In 2001, NHTSA and the Maternal and Child Health Bureau within HRSA released the eight recommendations: (1) career EMS investigators should be developed and supported; (2) centers of excellence should be created to facilitate EMS research; (3) federal agencies should commit to supporting EMS research; (4) other public and private institutions should be encouraged to support EMS research; (5) results of this research should be applied by EMS professionals and others; (6) EMS providers should require that evidence be available before implementing new procedures, devices, or drugs; (7) standardized data collection methods should be established; and (8) exceptions from informed consent rules should be adopted (NHTSA, 2001a).
The above efforts have helped draw attention to the lack of a research base for EMS and spurred some development in the area.
In three consensus reports released in 2006, the Committee on the Future of Emergency Care in the United States Health System documented the state of affairs and discussed ways to improve the 9-1-1 and medical dispatch systems, prehospital emergency medical services (EMS), and hospital-based emergency and trauma care networks that serve adults and children.
To develop these reports, the staff and committee chair organized the committee into three subcommittees (that included external participation from individuals not affiliated with the primary consensus committee) to address focal areas of emergency care: prehospital services, pediatric emergency care, and hospital-based emergency care.
Trauma care deals principally with the acute management of patients with traumatic injuries.
Like emergency medicine research, trauma care research is concerned with the treatment of these patients in the prehospital and hospital settings, but it reaches further into the inpatient setting, particularly the intensive care unit (ICU) and surgical departments.
It addresses conditions and interventions common to the prehospital EMS and hospital emergency department (ED) settings, and its focus is on the acute management of patients.
It is often conducted by emergency physicians in collaboration with specialists in other fields, such as pediatrics and cardiology.
Despite the size, scope, sophistication, and critical role of EMS in the United States, the evidence base to support EMS-related clinical and system design decisions is much less well developed than that in other areas of medicine (NHTSA, 1996).
Consequently, EMS has for years operated without a sufficient scientific basis to support many of its actions (NHTSA, 2001a; Mc Lean et al., 2002; Sayre et al., 2003).