International EMS systems in South Africa: past, present, and future

• Published in: Resuscitation Vol. 64; no. 2; pp. 145 - 148
• Main Authors: MacFarlane, Campbell, Loggerenberg, Charl van, Kloeck, Walter
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.02.2005; Elsevier
• Subjects: Ambulance response times; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Diseases caused by trematodes; Emergency and intensive care: techniques, logistics; Emergency departments; Emergency Medical Service Communication Systems - organization & administration; Emergency Medical Services - organization & administration; Emergency Medical Services - trends; Emergency Medical Technicians - education; Emergency medicine; Emergency Medicine - education; Emergency Nursing - organization & administration; Emergency Service, Hospital - organization & administration; Emergency training; EMS; Helminthic diseases; Humans; Infectious diseases; Intensive care medicine; Intensive care unit. Emergency transport systems. Emergency, hospital ward; Medical sciences; Medical Staff, Hospital - organization & administration; Parasitic diseases; Pre-hospital care; Schistosomiases; South Africa; South Africa; Africa; Emergency departments; EMS; Ambulance response times; Pre-hospital care; Emergency training; Emergency medicine; Intensive care; Emergency department; Ambulance; Emergency; Resuscitation
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2004.11.003

Emergency medical services (EMS) in South Africa have developed rapidly over the last 20 years. However, there is inequitable distribution of services, with many rural areas being poorly resourced. This is partly as a result of the historical inequalities prevalent in the South African society of the past; efforts are being made to address this. EMS training is provided at basic, intermediate and advanced levels. The advanced level of training is comparable with the best in the world. Emergency care practitioners are registered with the Health Professions Council of South Africa and are thereby subject to the regulations, scope of practice and disciplinary structures of the council. Response times vary from 15 min in sophisticated urban systems to 40 min or longer in some rural services. Emergency departments (ED) are very busy, usually overloaded with patients, often poorly resourced and are similar to “Casualty Departments” that existed in the UK in the past. Facilities, staff and equipment are variable, and until recently there has been no formal career structure for emergency doctors. The introduction of emergency medicine as a new full speciality in 2004 will transform emergency care in Southern Africa, and appropriate training programmes are already being developed, together with progressive upgrading of emergency departments. EMS personnel face a vast spectrum of clinical cases, particularly all forms of trauma. Recent improvements in organisation, education and resources, coupled with better distribution of services, upgraded emergency departments and the development of emergency medicine as a speciality, should provide a significant boost for emergency care for the community.