The American system favors care carried out by paramedics (technicians), while the French favors the presence of doctors at the scene of the incident. Such systems usually have

good results in terms of reducing morbidity and mortality, and neither model has been shown to be more effective than the other [3–7]. Brazil officially adopts the principles of the French model, the Mobile Emergency Care Service (MECS, or SAMU in Portuguese), adapting it to the local reality. The Brazilian Ministry of Health stipulates that critically ill or high-risk patients can only be removed from the scene of the accident in the presence of a full staff, including a doctor, QNZ travelling in an ambulance with advanced life support systems [8, 9]. According to the Brazilian proposal, the population has two types of services at its disposal [9–11]: basic life support units (BLS, or UBS in Portuguese)

with a Compound C mouse paramedic (nursing technician) and advanced life support units (ALS, or USA in Portuguese), in which the minimum crew consists of a paramedic, a doctor and a nurse, together with intensive care equipment, the team members receiving guidance of doctors from central regulators [5, 7]. In addition to SAMU, we also have the services of the Fire Department, through its “Rescue 193” (Fire Brigade Group – CB or “Resgate 193” in Portuguese). We are seeing a slow transition between the two services, one medicalized and with medical regulation, Panobinostat nmr and the other driven by protocol. In the city of Catanduva, which has a population of 112,820, there are two public pre-hospital healthcare services operating in the micro-region; one linked to the Municipal Health Department – the SAMU service

– and the other to the Military Police Fire Department (CB) of the State Secretariat for Public Security Affairs of the State of São Paulo. These services work independently, acting in a loosely integrated way, but with no formal partnership between them at managerial level. Thus, there is a lack of practical action, when it comes to management, in the area of forming and improving the service, making best use of the training and experience of professional firefighters. This study analyzes the APH performed by two different institutions; SAMU and Coproporphyrinogen III oxidase CB, in the service to traumatized patients admitted to the only tertiary hospital belonging to the public health system in the municipality of Catanduva, in the state of São Paulo. This is probably the reality of pre-hospital care in various countries around the world, especially in terms of the resources used for this purpose. We therefore decided to study how the implementation of a new service affects the care of trauma patients. Material and methods The Catanduva SAMU operates from a single base located in the center of the city, where three USB and one USA vehicles are housed.