INDEX
Health Planning
Bibliography Series!
Emergency Medical
Service Systems
and Health Planning
A Bibliography
D0Cir*rMT^
1979.
LIBRARY
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U,S. DEPOSITORY
MAR 21197^=
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410
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no. 10
PUBL.
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LIBRARY
UNIVERSITY Of
CALIFORNIA
HEALTH PLANNING SER.IES
The Bureau of Health Planning is a primary resource for current
information on a wide variety of topics related to health planning.
To facilitate the dissemination of this information to health
planners, the Bureau issues publications in the following series:
Health Planning Methods and Technology
This series focuses on the technical and administrative
aspects of health planning. Included are such areas
as methods and approaches to the various aspects of the
health planning process, techniques for analyzing health
planning information and problems, and approaches to the
effective dissemination and utilization of technical in-
formation.
Health Planning Information
This series presents information on the analysis of issues
and problems relating to health planning including trend
data, data analysis, and sources of data to support health
planning activities.
Health Planning Bibliography
Bibliographies on specific health planning subjects are
published in this series. Subject areas are selected
by the frequency of inquiries on specific topics and
from suggestions by Bureau staff and health planners
throughout the nation.
"Emergency Medical Service Systems: A Bibliography" is the
tenth publication in the Health Planning Bibliography Series.Emergency Medical
Service Systems
and Health Planning:
A Bibliography
October 1978
U.S. DEPARTMENT OF
HEALTH, EDUCATION, AND WELFARE
Public Health Service
>c- Health Resources Administration
Bureau of Health Planning \
National Health Planning Information Center
3700 East-West Highway
Hyattsville, Maryland 20782
DHEW Publication No. (HRA) 79-14000
HRP-0301001b\ 6'i3feS<f
For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402
Stock Number 017-022-00659-0PREFACE
In 1960, Emergency Medical Services as a program was lodged in the Department of Health, Education,
and Welfare (DHEW), Bureau of State Services, Division of Accident Prevention. Some of their
activity was within the administrative responsibli1ity of the Division of Chronic Diseases,
Bureau of State‘Services. The Department's philosophy toward emergency medical service was to
emphasize the categorical nature of the program. So emergency medical service was approached
from the point of view of the ailment, not the system of delivering emergency aid. The Division
of Chronic Disease supported emergency services through its heart disease activities and the
Division of Accident Prevention approached it from the aspect of automobile accidents. The
establishment of the Department of Transportation in 1967, and the subsequent publication of
Standard 11, Emergency Medical Services, allowed the Department of Transportation to play a
major role in emergency medical service and accident prevention.
The present emphasis and actual federal activity is moving toward an eventual nationwide network
of interlaced comprehensive emergency medical service systems. At the national level, all of
the Department of Health, Education, and Welfare's activity in bringing adequate and prompt
emergency medical service to those people who need such services is through the EMSS Act of 1973.
There are several motives why such a task as the compilation of a comprehensive bibliography of
planning emergency medical services was undertaken. Specifically, there were three reasons for
compiling this volume:	it was a challenge; there is a need for it; and hopefully this is a
contribution to the literature. The challenge comes from the variety of sources that have to be
tapped in order to reach all of the published material on planning in emergency medical services.
Both computer data file searches and manual searches were used to achieve the maximum number of
articles and books. The importance of the form and substance of emergency medical service
delivery has mushroomed since 1960. This compilation is an effort to provide the
layman, health professional, practitioner, and researcher with a usable, non-clinical,
comprehensive bibliography on planning in emergency medical services.
The sources for the approximate 170 citations are widely varied. A partial listing included the
following: the MEDLINE System, the Drug Abuse Clearinghouse, the Alcoholic Clearinghouse, the
National Health Planning Information Center, National Technical Information Service, Smithsonian
Science Information Exchange, and the usual secondary sources of bibliography, including the
excellent Parklawn Health Library, Rockville, Maryland. These citations of books, articles, and
government publications are arranged alphabetically by author or first word of the title,
dropping the article.
Documents which are noted as available NTIS may be purchased (by order number) from the following
address:
National Technical Information Service
5285 Port Royal Road
Springfield, Virginia 22161
Phone (703) 557-4650
Journal articles may be available at a local university library or in a Regional Medical Library.
Other availability sources for copyrighted documents and documents not available at NTIS are
noted.
