Academic journal article Homeland Security Affairs

EMS and Homeland Security

Academic journal article Homeland Security Affairs

EMS and Homeland Security

Article excerpt


Emergency Medical Services (EMS) plays a vital role in the United States in responding to medical emergencies and transporting patients. While a relatively young profession, EMS, with law enforcement and the fire service, constitute one third of the routine 911 emergency response system. The out-of-hospital treatment and transport of patients, a function performed by EMS, is a primary function required at almost every disaster. While the response-phase contribution of EMS is understood, EMS has can make significant, unique, critically important contributions to the prevention, mitigation, and recovery phases of the homeland security cycle.

EMS personnel can be trained to function as intelligence sensors to identify suspicious indicators of terrorism and to report those indicators to intelligence fusion centers. EMS personnel can also provide medical intelligence within fusion centers to help those centers better understand the significance of clinically related tips, leads, and indicators. EMS personnel can also develop and disseminate medical intelligence briefs, which inform EMS, fire, law and other responders of medically based threats to their health and safety. This is an important component of comprehensive force protection and has been used by the United States and foreign military for decades. EMS must lead development of multi-disciplinary mass casualty response plans and other emergency medical related planning and exercising. At the county, regional, or state level, EMS must form networks of ambulance strike teams to respond to areas devastated by catastrophic events. Finally, EMS data can be used to augment and enhance current syndromic surveillance systems to provide earlier warning of a pandemic or terrorist incident.


EMS has existed in its modern form since the early 1970s. It is a young and dynamic profession. While most people recognize EMS as a fire engine or ambulance responding to an emergency call, EMS also includes using paramedics to provide support to primary medical care in communities, and transporting ill or injured patients between medical facilities. EMS is provided by municipal and county-based providers, fire based systems, private providers, and hospital based systems. EMS personnel are paid and volunteer. These various delivery systems have complicated the maturation of EMS, because each delivery system has a slightly different perspective of the optimal EMS system; some have adapted EMS to better suit their core mission. These divisions have resulted in inconsistent lobbying efforts at local, state, and federal levels.[1] As a consequence, the federal government has not designated a lead agency for EMS, set standards for EMS performance in the homeland security mission, provided adequate funding to EMS (less than 4 percent of HHS and DHS grant funding has been dedicated to EMS), nor provided adequate homeland security related training for EMS personnel.[2]

The Core Mission of EMS

Most EMS agencies and personnel are very clear about what their core mission is from day to day. Even with a diverse set of agencies providing EMS services, what is provided falls within a fairly recognizable scope. EMS responds to, treats, and transports patients who are ill and injured. EMS occasionally responds to mass casualty incidents and also occasionally to unusual calls such as hazardous materials. EMS also provides ground and air transport over long distances and generally provides a form of social services in the field when no other agencies are indicated or available. This common ground could be the basis of forming a cohesive scope of practice within homeland security that could be applied to all EMS agencies regardless of what delivery model is used. Delivery methods of EMS vary mainly because local needs are different; however a universal approach to homeland security issues could easily be applied to all of the divergent agencies to create a powerful extension of the homeland security enterprise. …

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