Emergency Medical Services

In an era where prehospital care is rapidly evolving, the Eastern Health Cluster is taking a bold step toward transforming how paramedics learn, collaborate, and grow.

Wiki-SEM strong support for the new wiki‑based Continuing Medical Education (CME) initiative hosted on wiki‑sem.org, describing it as “a powerful catalyst that will elevate the competence and confidence of paramedics in real‑world practice.”

Wiki-SEM emphasized that global research consistently shows the effectiveness of open‑access, collaborative learning platforms in improving clinical decision‑making and team performance. One notable example comes from British Columbia, Canada, where a provincial EMS service adopted a wiki‑based FOAM (Free Open Access Medical Education) model to standardize protocols, share case reviews, and support rural paramedics. The result was measurable improvement in protocol adherence, faster knowledge dissemination, and stronger professional engagement across the system. We believes the Eastern Health Cluster can achieve similar—if not greater—impact.

A Wiki‑Driven Vision for EMS Education

The wiki‑sem.org platform will serve as a dynamic, living repository of EMS knowledge, built collaboratively by practitioners, educators, and subject‑matter experts. We highlights three pillars guiding this initiative:

• EPA‑Based Competency Development: Entrustable Professional Activities will structure learning outcomes, ensuring paramedics progress through clearly defined, workplace‑relevant competencies.

• FOAM Integration: Open‑access educational resources will be curated, peer‑reviewed, and adapted to local practice, making high‑quality learning accessible to every paramedic.

• Collaborative Knowledge Building: The wiki model encourages continuous updates, shared authorship, and real‑time refinement of clinical content.

Rosen’s EMS Topics as the Foundation of the CME Plan

Drawing from the authoritative Rosen’s Emergency Medicine, the CME plan will incorporate essential domains that reflect the realities of prehospital care. These topics will be organized into a structured, year‑round learning pathway:

Proposed Continuous Education Plan (CME) on wiki‑sem.org

1. Core Clinical Foundations

   • Airway management and difficult airway algorithms

   • Shock recognition and resuscitation principles

   • Trauma assessment, hemorrhage control, and spinal injury management

   • Cardiac emergencies and prehospital ECG interpretation

   • Medical Emergencies

     1. • Respiratory distress and asthma/COPD exacerbations

     2. • Diabetic emergencies and metabolic crises

     3. • Toxicology essentials and field antidote protocols

     4. • Neurological emergencies including stroke and seizures

2. Operational Readiness

   • Mass‑casualty incident (MCI) principles

   • Scene safety, triage systems, and communication

   • EMS quality improvement and documentation standards

3. Special Populations

   • Pediatric assessment and resuscitation

   • Obstetric emergencies

   • Geriatric considerations in prehospital care

Courses and Learning Modules

Each module will include:

• Short wiki‑based readings

• FOAM‑linked videos and case discussions

• EPA‑aligned skill checklists

• Scenario‑based simulations

• Peer‑reviewed updates contributed by EMS professionals

Empowering Paramedics Across the Eastern Health Cluster

Wiki-SEM stresses that this initiative is designed for the paramedics themselves—those who serve on the front lines of the Eastern Health Cluster every day. By giving them a platform to learn, contribute, and shape their own educational ecosystem, the Cluster is investing in a culture of excellence and continuous improvement.

“Wiki‑SEM.org will not only enhance clinical competence; it will strengthen our identity as a learning EMS community. This is how we prepare for the future—together, openly, and with purpose.”

1. Definition and System Overview

Emergency Medical Services (EMS) in Saudi Arabia comprises the coordinated system that delivers prehospital emergency medical care, rapid response to urgent medical conditions, stabilization on scene, and safe transport of patients to definitive care locations. This system follows a model similar to the Anglo-American EMS system, with ambulances staffed by trained EMTs/paramedics providing care outside of hospital settings.  

2. Organizational Framework

2.a. Saudi Red Crescent Authority (SRCA)

• The SRCA is the principal national EMS provider. It operates emergency response ambulances nationwide and is integrated into the Kingdom’s emergency response infrastructure.  

