to have country-specific articles about topics such as this. Arcturus 22:46, 7 February 2007 (UTC)

text: EMS by country pages are currently being worked on.  They are being expanded from the existing stubs, and also provided with a standard format for ease of reference and comparison.  So far, I have completed Canada, France, Germany, Italy and Norway.  Have a look at the completed pages, and let me know what you think.  Future plans include U.K., U.S.A., Australia, South Africa, and Hong Kong to be done, and I will get to these as I have time.  Any help would be appreciated.  This will permit this existing page to become purely generic, with references and links to the information for specific locales.  For an example of what I am talking about, see the 'Paramedic' page.  By the way, my ultimate goal for that is to also have specific pages on paramedics, providing more detail for different countries.  In addition, I have created a page for CEN 1789, the European standard for ambulances, with links to the European EMS pages.  If someone were interested enough to put in the effort creating pages, and had sufficient knowledge, similar pages for the U.S. standard KKK-1822, and the Australian standard would be valuable additions.  The whole intent of this is to make this entire section a great deal less U.S.-centric than it currently is.  For the record, that is not about bashing the U.S. by any means; I am the first one to recognize that the majority of writers here are from the States, and that people typically write about what they know.  That leaves it to the rest of us, wherever we are, to supplement what our U.S. colleagues are writing with a more global perspective, ensuring that pages that should be generic are generic, and that information from other places and perspectives is also shared.  The result will be not just a GA rating for Emergency medical services, but a more comprehensive and professional approach to how we present ourselves, both among ourselves and to others.  Emrgmgmtca (talk) 12:16, 12 September 2008 (UTC)

text: I just came across this post after adding my own at the bottom ("Organization in different countries"). I'm from the US and I have to agree with the thoughts here about this page being uber-US-centric (if you permit me). There's an awful lot going on out there that should be mentioned. The problem is that the vast majority of what's being done on this page, despite noble efforts by those such as Emrgmgmtca, is High-income-country-centric - the only systems we're talking about are in developed countries, which is only 1/3 of the story. There's a whole lot going on in developing countries that's really fascinating, but I don't believe would fall into a formal EMS wikipage, though it is prehospital nonetheless. I have put together a database of International EMS Systems on my own non-profit's website, www.trekmedics.org/projects/diems/ but, as i described below, i'm having trouble finding a way to add this due to potential COI (all my country pages are written based off reputable *international* medical journals). Likewise, with the attention that Prehospital Care Systems are getting from WHO, it would be responsible to acknowledge these prehospital schemes (in the British sense) with their own space. I support Flying Doctor's notion to create a generic document - that's what i did. Unfortunately, I can offer nothing more than the model i put together, as i don't have the wikiwherewithal to do this myself (nor the time to figure it all out). I would also say that India is deserving of an entire page based on their noble, yet ultimately misguided and unsupported (or exclusionary) adventures into EMS. i.e., EMRI, 108, 1298, CATS etc. It would serve as a good reference for other developing countries ... in the same spirit as the PAHO book "EMS Systems Development: Lessons Learned from the USA for Developing Countries" TrekMedics 69.119.99.196 (talk) 02:24, 22 September 2010 (UTC)
thread_title:  EMS by country 

message: I edited the History section to include a link to The White Paper, as the article talks about "studies" in the 1960's but doesn't actually reference any.Yelruh 21:41, 3 September 2007 (UTC)
thread_title:  The White Paper 

message: References should not be towards specific agencies, so stop adding them.  Book references should be in the manner of the Chicago Manual of Style, please learn what that is.  Demantos (talk) 18:39, 18 November 2007 (UTC)
replies: text: Sorry, but i must disagree.  Before i say why, i suggest not being so rude with your comment.  Anyway, without those references, it becomes original research, strictly prohibited in WP:NOR and WP:V.  In terms of citation, i'm happy to use the cite template, and i generally use this in all articles i edit, so i've kept that in, i just missed that change first time round.  Wikipedia does not use the Chicago manual of style, it uses its own - WP:MOS.  There is no reason not to reference specific agencies when the citations seek to prove their existence!  Also, any third party website is 'specific' - why is an individual ambulance service not, in your opinion, worthy of a citation, whereas a governing body might be? Regards, Owain.davies (talk) 19:55, 18 November 2007 (UTC)
thread_title: References

