Emergency Medical Services, more commonly known as EMS, is a system that provides emergency medical care. Once it is activated by an incident that causes serious illness or injury, the focus of EMS is emergency medical care of the patient(s).
EMS is most easily recognized when emergency vehicles or helicopters are seen responding to emergency incidents. But EMS is much more than a ride to the hospital. It is a system of coordinated response and emergency medical care, involving multiple people and agencies. A comprehensive EMS system is ready every day for every kind of emergency.
EMS is an intricate system, and each component of this system has an essential role to perform as part of a coordinated and seamless system of emergency medical care. Here in Maine, EMS clinicians are more than what is seen "in the movies" (and EMS is rarely like what is on TV!). In fact, EMS is less about "emergency" and more about "medical service".
EMS clinicians in Maine perform many of these roles (and more!):
- Traditional 911 response on ambulances
- Interfacility transport - many local hospitals may need to move patients to larger hospitals for more advanced care. Managing multiple IV drips, medication dosing, ventilators, and other critical care interventions are daily occurrences.
- Designing and delivering educational programs at colleges and training centers throughout the state.
- Teaching CPR and Stop the Bleed courses.
- Providing community paramedicine care, with medication reconciliation, blood draws, and overall wellbeing checks.
- Setting up, running and administering medications at vaccine clinics.
- Using their education to staff urgent care centers, and emergency departments throughout Maine.
- Developing disaster plans and medical preparedness guidelines.
- And a million and one other activities.
An EMS system comprises all of the following components:
EMS Response
- Who provides EMS and finances the services, varies significantly from community to community. Prehospital services can be based in a fire department, a hospital, an independent government agency, a non-profit corporation, or be provided for by commercial for-profit companies. Nearly 300,000 EMS calls occur every year in Maine.
- As of January, 2021, Maine has over 276 licensed EMS services. They include:
- 173 Fire Departments
- 41 Non-Profit Community EMS Services
- 35 Independent Municipal EMS Services
- 11 Private EMS Services
- 11 Hospital-based EMS Services
- 3 College-based EMS Services
- 2 Tribal EMS Services
- As of January, 2021, Maine has over 276 licensed EMS services. They include:
Emergency Medical Dispatch (visit our EMD page)
- Calling 911 is often a person's first encounter with EMS. When a 911 call is placed, it is answered at a Public Safety Answering Point (PSAP). When needed, specially trained dispatchers provide emergency medical instructions to the caller. This is provided by Emergency Medical Dispatchers (EMD). Nearly three quarters of a million emergency calls are placed every year in Maine.
- As of January, 2021, Maine has
- 413 licensed EMD providers
- 29 licensed Emergency Medical Dispatch Centers
- 24 Public Safety Answering Points
- As of January, 2021, Maine has
Ambulances, firetrucks, police cars and helicopters
- Maine EMS licenses a variety of vehicles, however different vehicles may respond to a 911 call. This varies in every community. In some cases, communities use other public safety resources to provide a quicker and safer response to the emergency. Communities might use, as example:
- A firetruck with additional EMS clinicians for care or to assist with carrying a patient. Firetrucks also bring extrication equipment ("jaws of life") and other tools.
- A police car for additional EMS clinicians (yes, many of our police officers are EMS clinicians as well, and some bring an AED as well) as well as safety, traffic control and other reporting requirements.
- A first response vehicle, such as a pick-up truck or SUV, with EMS clinicians and supplies on board.
- Private vehicles. Many volunteer agencies have EMS clinicians who respond directly from home and they may park their car on your street or nearby.
- Helicopters. Maine EMS has one licensed air service (Lifeflight of Maine) and although they will probably not land in your backyard, an ambulance may transport you to a landing area for faster transport depending upon your location and condition. Lifeflight also transports many patients from one hospital to another.
Hospitals, trauma centers, and specialty care centers
- EMS clinicians generally transport people to the hospital of their choice, which is usually the closest hospital. In a 911 setting, EMS uses a set of protocols to guide their care, and use this with other factors, such as weather, severity of illness/injury, and local resources to determine the hospital to go to. EMS may not be able to go your preferred hospital, but will make every attempt to.
- In terms of 911 transports, Maine has:
- 33 Hospital Emergency Departments with in-patient capabilities
- 2 Hospital-based free standing Emergency Departments
- 2 Maine EMS approved alternate EMS destinations
- Ability to transport to nearby out-of-state hospitals in New Hampshire
- In terms of 911 transports, Maine has:
- In some cases, patients need to be moved from one hospital to another. This may be done for a variety of reasons, but often is to obtain greater depth of care at a larger hospital. This is called an interfacility transport. Not all EMS organizations in Maine perform these transports, and hospitals may use private EMS services to perform this transport. These may be scheduled, or emergent, based on the condition of the patient. Generally, the transport will be to another Maine hospital, but transports can occur to other states (Massachusetts, New Hampshire and Connecticut are most common, but transports to New York, Maryland, Ohio and other states do occur. Occasionally, Maine services even transport to and from Canada).
- Maine has a trauma system of care for people injured throughout the state. Based on protocols and severity, location, weather and other factors, traumatically injured patients may go to a trauma center or to one of many trauma participating hospitals.
- Maine has:
- 3 trauma centers
- Central Maine Medical Center, Lewiston
- Maine Medical Center, Portland
- Northern Light Eastern Maine Medical Center, Bangor
- 32 trauma participating hospitals
- 3 trauma centers
- Maine has:
Who is on an ambulance?
- Maine law requires at least one EMT on ambulances, and many staff to the paramedic level (but not always). Response to emergencies are done by highly trained professionals licensed at one of four levels:
- As of January, 2021, Maine has 5,063 volunteer and career licensed EMS personnel
- 85 Emergency Medical Responders (EMRs)
- 2,631 Emergency Medical Technicians (EMTs)
- 878 Advanced Emergency Medical Technicians (AEMTs)
- 1,469 Paramedics
- Although not licensed by Maine EMS, some EMS services also use a number of people as vehicle operators to drive safely to the scene and to the hospital.
- As of January, 2021, Maine has 5,063 volunteer and career licensed EMS personnel
Who else is part of the EMS system?
- Physicians, nurses, and others
- Maine EMS care is overseen by the Maine EMS Medical Direction & Practices Board (MDPB). This board determines evidence-based protocols that guide care for all EMS providers. Maine uses state-wide protocols (not all states do), so EMS is consistent whether you are in Portland or Fort Kent.
- Maine EMS has three physicians contracted with the state (A state medical director, an associate state medical director and a pediatric medical director).
- Maine EMS is divided into six EMS regions and each region has a physician medical director.
- Many Maine EMS services also have a medical director affiliated with their service directly. Effective January 1, 2022, all services providing care at the AEMT or Paramedic level will be required to have a medical director.
- Administrators and government officials
- The Maine EMS system is overseen by the Maine EMS Board and the Bureau of EMS, based in the Department of Public Safety.
- An informed public that knows what to do in a medical emergency. We encourage you to:
- Learn CPR (Youtube) (1 minute video)
- Learn to Stop the Bleed (Youtube) (6 minute video)
- Become an EMS professional
SAVE A LIFE - LEARN CPR!
STOP THE BLEED
EMS does not exist in isolation, but is
integrated with other services and systems intended to maintain and enhance the community's health and safety. As seen in the graphic below, EMS operates at the crossroads between health care, public health and public safety.