Comparison of emergency medical services systems in the pan-Asian resuscitation outcomes study countries: Report from a literature review and survey

Abstract

Objective: Asia-Pacific countries have unique prehospital emergency care or emergency medical services (EMS) systems, which are different from European or Anglo-American models. We aimed to compare the EMS systems of eight Asia-Pacific countries/regions as part of the Pan Asian Resuscitation Outcomes Study (PAROS), to provide a basis for future comparative studies across systems of care.

Methods: In the first phase, a systematic literature review of EMS system within the eight PAROS countries/regions of interest was conducted. In the second phase, PAROS site directors were surveyed for additional information about the demographics and characteristics of EMS services at their sites.

Results: The database and bibliography search identified 25 eligible articles. The survey of EMS systems was completed by seven PAROS directors. By combining information sources from phases 1 and 2, we found that all PAROS EMS systems were single-tiered, and most were public (vs private) and fire-based (Thailand, Malaysia, Singapore, Taiwan, Japan, Korea). Ambulance personnel were primarily emergency medical technicians and paramedics, except for Thailand and Turkey, whose personnel include nurses and physicians. Personnel were trained to use automated external defibrillators and have basic cardiac life support certification. The service capability of each EMS system in terms of dispatch, airway management and medications, for example, varied greatly.

Conclusion: We found variation in the EMS systems across the eight Asia-Pacific countries/regions studied. The findings will inform the construction of a multinational Asia-Pacific research network for future comparative studies and could serve as a model for international research networks.