Expertise and Decision-Making in Emergency Medical Services
In the context of emergency medical service (EMS) practice, the characteristics identified with the naturalistic decision-making enterprise are applicable. Time pressures, high stakes, competing priorities, incomplete information, changing conditions, and vague goals can all be applied to the context in which paramedics operate. Their decision-making is bounded by two broad frameworks: situational awareness and patient treatment. The emerging aspects involved in expert decision-making in EMS reflect a number of changes that are taking place in paramedic practice. The historical role for EMS evolved from the ambulance service provided as a sideline to other ventures, such as funeral services. The parameters that influence a decision in the high-stress, high-stakes, and time-pressured circumstances of EMS practice preclude the possibility of applying an analytic method to making the decision. As the importance of decision-making and expertise in EMS continues to expand, so too does the notion of professionalism, and the emergence of increased focus on degree programs in EMS reflects the change.