12 S70
i i iACKNOWLEDGMENTS
Only a few works are done single-handed; this effort is by no means an exception.
The compilers wish to thank Mrs. Geraldine A. Brooks, Interlibrary Loan Librarian,
Parklawn Health Library, Rockville, Maryland; Mr. Edwin P. Sunderland, Jr.,
Reference Librarian; and Ms. Elaine Jastram, Emergency Medical Services Informa-
tion Center, American College of Emergency Physicians, East Lansing, Michigan.
The compilers hope this effort will be useful to those who have to know the
various aspects of emergency medical services. Efforts are already underway to
collate a supplement that will cover any important citations that were omitted
in this volume and include all relevant citations for 1978.
Lary C. Rampp
Hyattsville, MD
October, 1978
Donald L. Rampp
New Orleans, LA
October, 1978
Robert J. Groner
Rockville, MD
October, 1978Adams, S.; Schiller, A.; Pizzano, W.A.; and Flashner, B.A. Handbook for Patient
Recordkeeping -- Systems for Emergency Medical Services -- List of Minimum Data.
Washington, D.C.:	Young (Arthur) and Co. Rockvilie, Md.:	U.S. Department
of Health, Education, and Welfare, Health Services Administration, Office of
Planning, Evaluation and Legislation, 1976.
The handbook has been developed as a guide to HEW/EMS grantees across the country
in their development, implementation, and modification of recordkeeping systems
designed to monitor on-going program activities. The introduction provides an
overview of the design, utilization, and rationale of a statistically rigorous
recordkeeping system. The chapter on 'List of Minimum Data1 outlines four cate-
gories of data:	general, communications, transportation/intervention, and
emergency facility data. Section III concerns the utilization of such data for
management information, process evaluation, and clinical impact studies. The final
chapter presents several data collection forms and briefly discusses the strengths
and weaknesses of each. A data system based on the data elements presented in
this handbook can be used internally by program management as well as by outside
evaluators and researchers. Order Number:	HRP-1002382
Airport Emergency Medical Services. A Guide to Planning. Chicago, 111.: American
Medical Association, Department of Emergency Medical Services, 1976.
Guidelines are presented to assist airport directors in initiating and implementing
a plan for emergency medical services in airports. The following functions of the
emergency plan are defined:	the provision of triage and emergency services to
casualties at a disaster site within a minimum of elapsed time; the provision of a
holding area in the airport for further treatment and observation of injured per-
sons to hospital facilities when appropriate. It is suggested that a physician be
given the responsibility for coordinating and directing the airport's emergency
plan. Considerations of personnel training, communications, and facilities and
equipment to be taken into account in the overall plan are discussed. The follow-
ing materials are appended to the guidelines:	an outline of a 16-hour course in
emergency medical care for airport personnel; a list of recommended medical
supplies for the triage area and for emergency medical care bags; and a list of
suggested readings.
Albin, S.L.; Wasserthei1-Smol1er, S.; Jacobsen, S.; and Bell, B., "Evaluation of
Emergency Room Triage Performed by Nurses," American Journal of Public Health,
Vol. 65, No. 10 (October, 1975), 1063-1068.
Aldrich, C.A.; Hisserich, J.C.; and Lave, L.B., "An Analysis of the Demand for
Emergency Ambulance Service in an Urban Area," American Journal of Public
Health, Vol. 61, No. 6 (June, 1 971 ), 1 1 56-1 1 69.
1Allen, A.B.; Barnard, B.G.; Falk, W.; Higgs, E . R . ; and McCracken, J.G., "A Study
of Waiting Time in an Emergency Department," Canadian Medical Association
Journal, Vol. 109, No. 5 (September 1, 1973), 373-376.
Area Emergency Medical Services System Plan:	An Aid for Long-Range Planning.
Tulsa, Okla.:	Tulsa Area Health and Hospital Planning Council. Oklahoma
City, Okla.:	Oklahoma State Department of Health, 1975.
