title: Evolution of rescue systems: a comparison between Cologne and Cleveland.
abstract: BACKGROUND
  Comparisons of different emergency medical services (EMS) systems often are reduced to simple comparisons between distinct facilities or strategies (e.g., prehospital physician versus paramedic, "scoop and run" versus "stay and play").
  
  
  METHODS
  The EMS systems of similar cities (Cologne and Cleveland) in two different countries (Germany and the United States) are compared. The comparison is seen from the perspective of an evolutionary standpoint that reflects the development of the EMS system in connection with the special environments. Data on rescue times, facilities, and (trauma) outcomes are compared.
  
  
  RESULTS
  No statistically significant differences in outcome between the systems were detected.
  
  
  CONCLUSIONS
  Both systems are developed in special environments and are optimized over decades, which explains the similarities in outcome.
authors.affiliation: Department of Surgery, University of Cologne, City Hospital Koeln-Merheim, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Lechleuthner
authors.forename: C
authors.initials: C
authors.lastname: Emerman
authors.forename: A
authors.initials: A
authors.lastname: Dauber
authors.forename: B
authors.initials: B
authors.lastname: Bouillon
authors.forename: J A
authors.initials: JA
authors.lastname: Kubincanek
mesh_terms: D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration*; D004634:Emergency Medical Technicians; D005858:Germany; D006302:Health Services Research; D006801:Humans; D017146:Models, Organizational; D009820:Ohio; D017063:Outcome Assessment, Health Care; D013997:Time Factors; D014504:Urban Health