EMS

Introduction

Emergency medical services (EMS) has evolved over time from ambulances transporting patients to a hospital to a system in which actual medical care is provided on scene and during transport to a hospital. This is usually referred to as pre-hospital care. A local EMS service can have many names such as a rescue squad, FAST squad, ambulance corps, life squad, or ambulance service.

The EMS pages are intended to show where each municipality in the six New England States get their EMS services and the trauma centers (hospitals) in each of the New England States.

Hospitals by State

Many hospitals have an emergency room to deal with various types of injuries someone may experience. But, these same hospitals may not be equipped to help if someone is severely injured. As a result, the American College of Surgeons Committee on Trauma has come up with terminology that indicates what a hospital is capable of providing on an emergency care basis. This committee refers to hospitals as trauma centers and classifies them into one of five levels: Level I to Level IV and unspecfied. A Level I trauma center is the highest possible ranking and provides the highest level of trauma care while Level IV trauma centers provide initial trauma care and then transfer the patient to another hospital providing a higher level of trauma care if necessary. Unspecified means that the hospital has not applied for a designation – it does not mean that the hospital is incapable of providing trauma care.

The following lists each hospital in each New England State by trauma level.

New Hampshire

The State implemented a new trauma plan in 2010. This new plan is fairly closely aligned with that recommended by the American College of Surgeons with some modifications to better suit the specific needs and resources of New Hampshire. As a result, some of the hospitals now have a lower trauma level. This is not due to a reduction in the ability of these hospitals to provide trauma care, rather the qualifications to become a level I, II or III have increased. For example, the new trauma plan places considerable emphasis on the development and utilization of a trauma specific Performance Improvement and Patient Safety (PIPS) program within each hospital.

Level 1 Trauma

Level 2 Trauma

Level 3 Trauma

Level 4 Trauma

New Hampshire

The State implemented a new trauma plan in 2010. This new plan is fairly closely aligned with that recommended by the American College of Surgeons with some modifications to better suit the specific needs and resources of New Hampshire. As a result, some of the hospitals now have a lower trauma level. This is not due to a reduction in the ability of these hospitals to provide trauma care, rather the qualifications to become a level I, II or III have increased. For example, the new trauma plan places considerable emphasis on the development and utilization of a trauma specific Performance Improvement and Patient Safety (PIPS) program within each hospital.

Level 1 Trauma

Level 2 Trauma

Level 3 Trauma

Level 4 Trauma

Ambulance

The subject of providing a publicly funded ambulance service or using a private ambulance company has been the subject of much discussion lately. Milford voters were asked to choose between public or private ambulance service in the Spring of 2005. Bedford selectmen looked into using a private ambulance service in late 2004 until they found out it would not reduce the headcount in the fire department.

The following document tries to show how ambulance services are provided by the different municipalities in all the New England States. Rhode Island municipalities mostly rely on their fire departments to provide emergency ambulance service. Vermont municipalities rely more on non-profit ambulance services. Maine, on the other hand, relies more heavily on the local hospitals than any of the other New England States.