message: Since it was submitted before I could finish the entry note, I added the term "prehospital" in "highest medical care" to clarify that the paramedic level is the highest level of prehospital care. Obviously (I hope, at least), the highest level of medical care is the physician level (specialty of Emergency Medicine in this case).  —Preceding unsigned comment added by 70.22.228.240 (talk) 03:43, 3 March 2008 (UTC)
replies: text: In most places in America, the Paramedic or Critical Care Paramedic is the HIGHEST level of Prehospital EMERGENCY care. WHile physicians are the highest level of care, they are not employed usually in a field response methodology due to the legal risks of this, as well as their limited effectiveness. (Most surgical or radiological interventions cannot be done in an Ambulance, expecially under movement). There are exceptions to this rule, such as Boston Fire (The Medical Director responds to major or complex incidents), or neonatal critical care transport (Most transports of less than 1000 grams are escorted by a Neonatologist or a Neonatal Nurse Practicioner). So this was technically correct. Although SMUR and certain Euro countries use Ambulance based MDs, this is not a very common practice. 75.64.179.85 (talk) 04:48, 21 May 2008 (UTC)
replies: text: So your problem with noting that paramedics are the highest level of prehospital care is, what, again? The only logical alternative is the scrap any mention of paramedics being the highest anything outside of highest level of EMT (using NHTSA levels). JPINFV (talk) 06:01, 21 May 2008 (UTC)
replies: text: This issue keeps arising.  I would respectfully suggest that we all try to remember that Wikipedia and its articles are not solely about the United States, and refrain from making statements that we pretty much KNOW already will only apply in the U.S..  The original unsigned contribution makes a valid point if you read it carefully; in that the physician is the highest level of medical care.  The whole thing goes off the rails when it, and subsequent posts, say that paramedics (of any type) are the highest level of anything, because that is simply not universally true; that statement ONLY works in the U.S..  Additionally, the comment by chancegemtiv about ambulance-based MDs not being 'a very common practice' is quite simply wrong.  Throughout France the role of paramedic is completely unknown and almost ALL (some Fire Service responses have ALS performed by a specially trained nurse, but these are quite limited) major emergency responses include the SMUR, which is physician-led in the field, all the time.  In the German-speaking parts of Europe (Germany, Austria, Switzerland) the response of a specially trained physician (Notarzt), occurs on almost all major emergencies.  In fact, in German speaking countries the Rettungsassistent, which is their version of a paramedic, is only permitted to practice ALS skills in the physical presence of the physician, except in cases of extreme emergency.  Emergency response by mobile physicians is, in fact, quite common in the majority of Europe, and not uncommon in the U.K..  We need to avoid making general statements as if they are universal truths, when in fact, they are only local, or regional, realities.  Emrgmgmtca (talk) 12:36, 12 September 2008 (UTC)
thread_title:  Change: "Prehospital" 

message: I am currently working on cleaning up the categorization of articles in :Category:Prehospital care.  Additionally, I have proposed renaming :Category:Prehospital care to :Category:Emergency medical services (as a more accurate, well known name to parallel :Category:Firefighting, :Category:Law enforcement, and :Category:Rescue).  If you have an opinion on the renaming of this category, please make a comment at Wikipedia:Categories for discussion/Log/2008 April 3#Category:Prehospital care.  So far, there has been very little interest this category one way or the other.  --Scott Alter 11:25, 4 April 2008 (UTC)
thread_title:  "Prehospital care" category 