An emergency medical services (EMS) system implementation plan is presented which
meets contractual specifications established between the Tulsa Area Health and
Hospital Planning Council and the Oklahoma State Department of Health. The
definition, principle and standards of the plan are stated, and geographic and
demographic considerations of the area are defined. EMS resources such as ambu-
lance services and hospitals are identified and located on maps; communications
systems of hospitals and emergency vehicles are described, and special care units
located in three counties are listed according to type of unit, hospital, and
location. Transfer of patients from one facility to another has been made easier
through use of standardized patient recordkeeping forms. Analysis of the EMS
system has been achieved by comparing conditions as they were reported in October
1974 with standards presented for each of 15 components in the system. Where
deficiencies exist, they are identified, and a hierarchy of priorities relating
to the components has been established. Implementation recommendations are given,
and provision is made for evaluation of the plan at 3-year intervals. Appendices
include a list of task force participants, projected emergency service training
course schedules, essential equipment for ambulances, and a sample of the patient
recordkeeping form. Order Number:	HRP-0004545
Arkansas Emergency Medical Services Demonstration Project. Final Report. Little
Rock, Ark.:	Arkansas Health Systems Foundation. Hyattsville, Md.:	D.S.
Department of Health, Education, and Welfare, Bureau of Medical Services,
Division of Emergency Medical Services, 1975.
Nearly three years ago, Arkansas embarked upon a task-- bui1 ding a comprehensive
statewide emergency medical services (EMS) system. There was no question about the
need for Arkansas to improve its emergency medical care, but there was no consensus
on what type of system was wanted or appreciation of the sustained and far-reaching
effort that would be required to achieve it. Progress was very slow for the first
two years, but today, Arkansas is on the verge of completing its total EMS system.
The report gives an overview of the Arkansas EMS system from 1972-75.
Order Number:	HRP-1001658
Arkansas Emergency Medical Services System:	A Statewide Experiment in Rural Human
Service Delivery. Little Rock, Ark.:	Arkansas Health Systems Foundation,
1 975.
Armington, C.L., "Legal Implications in Emergency Services," Nursing Clinics of
North America, Vol. 9, No. 3 (September, 1974), 445-451.
Bachrach, Peter. Evaluation of the Effectiveness of Emergency Medical Services
Councils in Wisconsin. Madison, W i s.:	Wisconsin Regional Medical Program,
1 976.
The effectiveness of eight areawide emergency medical services (EMS) councils in
Wisconsin is evaluated. The councils, organized under the aegis of comprehensive
2health planning agencies, were funded by the Wisconsin Reoional Medical Program
through the Wisconsin EMS program from July 1972 through June 1975. Composed of
volunteers, staffed by an EMS coordinator, and charged with the responsibility of
improving the delivery of emergency care, these councils approached their task
differently. The method used to evaluate the EMS councils is described. Integrat-
ing quantitative and qualitative measures with interviews, different but comple-
mentary perspectives on the evaluation of EMS council effectiveness are provided.
The evaluation results focus on the relationship between local organization and
areawide organization. It is concluded that an areawide council will be more ef-
fective if there is a significant amount of local organization prior to the area-
wide organization. Three reasons for this conclusion are given:	(1) increased
knowledge of EMS among people who will ultimately make the important decisions at
the county level; (2) increased knowledge of the potential uses of and constraints
on an EMS coordinator; and (3) increased accountability among the people involved.
The evaluation results also emphasize the relationship between the EMS program at
the state and areawide levels. It is felt that a lack of state-level leadership in
creating an EMS management structure was a major weakness of the entire EMS effort
in Wisconsin. The recommendation is made that a policy-making body be established
at the state level to provide coordination for the future development of emergency
medical services. Order Number:	HRP-0011220
Baker, S.P., "Evaluation of Medical Care of the Injured," Journal of Trauma,
Vol. 11, No. 10 (October, 1971), 892-894.
Baltzan, M.A., "The New Role of the Hospital Emergency Department," Canadian
Medical Association Journal, Vol. 106, No. 3 (February 5, 1972), 249-256.
Bastnagel , G.; Cristiano, P.J.; and Achilli, R., "Hospital, Community Establish
EMS System," Hospi tals, Vol. 48, No. 15 (August 1 , 1 974 ), 59-62 .
Bautsch, C., "Nurse's Role in Training EMT's," Emergency Medical Services, Vol. 3,
No. 5 (September - October, 1 974), 46-47.
Becker, Robert E., and Severin, Nelda K. "Nurses as Psychiatric Consultants in a
General Hospital Emergency Room," Community Mental Health Journal, Vol. 10,
No. 3 (Fall , 1 974 ), 261 -267 .
