Mapping the impacts of climate change on prehospital emergency medical services: protocol for a scoping review

Climate change is intensifying extreme weather events and altering environmental conditions in ways that increasingly strain health systems. Prehospital emergency medical services (EMS), as the frontline interface between communities and acute care, are uniquely vulnerable to these pressures. Rising call volumes, infrastructure disruption, occupational heat and smoke exposure and service delays have been reported, yet the evidence remains fragmented across disciplines and regions. This scoping review aims to systematically map the global literature on climate-related hazards and their impacts on EMS operations, workforce health, patient outcomes and system adaptation.

This scoping review follows Joanna Briggs Institute methodology and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extensions for Scoping Reviews (PRISMA-ScR). Searches will be conducted in PubMed/MEDLINE, Web of Science, Scopus, CINAHL and Embase together with grey literature sources for English-language studies published from 2000 onwards. Using the Population-Concept-Context framework, studies on climate-related hazards affecting prehospital EMS operations, workforce health, patient outcomes or system adaptation will be included. Non-EMS studies, studies unrelated to climate-related hazards and non-primary reports will be excluded. Two reviewers will independently screen and chart the data. Findings will be summarised descriptively and thematically and presented in an evidence map.

As this study uses publicly available data, ethical approval is not required. Findings will be disseminated through peer-reviewed publication, conference presentations and policy-oriented outputs targeting EMS leaders and public health stakeholders.