message: * Support I believe that Organization of emergency medical assistance needs to be re-organized and SELECT parts of the page be transferred over.  The page is written on a soapbox and has little if NO evidence (no cites or references) supporting most of the article and really has no EMS DOT theory behind it. Please discuss your opinions. Thanks! Medicellis (talk) 15:44, 29 June 2008 (UTC)
thread_title: Merge Proposal

message: * Article merged: See old talk-page Talk:Organization of emergency medical assistance
* Per Wikipedia:Articles_for_deletion/Organization_of_emergency_medical_assistance select parts of the page were merged into this article.  These sections are in need of reference espeically the "stay and play" and "load and go".  I merged some of the other countries info, but this might be better merged into the specific EMS pages by countries, as I verify the information and I will move/merge the information as appropriate. Medicellis (talk) 23:12, 21 July 2008 (UTC)
thread_title: Merge of [[Organization of emergency medical assistance]]

message: We have selected this article as Wikipedia talk:WikiProject Medicine/Emergency medicine and EMS task force good article drive.  We feel this article is of the utmost importance and would like to spear head a drive!  We hope we can have a good collaborative effort, appreciate any help editors can give. Medicellis (talk) 20:15, 5 August 2008 (UTC)
replies: text: Happy to help with this! I'll try and get soime time later in the week, or maybe next week. OwainDavies (about)(talk) edited at 17:58, 6 August 2008 (UTC)
thread_title: Good Article (GA) drive

message: Something to add to this article, either under "First responder", or separately, is the difference between road-based and wilderness first responders.  The logistics are so different.  Ordinary first responder training involves patient assessment, use of equipment, and preparation for transport.  Wilderness first responder also has patient assessment, but then stresses improvization.  The available equipment may be limited, and transport by stretcher and ambulance may be days out of reach. --Una Smith (talk) 14:53, 6 August 2008 (UTC)
replies: text: Agreed, I will be adding a Wilderness EMT and 1st responder into the section, as there are a important part of EMS not mentioned.  If you have experience and want to expand please do
* Wilderness Emergency Medical Technician
* Wilderness First Responder
Medicellis (talk) 02:05, 7 August 2008 (UTC)
thread_title:  First responder 

message: The article currently confuses emergency ("emergent") and urgent medical care.  One short hand is for the difference is this: emergent = call 911, urgent = call or visit doctor today. --Una Smith (talk) 14:58, 6 August 2008 (UTC)
replies: text: I'm not convinced that patients know the difference!  Certainly in some countries, ambulances and EMS are regularly used for urgent (not emergency) conditions.  Loads of news stories for cites on that too, OwainDavies (about)(talk) edited at 17:59, 6 August 2008 (UTC)
replies: text: Confusion may be widespread but that does not justify its continuation here;  disambiguation is part of the job of an encyclopedia.  Some large metropolitan areas support multiple "ambulance" services that perform only non-emergency, non-urgent, scheduled transport of patients, often between hospitals and homes. --Una Smith (talk) 19:00, 6 August 2008 (UTC)
replies: text: Often these services are conducted by what is called "medi-van" or "medivan", these services are usually a 3rd party private agency usually not associated with emergency medical services.  Some private ambulance agency do provide this medi-van service but in complete different vehicles and are scheduled tranports.  But I in most cases this type of service is not considered EMS, in anyway shape or form, they provide no care and on the contrary if the patient cannot adjust there own oxygen the medi-van cannot transport that person.  I would consider all medi-can transport non-urgent or non-emergent transports.  If a ambulance is called it is considered emergent (as in 911) or urgent (as when called by a walk-in medical center). Medicellis (talk) 21:02, 6 August 2008 (UTC)
replies: text: With all that being appreciated, I don't see many references to it in the article, and the fact remains that in some countries, like the UK, the ambulance services also perform the vast majority of the urgent transfer work - deploying front line crews to do so, so we can't ignroe it entirely.  OwainDavies (about)(talk) edited at 08:10, 7 August 2008 (UTC)
thread_title:  Emergent vs urgent 

