Emergency and Other Pre-hospital Medical Services

William E. Coll, M, PUB, AFF, BA, REHS, LP Program Manager, Infection Preventionist

Office of the Medical Director
Austin/Travis County EMS System
Austin, TX

Katherine West, RN, BSN, MSEd Infection Control Consultant

Infection Control/Emerging Concepts Inc.
Manassas, VA

Revised Publication:
December 22, 2020
Original Publication:
October 2, 2014
Declarations of Conflicts of Interest:
  • William E. Coll reports no conflicts of interest.
  • Katherine West reports no conflicts of interest.


The issues of infection prevention are not significantly different in the prehospital setting from those of the hospital environment. The major differences are the dynamic and unstructured environments in which emergency field responders are required to work. Today, ambulances are compact emergency departments that can provide state-of-the-art medical care both on the scene and during transportation to a medical facility. The prehospital care providers comprise not only paramedics and emergency transport personnel but also various first responder components: fire departments, police agencies, corporate emergency response teams, volunteers, those involved in public access automated external defibrillation programs, and citizen rescuers. The scope of practice for the public safety arena extends far beyond just patient care and involves many facets. Risk for contact with biological hazards can occur in a variety of situations; from an officer in direct contact with individuals during restraint for arrest to individuals involved in the collection and inventory of property and evidence. As healthcare evolves in the United States, the role of emergency medical service personnel in providing care to the community will also expand with the concept of community para-medicine in the near future.