Major Incidents in Region Vastra Gotaland, Sweden, during 25 years

s 13th World Congress for Disaster and Emergency Medicine S77 Prehospital Care in Rural Settings AttilaJ. Hertelendy, BHsc, CCEMT-P, NREMT-P University of Mississippi Medical Center, USA Oxford, Mississippi USA The delivery of prehospital care in a rural setting requires a conceptual framework quite different from that required in urban and suburban environments, given that available resources are limited in the rural setting. The intermittent and episodic nature of seriously ill and injured patients who present to rural emergency medical services (EMS) makes it difficult to plan, staff, and equip in order to provide emergency medical care at the same level seen at highervolume urban or suburban institutions. The objective of this presentation is to describe the distinctive nature and widely unrecognized features of prehospital care in rural and remote areas, with a focus on clinical, workforce, and economic issues, through a Canadian perspective that adds the element of extreme temperatures. The author presents recommendations for a paradigm shift in thinking, and a call to action on behalf of all prehospital care professionals that are based on a realistic assessment of the current status of emergency medicine, and that are needed to develop and sustain high-quality emergency medical care in rural environments.