The Evolving Role of Paramedics in Hospital Emergency Care: Bridging Pre-Hospital and In-Hospital Services

Abstract

Emergency Medical Services (EMS) have traditionally emphasized pre-hospital care, with paramedics primarily responsible for stabilizing patients and transporting them safely to healthcare facilities. However, the evolving demands of modern healthcare systems and the rising complexity of emergency cases have expanded the paramedic’s role beyond the pre-hospital setting into hospital-based emergency care. This review explores the evolving role of paramedics in hospital emergency departments, focusing on how they bridge the continuum between pre-hospital and in-hospital services. A systematic search of major databases, including PubMed, Scopus, and Web of Science, was conducted for studies published between 2010 and 2025, examining the contributions, outcomes, and challenges associated with integrating paramedics into hospital emergency care. The findings indicate that paramedics enhance patient flow, reduce emergency department waiting times, and contribute significantly to critical interventions such as advanced life support, triage, and trauma management. Evidence also highlights their impact on improving continuity of care, reducing mortality in time-sensitive conditions, and supporting hospital efficiency. Despite these benefits, challenges persist, including regulatory constraints, variations in training standards, and inter-professional collaboration barriers. The review concludes that paramedics are increasingly vital to hospital emergency care, serving as a critical link in ensuring timely, efficient, and safe patient management. Strengthening policies, expanding training, and fostering collaboration between paramedics and other healthcare professionals are essential to maximizing their potential in hospital-based emergency services