EMS World

SEP 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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14 SEPTEMBER 2018 | EMSWORLD.com W ales is one of the four coun- tries that comprise the United Kingdom. A proud Celtic nation with a distinct heri- tage and cultural identity, Wales is in many parts sparsely populated, with large areas of beautiful but rugged terrain including two mountain ranges and three national parks. Wales even has its own language, which is spoken by 20% of the population and is the first language in parts of northwest and western Wales. At 8,000 square miles, Wales is a fraction bigger than Massachusetts. Its population of 3.1 million is served by a single ambulance service: the Welsh Ambulance Service Trust (WAST). This is a huge service by U.S. stan- dards (the U.S. has around 15,000 services providing emergency responses to a popula- tion of around 326 million—22,000 people per service) but not unusual in the U.K., which has just 14 ambulance services within a 9-9-9 system that serves a population of 66 million. WAST is a medium-size ambulance service in U.K. terms. In Wales like the rest of the U.K., healthcare is provided on a universal-coverage basis by the National Health Service (NHS), funded via taxation and free at the point of use. This includes EMS: 9-9-9 ambulance services are free for all who need them. Welsh EMS: A History The development of EMS in Wales mir- rors the rest of the U.K. From ad hoc local arrangements (e.g., 200 years ago, a horse and cart were used to transport injured slate miners in Bangor, although later in the 19th century, hospitals were built right up in the slate quarries) ambulance services became the responsibility of local medi- cal boards or the police. Later in the 20th century, ambulances were built by Daim- ler on a concrete floor for improved weight and stability, and if the doctor deemed an ambulance essential, the local mechanic would be summoned to drive the patient to the hospital. With the creation of the welfare state after WWII, provision of ambulance services became the responsibility of local authori- ties (i.e., town/regional councils) in 1948, then transferred to the auspices of the NHS in 1974. At that point Wales had five separate regional ambulance services. These were amalgam- ated to a single service 20 years ago. The clinical capability of EMS in Wales has steadily increased. From 1948–1974, local authorities provided only transport and basic first-aid capability. Post-1974, once EMS was brought into the NHS, clinical training and competencies were boosted by the so- In Wales, Honesty Is the Best Policy A new response model prioritizes the right help over help that's just fast By Linda Dykes, MBBS (Hons.) EMS AROUND THE WORLD A mid-1980s MVA. Photo: Carey Jones Featured speaker at EMS World Expo, Oct. 29-Nov. 2, 2018, Nashville, TN emsworldexpo.com

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