Benson, D.M., and Safar, P., "Categorization and Regionalization of Hospital
Emergency Facilities," Clinical Anesthesia, Vol. 10, No. 3 (1974), 137-159.
Bible, B.L., "Organizing and Establishing a Rural EMS System," Journal of the
Medical Association of the State of Alabama, Vol. 44, No. 2 (August, 1 974) ,
91-92.
Blum, Marc S., and Stone, Linda S. Evaluation of Emergency Medical Services
Systems Impact. Final Report. Atlanta, Ga.:	Transaction Systems, Inc.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare, Health
Services Administration, Office of Planning, Evaluation and Legislation,
1 975.
3The scope of the project is to review pertinent data to determine the efficacy of
EMS in reducing mortality in critical patient categories, to investigate the
rationale for regionalization of EMS systems, and to identify the existence of
effective regionalized systems. The project consists of four phases including the
identification and procurement of data sources, the review of literature and data,
an analysis to evaluate EMS systems impact, and the documentation of conclusions
and observations. The results of the project should provide HSA/OPEL with suffi-
cient data to determine the level of need for more extensive evaluation of impact
of regionalized systems on major user groups. Order Number:	PB 247-311
Bohn, G.S., and Richie, C.G., "Learning by Simulation. The Validation of Disaster
Simulation:	Medical Scheme Planning," Journal of the Kansas Medical Society,
Vol . 1, No. 11 (November 1 970), 41 8-425.
Boyd, D.R.; Dunea, M.M.; and Flashner, B.A., "The Illinois Plan for a Statewide
System of Trauma Centers," Journal of Trauma, Vol. 13, No. 1 (January, 1973),
24-31.
Boyd, D.R.; Pizzano, W.A.; and Murchie, P.A., "Categorizing Hospital Capabilities,"
Emergency Medical Services, Vol. 4, No. 2 (March - Apri 1 , 1 975 ), 22-31 .
Bromberg, M.J., "Legal Problems and Safeguards in the ED," Registered Nurse,
Vol. 36, No. 5 (April, 1 973) , 49f.
Brook, R.H., and Stevenson, R.L., "Effectiveness of Patient Care in an Emergency
Room," New England Journal of Medicine, Vol. 283 (October 22, 1970), 904-907.
Buck, Gary L.; Brimmer, Pauline F.; and Putzier, Lois T. Emergency Medical
Services Research:	Effectiveness of Emergency Care. Final Report.
30 Jun 75 - 30 Sep 76. Tucson, Ariz.:	Pima Health Systems, Inc.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare,
National Center for Health Services Research, 1976.
The report summarizes three studies. They were drawn from an emergency medical
services (EMS) reporting system in Tucson which allows tracking a patient's path
from the time of seeking an ambulance through hospital admission and eventual
discharge. The first study involves structural and process data on EMS systems,
controlling for age, severity, and disease, and relating these data to such out-
come measures as length of hospital stay, disposition, and cost. The second study
assesses EMS utilization by health maintenance organizations members. Segments
of an eligible population who have subscribed to a health maintenance organization,
versus those who have not, are compared to identify relationships between prepaid .
health care and the community-based emergency system. The third project identi-
fies relationships between various types of health insurance coverage and utiliza-
tion patterns of emergency services. Order Number:	PB 262-766
Buckingham, R.E., Jr., "The I.P.C.A.R. Score. A Method for Evaluation of the
Emergency Patient," Journal of the Indiana State Medical Association,
Vol. 67, No. 1 (January, 1974), 21-25.
4Caldwell, Elaine, and Trimarco, Josephine, "Emergency Care--Assessment and
Action" Journal of Practical Nursing, Vol. 8 (October, 1975), 20-23f.
California State Plan for Emergency Medical Services. Volume I. Sacramento,
Calif.:	California State Department of Health. Oakland, Calif.:	California
Regional Medical Program, 1975.
California's 1975 emergency medical service (EMS) plan is described. The goal of
the plan is to:	provide a framework for county, area, and regional EMS planning;
establish policies for daily emergency medical services and for the development of
state standards and regulations; provide guidelines for statewide programs to
develop or allocate resources relating to EMS; serve as a basis for the California
State Department of Health to review EMS applications for state and federal funds
or funds from private foundations; and stimulate legislation to improve EMS.
