Historically, the ambulance service has been viewed as an organization responsible for the transportation of sick people into hospital, but as a result of advances in surgical techniques, resuscitation and pharmacology, this has led to the discipline of pre-hospital emergency care becoming established and recognized as an important part of the patient's total care. In addition, medical and technical developments have led to pre-hospital emergency care becoming a kind of advanced nursing and an important first link in the chain of care. This has resulted in the emergence of a new discipline of ambulance nurses. Their entrance onto the scene is gradually changing and developing the ambulance service. Nurses with a background in anaesthetics, intensive care and cardiology units have for many years been employed for pre-hospital work (Suserud et al. 1998). In Sweden, nurses, and in particular anaesthetic nurses, have been increasingly used for pre-hospital work in Mobile Intensive Care Units (MICU) and on medical emergency teams. These nurses have traditionally taken an active part in the intra-hospital routine treatment of patients with complex conditions and who are clinical unstable. Medical directors' and ambulance chiefs' views have been that those nurses who are used to working independently and have competence in advanced life support are suitable for this role. I also think that many of them, as well as many ambulance nurses, are attracted to working at the front line. However, I would say that most are not prepared for the diversity of patient they will meet outside the acute hospital.