message: The article content should be moved to Emergency medical service (singular of the current title), which now is a redirect here. --Una Smith (talk) 15:02, 6 August 2008 (UTC)
replies: text: Oppose - There is an original discussion on this at the start of the talk page.  Personally I think that services reads better, because we are covering EMS worldwide (i.e. many systems), rather than just one system - doesn't make grammatical sense to be service in the singular. OwainDavies (about)(talk) edited at 18:01, 6 August 2008 (UTC)
thread_title:  Article title 

message: I appreciate that citations are important, and i have spent a lot of time on WP adding them, but i think that there may be too many citation tags on this article.  Citations are only for statements which are liekly to be challenged, and may not be common knowledge to someone with a grasp of the subject.  Specifically, cite requests, such as on the first paragraph, where one is requested for stating that EMS is invovled with treatment and transport of patients in an emergency.  I can't imagine that isn't common knowledge to anyone with a passing knowledge of the subject, or even to 90% of the world's population?  I didn't want to remove the tags without raising it first, so i would appreciate opinions.
More info on WP:CITE and Wikipedia:When to cite
Any thoughts? OwainDavies (about)(talk) edited at 12:14, 7 August 2008 (UTC)
replies: text: Aye, I agree I went a little over board on adding the cite tags.  I will remove some, please during the GA drive make changes you feel need to be done like this as it helps with move the article forward, thanks for being WP:NICE and posting on here first! Medicellis (talk) 13:57, 7 August 2008 (UTC)
replies: text: I agree.  I've seen entire Doctoral dissertations with as few as 20 citations, and this article has nearly 70!!!  Furthermore, I just got finished attempting to validate them all, and there are ten or so that no longer work!  I'm not sure whether that's misunderstanding the purpose of citations, or simple insecurity on the part of some of the writers...to be honest, when you see the way some run around waving 'qualifications' or certification levels, I frankly wonder whether it might be the latter in some cases.  "Well...you're just an EMT-B and I'm an EMT-I 6 and 7/8s (whatever THAT is!)."  In some cases it feels like a sort of classism among ourselves, but I think that more often it is simple insecurity. It almost seems in some cases as if they feel that they have to cite every single statement that they make, and sometimes the citations used are a little weak.  To illustrate, if I were marking this article as a student paper, I would be more than willing to accept that EMS systems go by a variety of names without proof being provided, but here we have one citation for each type of name, and those don't provide descriptions of the title choice, they simply link to an organization's website, which generally doesn't explain why it is called what it is. 
Emrgmgmtca (talk) 17:11, 12 September 2008 (UTC)
thread_title:  Too much on the citations? 

message: I would like opinions on wither we should add back in EMS in different countries with short paragraphs, or keep the section the way it is? Medicellis (talk) 14:29, 7 August 2008 (UTC)
replies: text: Having seen both, I've always favoured just having the wikilinks in that section (although they ought to be to 'Emergency medical services in ***' rather than 'paramedics in ***' - actually i might fix that in a minute), because it makes the page more understandable.  This doesn't stop the use of examples throughout the main article, although they should clearly be examples, not given as worldwide fact. OwainDavies (about)(talk) edited at 07:25, 8 August 2008 (UTC)
replies: text: I agree with Owain, and that's the process that I've started.  Frankly, there's nothing wrong with a fairly decent overview of the similarities and differences between systems in different parts of the world.  It allows the main article to remain generic, focused, and uncluttered, but permits the reader to find appropriate information on specific locales and systems when they want it.  Owain, the same thing could, and probably should, be done for the Paramedic article eventually.  There are enough differences in training, certification and permitted procedures from one place to the next to justify it.  It's also a good way to include the 'sub-specialties' such as Wilderness, Flight, Tactical, etc., without the generic article becoming cluttered and beginning to run off on tangents all over the place.  I'm thinking of it in terms of a cascading effect; read the generic, then compare countries, if you want that much information move on to specific services and systems.  Or read the generic "Paramedic", then compare Canadian and British or South African, then look at sub specialties if you need to.  To me, it makes sense, but I'd welcome both your thoughts.  Emrgmgmtca (talk) 17:22, 12 September 2008 (UTC)
thread_title: See also section