• It maintains a network of first aid centers and ambulances distributed across regions.

• SRCA is also responsible for Air Ambulance services, which include helicopters and fixed-wing aircraft used for critical cases and during mass events like the Hajj.  

2.b. Ministry of Health (MOH) and Other Providers

• Public health facilities operate EMS through hospital-based units; private EMS companies (e.g., Saudi EMS Co., Team 1, RPM Saudi) provide both emergency and non-emergency transport, including corporate, event, and scheduled services.  

2.c. Professional Standards and Regulation

• Saudi national EMS standards define scope of practice, credentialing, clinical competencies, and operational protocols for prehospital providers.  

3. Prehospital Response and On-Scene Care

3.a. First Contact and Dispatch

• Patients in emergency situations access EMS via the national emergency number (e.g., 997 for SRCA).

• Dispatch centers triage calls, allocate appropriate resources (BLS/ALS), and provide first-aid instructions when possible.

3.b. Response Team Composition

• Standard response teams include EMTs and paramedics trained in prehospital assessment, stabilization, and interventions such as airway management, hemorrhage control, IV access, and ECG-capable monitoring.  

• Some specialized services include physician-led or critical care teams for high-acuity patients.

3.c. On-Scene Medical Care

• Initial assessment follows structured algorithms (e.g., ABCDE, trauma protocols).

• Basic Life Support (BLS) includes oxygen therapy, bleeding control, splinting, and basic airway support.

• Advanced Life Support (ALS) includes cardiac rhythm interpretation, advanced airway management, IV/IO medications, and advanced interventions for cardiac arrest, stroke, sepsis, and trauma.

3.d. Stabilization Prior to Transport

• EMS providers stabilize the patient according to severity, maintain vital functions, and prepare for transport.

• Documentation and communication with receiving facilities begin on scene.

4. Transport Operations

EMS transport operations are classified into emergency transport and non-emergency (inter-facility) transport.

On-Scene to Hospital (Emergency Transport):

• • Rapid and safe transfer of urgent cases from the scene to the appropriate facility.

  • Vehicles are equipped according to the level of care:

  • BLS ambulances: Basic monitoring, oxygen, splints, AED.

  • ALS ambulances: Advanced cardiac monitoring, medication administration, advanced airway equipment.

  • Goal is to minimize on-scene time and optimize outcomes by early definitive care.

5. Inter-Facility Transport (IFT)

5.a. Definition:

Inter-facility transport refers to planned transfer of patients between healthcare locations (e.g., from smaller facility to tertiary center, ICU to specialized unit) when ongoing care or diagnostics are required.  

5.b. Clinical Criteria and Stabilization

• Patients must be stabilized before transfer; unstable patients require continued care during transport.

• A transfer team may include paramedics, ICU nurses, and/or physicians depending on acuity and risk.

• Documentation includes:

• Pre-transfer stabilization summary

• Care plan during transport

• Handoff communication protocols

5.c. Transport Modalities:

• Ground ambulances for most transfers within cities or nearby regions.

• Air ambulances (helicopter or fixed wing) for long distances, remote areas, or time-critical transfers.  

5.d. Medical Oversight:

• Transport teams operate under medical directions and may escalate interventions if necessary.

• Stable patients requiring chronic therapy support (e.g., dialysis transport) are managed under non-emergent protocols with appropriate monitoring.

6. Challenges and Development Needs

• Paramedic workforce gaps, variations in educational preparation, and distribution across urban versus rural areas remain challenges.  

• Continued professional education, research development, and integration with hospital systems are ongoing priorities.

*References for EMS in Saudi Arabia*

• National scope of practice and professional EMS standards.  

• Saudi Red Crescent Authority (national EMS provider).  

• Saudi Air Ambulance services under SRCA.  

• Private and supplementary EMS providers (e.g., Team 1, Saudi EMS Co.).  

• EMS education and workforce development literature.