Authors: Paul E Pepe1,2*, Lynn P Roppolo1,2 and Raymond L Fowler1,2
1 University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, USA
2 The Parkland Health and Hospital System, Dallas County, USA

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2015 and co-published as a series in Critical Care. Other articles in the series can be found online at CCFORUM. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from Springer.

INTRODUCTION: Modern out-of-hospital emergency medical services (EMS) systems, as we have come to recognize them today, were established in the 1960s and 1970s when a cadre of intrepid physicians ventured into the streets and later published their successful experiences with lifesaving approaches to managing acute coronary syndromes, trauma care, and cardiopulmonary arrest on-scene…

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