System organization and management aspects of the plan are discussed. Also covered
are the following components:	(1) the data collection and analysis element;
(2) the public education and information subsystem; (3) the communications sub-
system; (4) the emergency medical transportation subsystem; (5) the medical care
subsystem; (6) the manpower development subsystem; and (7) disaster planning. A
timetable for the plan's development is presented. California's statutory
responsibilities for EMS are summarized. Order Number:	HRP-0004465
Central Midlands Regional Emergency Medical Services System Plan. Alexandria, Va.:
Paramed, Inc. Columbia, S.C.:	Central Midlands Regional Planning Council,
1 974.
A plan for improved emergency medical services (EMS) within the Central Midlands,
South Carolina, region is described. The key recommendations are summarized, and
goals, components, and standards for EMS in the area are discussed with regard to
the EMS organizational structures, existing and recommended facility services,
ambulance services, communications, recordkeeping, public education programs,
access, disaster planning, mutual aid agreements, and a schedule for implementation
is provided. The appendix presents an inventory of the existing emergency medical
facilities, a definition of intensive care units, an inventory of existing ambu-
lance services, ambulance service job descriptions, emergency medical technician
and related training course descriptions, a list of equipment essential for ambu-
lances, sample records, and summaries of existing legislation.
Order Number:	HRP-0003394
Chamberlin, R.T., "The Organization of Rural Health Services. An Approach by the
Upper Kennebec Valley Regional Health Agency," Journal of the Maine Medical
Association, Vol. 61, No. 2 (February, 1970), 27-29f.
Coleman, Robert R. Helicopter Ambulance Study. Final Report. Harrisburg, Pa.:
Pennsylvania Department of Highways, 1969.
The principal objective was to determine how effective a helicopter ambulance
could be in increasing the chances of survival of traffic accident victims. It
was hypothesized that travel time could be reduced particularly in an urban
environment where traffic congestion and other factors could delay conventional
ambulance response to traffic accidents. It was also the purpose of the study to
analyze the reactions of those transported, the operational problems of landing
at accident sites and hospitals, weather restrictions, communications, helicopter
characteristics, possible area coverage, costs and other than medical uses of the
helicopter. Order Number:	HRP-1000310
51
Communications:	Guidelines for Emergency Medical Services (EMS). Washington,
D.C.:	National Highway Traffic Safety Administration, 1972.
Information and guidance are provided for persons involved in planning and imple-
menting emergency medical communications systems. The purpose of such systems is
to reduce morbidity and mortality by bringing injured persons and definitive
medical care together in the shortest possible time. Types of emergency medical
systems communications systems include:	universal emergency telephone number;
other telephone systems; phone and radio patch; paying systems; selective calling
methods; physiological monitoring telemetry; and medical facilities data banks.
It is noted that Federal Communications Commission regulations form a boundary to
the EMS communications plan. The commission's rules involve frequency avail-
ability, applicant eligibility, and permissible communications rules. Suggestions
are offered for implementing the EMS communications system, and sample data sheets
are provided for a community EMS survey. A model of an EMS communication system
is provided. Order Number:	HRP-0005573
Communications in Support of Emergency Medical Services. Washington, D.C.:
Office of Telecommunications Policy, 1973.
Emergency medical services involve initial treatment of the acutely ill and the
severely injured, reporting of medical emergencies, and patient care en route to
hospital facilities. Electronic communications makes it possible to quickly and
reliably link ambulances, medical personnel at the scene of an emergency, and
hospital emergency facilities, to enable early diagnosis and treatment of patients
The report discusses the present radio frequency spectrum allocations for emergency
medical services, analyzes new requirements. An appendix contains five diagrams
indicating various concepts for basic emergency medical service systems communi-
cations. Order Number:	HRP-0003660
Community-Wide Emergency Medical Services:	Recommendations. Park Ridge, 111.:
American Society of Anesthesiologists, Committee on Acute Medicine, 1968.
