IT is Friday afternoon and you are driving home. You witness an accident. The female driver stumbles from the car and collapses.

While watching a football game you observe an older gentleman. He looks unwell. As you go over to him he slides to the ground seemingly unconscious.

A child in your care suddenly becomes short of breath during football training. What would you do in these situations?

Emergency Medical Services (EMS) refer to care of the ill and injured patient in the pre-hospital setting prior to arrival at hospital for definitive care. Such care is usually rendered by Medical First Responders (MFRs), Emergency Medical Technicians (EMTs) and paramedics with support from physicians who may be physically present or may co-ordinate the patients care through written protocols and direct radio communication, depending on the nature and severity of the illness.

A career in EMS is quite rewarding. Since 1996 the University Hospital of the West Indies has been training MFRs and EMTs through its Pre-Hospital Emergency Medical Services Programme (PHEMS). These courses are relatively short in duration and allow acquisition of the skills necessary to properly stabilise and transport a patient to the emergency room for further care.

Persons who have these skills are able to find employment with private or public ambulance services, the Jamaica Fire Brigade, the Jamaica Constabulary Force and the Jamaica Defence force. Several public and private corporate entities such as Jamalco, Red Stripe, Norman Manley International Airport and Airports Authority of Jamaica, train individuals in order to ensure that in the event of an emergency their staff are able to respond appropriately.

The acquisition of first responder skills within the community is to be encouraged, as this will create a society that is well prepared to address medical issues arising within the community. Not many persons are trained as paramedics in Jamaica, however it is anticipated that this training will soon be available locally.

At present, the local emergency medical services are inadequate to meet the needs of the population as a whole. Consequently the average individual cannot access an ambulance and people continue to rely on private transportation, the assistance of the police to get to hospital or private ambulance companies if they can afford this.

In doing so they may be denied important potentially life-saving interventions or even suffer worsening of their injuries/illness. Well-meaning persons may do more harm than good. An example of this is the person in a motor vehicle accident whose spinal cord injury is made worse when they are transported to hospital by onlookers without proper immobilisation of the spine, and have a worsening of their injury as a result.

If this is to change then we must have well-trained first responders in our communities and well-trained EMTs staffing ambulances which are available and accessible to all.

Persons who are well-suited to EMS are caring, practical individuals who enjoy a hands on career, and are in good physical shape. To enrol in an EMT training course you should be 18 years or older and have three subjects at the CSEC/GCE O’level. Many persons were trained previously but need to re-certify. Other courses are available for first responders. If you are interested in further information on courses call PHEMS at 368-8706 or email us at phemsuwi@gmail.com. A career in EMS could be yours. The time is now!

Dr Simone French is director, PHEMS and a consultant emergency physician.