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Ambulance services operating on a private/for profit basis have a long history in the U.S. Often, particularly in smaller communities, ambulance service was seen by the community as a lower priority than police or fire services, and certainly nothing that should require public funding.
Each county developing an EMS system must designate a local EMS agency (LEMSA) which can be the county health department, an agency established and operated by the county, an entity with which the county contracts for the purposes of EMS administration or a joint powers agency. There are 34 single-county or multi-county local EMS agencies.
Emergency Medical Responder (Not recognized by the Arkansas Department of Health, certification issued by local EMS Authorities and/or the Arkansas Fire Training Academy) [5] Emergency Medical Technician (EMT) [6] Advanced Emergency Medical Technician (AEMT) [6] Paramedic [6] Community Paramedic [5]
The new policy allows county Emergency Medical Service workers to leave stable patients in the hospital staff’s care after the ambulance arrives, even if a bed is not ready for the patient.
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In the United States, ambulance services provided by a local government are often referred to as "third service" EMS (the fire department, police department, and EMS department forming an emergency services trio) by the members of said service, as well as other city officials and residents.
Each ambulance service is required to employ a medical manager whose role is oversight and quality assurance, and who may be contacted for directions by any paramedic who has reached the limits of their scope of practice, just as in the Anglo-American model. When necessary, however, the paramedic may request a rapid response by a physician ...