A new study comaparing with the assessment, treatment, referral, and follow up contact with the dispatch centre of emergency patients treated by two types of solo emergency care providers in ambulance emergency medical services (EMS) in the Netherlands. The hypothesis of this study was that there is no difference in outcome of care between the patients of PAs and RNs.

Patients treated by PAs and RNs were similar with respect to patient characteristics. In general, diagnostic measurements according to the national EMS standard were applied by RNs and by PAs. In line with the medical education, PAs used a medical diagnostic approach (16 %, n = 77) and a systematic physical exam of organ tract systems (31 %, n = 155). In a cross-sectional document study in two EMS regions we included 991 patients, treated by two PAs (n = 493) and 23 RNs (n = 498). PAs and RNs provided similar interventions.

Additionally, PAs consulted more often other medical specialists (33 %) than RNs (17 %) (χ2 = 35.5, P <0.0001). PAs referred less patients to the general practitioner or emergency department (50 %) compared to RNs (73 %) (χ2 = 52.9, P <0.0001).  Our study shows that patients of PAs and RNs were comparable with respect to age, gender, and initial complaints/conditions. PAs and RNs reported diagnostic measurements according to the national EMS standard.  In line with the medical education, PAs additionally used the SCEBS methodology (16 %), and a systematic physical exam of organ tract systems in a third of the patients.

Possibly the use of the SCEBS methodology makes additional measurement of vital signs superfluous. This might explain why PAs complete their treatment on scene more often, as they have more skills to perform a medical assessment on scene, compared to RNs. Studies in other fields of healthcare have suggested that the basic competences of the PA for a defined group of patients are comparable to the competences of a physician such as the GP, ED physician , and surgical and anesthesiology residents.

Though, the PA needs a specific medical training, supervised by the GP, emergency physician or anesthesiologist before these competences are gained. In our study the two PAs received previously an education as ambulance RN. An observation of these restrictions, the results of this first study on the role and function of the PA in prehospital EMS are very interesting and could be promising regarding optimal care provision in prehospital emergency care.