**5. The triad of emergency healthcare**

In most countries, there are three health services that deal with patients regardless of their chief health complaint, age, or gender. Those are the prehospital emergency medical services (EMS), commonly managed by one more ambulance services, the hospital emergency departments, and the primary healthcare centers or clinics (PHC).

Traditionally, patients, who require emergency care seek treatment in an emergency department. They may either directly report there using their own means of transportation or may have been brought in by ambulance. Each approach has its own advantages and disadvantages depending on how the system operates and what resources are available. Ambulance services and hospital EDs around the world are often overwhelmed [12, 13] and this is where the primary healthcare system can play an important role in sharing the burden as described above where we presented the Qatar experience. In turn, this relies on facilities being appropriately resourced and the general public being educated to make the correct use of the services available based on the urgency of their apparent or suspected health related complaint.

We propose that the ideal solution to providing patients with effective access to emergency care relies on a collaborative triad composed of a clinically focused ambulance service, a network of primary healthcare centers with a minor illnesses and injury unit, and geographically distributed hospital-based emergency departments, also based on patient density. Their respective scope could be defined as follows:


have limited diagnostic equipment capability (e.g. X-ray, ultrasound) because of their holistic approach to patient assessment and care. They cannot admit patients, but can refer to other specialties. They are generally staffed by nurses and family physicians who may also have additional subspecialties such as women's health and dermatology to cite a few examples.

3.Emergency departments: Hospital department that can be accessed by any patient without prior appointment and that is staffed by a multi-professional team of clinicians able to deal with all emergency conditions. It reacts faster than other specialties in the hospital and provides rapid access to radiology and other urgent services such as cardiology and trauma surgery. They can facilitate admission of patients into the relevant department for definitive care.
