The practice of prehospital emergency medical care is a young profession by most standards. The modern day model of emergency medical services (EMS) is often traced back to its origin in the mid-1960’s with specialized equipment, trained emergency care providers, and recognition as a discipline within the profession of healthcare. Throughout its evolution, numerous changes have taken place in an effort to adapt and maximize its effectiveness in emergency prehospital care. One of the most significant changes is the creation of multiple levels of EMS provider credentials – including levels that are intermediary between basic and advanced life support providers.
To date, there has been no empirical determination as to the effectiveness or utility of each of these EMS provider credentials. Their acceptance and endorsement has been largely substantiated by presumptive and intuitive reasoning that higher levels of training equate to greater effectiveness and usefulness. This dissertation research represents an initial, exploratory endeavor to examine the perceptions among emergency physicians across the country as to the effectiveness and usefulness of the varying EMS credentials, in general and under select circumstances, and serves as a foundation for additional, outcomes-based inquiry.
Through survey instruments and semi-structured interviews, a sampling of EMS physicians from across the nation provided data to inform questions focused on determining perceived effectiveness and utility of these EMS credentials. Analysis of the findings enabled conclusions to be drawn that paramedics are strongly preferred over emergency medical technicians (EMTs) and EMT-Intermediates in most emergency situations; that in austere settings, intermediary EMS providers may provide a significant level of utility; that the credentialing process for EMS providers should be standardized nationally; and that additional studies are necessary to direct any future policy changes.
|Advisor:||Newcomer, Kathyrn E.|
|Commitee:||Infeld, Donna L., Johnson, Jean E., Levi, Jeffrey, Regenstein, Marsha|
|School:||The George Washington University|
|Department:||Public Policy and Public Administration|
|School Location:||United States -- District of Columbia|
|Source:||DAI-A 71/07, Dissertation Abstracts International|
|Subjects:||Public policy, Health care management|
|Keywords:||Credentials, EMS, Effectiveness, Emergency medical services, Paramedics, Prehospital, Utility|
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