message: Owain, great work so far on helping me with the GA drive! It seems myself and you are the only two interested in improving this article and Im glad I have someone to help!.  In regards to the pic, I love it but there is a typo.  The caption built into the picture - Healing is spelled wrong.  It is a easy fix with the pic and since you developed it prob is easier for you to change it with your edit program.  Again thanks for all your hard work and help!! Cheers - Medicellis (talk) 18:36, 10 August 2008 (UTC)
replies: text: Done!  Poor proof checking i'm afraid! OwainDavies (about)(talk) edited at 20:04, 10 August 2008 (UTC)
thread_title: Star of life pic typo

message: Please vote to keep/delete or rewrite the section, It has WP:N and WP:V but very little.  I say we re-name the section and have a complete re-write to make it complaint for a GA.
re-name and re-write Medicellis (talk) 21:33, 10 August 2008 (UTC)
replies: text: Definitely rename - frontier is very US/canada centric.  Don't know all that much about the subject, but I can see why some of the considerations are different. OwainDavies (about)(talk) edited at 05:32, 11 August 2008 (UTC)
replies: text: What's the matter Owain?  Can't visualize "Frontier" medics in the Netherlands???  Have you lot in the European Union run out of frontier???  Just Kidding!!!  We don't use the term in Canada, either...that one is a pure Americanism.  From my point of view, if they want inclusion, fine...but make it a separate, linked page, as I am proposing for the rest of the subspecialties.  Emrgmgmtca (talk) 17:27, 12 September 2008 (UTC)
thread_title: Vote on Rural/Frontier EMS  [[WP:GAEMS#Rural]]

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thread_title: Image copyright problem with File:CCEMTP.png

message: I'm new to editing wikipages, so i'm looking for a little guidance. I'd like to add an external link to "The DIEMS Project - the Database for International EMS Systems" www.trekmedics.org/projects/diems/
At first, i wanted to add it beneath the last country listed, but then i got the feeling that it might technically belong as an External Link.
However, after continuing to read about the guidelines, i am suspicious that there could be problems with this, possibly regarding accusations of COI: the website belongs to a non-profit organization, Trek Medics International, which I run. However, aside from the field work we do, I have also begun compiling information on as many international EMS systems as i can find into a database (26 countries and counting) which is all supported by referenced material from reputable medical journals (we will not post anything unless it can be cited).
However, because the source page is a part of my non-profit's website, I suspect there might be some potential to be accused of COI, even though I aspire to do nothing but make this database available to as many people as possible for educational purposes (there are no ads or any other fundraising efforts included in this database).
Please advise how (if) i may go about adding this valuable educational resource to the page.
Thanks 
TrekMedics (talk) 17:46, 21 September 2010 (UTC)
replies: text: If anywhere, it would go in external links.  It makes a good start as a reporting site, but there are a lot of gaps, and citations are not generally in line, so we only have your word for the reliability (no offence intended!).  As a general rule, under WP:SPS, this sort of self-published material is not usually permitted.  I think a better contribution for WP would be to add some of this information in to the relevant articles here along with the inline citations that open it up for checking by other editors.  I hope that is helpful, and that you can contribute some of this knowledge to wikipedia.  OwainDavies (about)(talk) edited at 20:20, 21 September 2010 (UTC)
thread_title: Organization in different countries

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thread_title: File:Garda victim.jpg Nominated for speedy Deletion

message: EMJ doi:10.1136/emermed-2012-202146 JFW | T@lk 14:52, 17 April 2014 (UTC)
thread_title:  Who calls often? 

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thread_title:  External links modified 

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thread_title:  External links modified