Recommendations for improving emergency medical services at the scene, during
transportation, and in hospitals are presented by the Committee on Acute Medicine
of the American Society of Anesthesiologists. The recommendations address the
following aspects of emergency care:	community-wide organization; resuscitation
training; treatment at the scene; transportation (organization, communication,
training of ambulance attendants, physician control of emergency transportation,
transportation by air, design and equipment of emergency ambulances); and hospital
facilities (categorization and regionalization of hospitals, emergency room organi
zation and staffing for facilities classified as emergency hospitals or major
emergency hospitals, backup services for major emergency hospitals, intensive care
facilities for major emergency hospitals). It is noted that the organization of
community-wide emergency care should provide for modern resuscitation and life-
supporting measures at the scene, during transportation, and in the hospital, with
special emphasis on the time factor. Ambulance attendants and allied health
professionals involved in managing life-threatening emergencies should be trained
by physicians. Hospitals should create patient care environments in which every
physician, regardless of speciality, is given the optimal opportunity to contribut’
his skills, knowledge, and judgment to the delivery of emergency care.
Order Number:	HRP-0015721
Consumer Information and Education Handbook for the Emergency Medical Services
System. Little Rock, Ark.:	Arkansas Health Systems Foundation, Inc.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare, Health
Services and Mental Health Administration, 1973.
6Suggestions for planning for a consumer information and education program relating
to emergency medical services (EMS) systems are presented in this handbook prepared
by the Arkansas Health Systems Foundation staff. The objectives of such programs
are to increase public awareness and involvement in activities of the EMS, with
special emphasis on education of the public in the handling and reporting of
emergencies. It is important to divide the community into audience groups (school
children according to age and/or grade level, professional groups, civic groups,
women's business and social groups), and to determine the type and amount of infor-
mation to be presented. Methods of enlisting aid from the media are presented,
together with detailed instructions on how to write a news release. Press confer-
ence procedures are discussed, and a sample fact sheet to be distributed to those
attending is included. For rural areas, it is extremely important to conduct out-
reach programs, and two pilot programs that can be successfully replicated are
described. The outreach program, which is a proven technique for information
dissemination in highly rural areas, is especially appropriate for districts
experiencing delay in implementing centralized dispatch. Methodology, field
reports, and sample fact sheets for the outreach program are provided.
Order Number:	HRP-0005723.
Cooper, Carole, and Powell, Mel D. Description and Analysis of Eighteen Proven
Emergency Ambulance Service Systems. Volume I. Washi ngton , D . C. :	National
Association of Counties Research Foundation, 1968.
This is a study to identify a range of nationwide working solutions to the ,
emergency medical services problem, and to investigate how several communities
evolved their approaches to providing adequate emergency medical services.
Order Number:	HRP-1000552
Cowley, R.A.; Cooper, A.B., 3d; Towson, D.E.; and Scherlis, L., "A Statewide
Communication System to Support a Regional Program for Emergency Health Care
Delivery in Maryland," Maryland State Medical Journal, Vol . 22, No. 1
(January, 1973), 61-66.
Cowley, R.A.; Hudson, F.; Scanlan, E.; Gill, W.; Lally, R.J.; Long, W.; and
Kuhn, A.O., "An Economical and Proved Helicopter Program for Transporting
the Emergency Critically 111 and Injured Patient in Maryland," Journal of
Trauma, Vol. 13, No. 12 (December, 1 973), 1 029-1 038.
Demontfort, Sister, "Emergency Room Organization and Staffing," Supervisor Nurse,
Vol. 2, No. 3 (March, 1 971 ) , 44-60.
Desoto County Emergency Medical Services Transportation Plan. Memphis, Tenn.:
Mid-South Medical Center Council for Comprehensive Health Planning, Inc.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare, Public
Health Service, 1974.
Current conditions and projections with regards to population, traffic volume, and
accidental deaths and injuries in Desoto County, Mississippi, are described.
Tables are used to display data documenting a projected increase in demand for
emergency medical services in the area over the next 20 years. Demand for service,
distribution of that demand, and emergency call demand centers are discussed as
components of the emergency medical services transportation plan. Estimated
capital requirements and annual operating costs for the transportation system
(contract with commercial ambulance company and county operated ambulance service)
7are summarized. Maps depict the emergency ambulance response times for different
ambulance base location configurations. Recommendations include restricting the
use of emergency ambulance vehicles for trauma or sudden illness patients through
use of invalid vehicles for transporting persons who are non-ambulatory but do not
require medical treatment while in transit. Appendices include a schematic frame-
work for emergency medical service planning, a map showing average daily traffic
burdens in the area, a survey instrument used in an inventory of ambulance
services in the area, and a table for determining driver/attendant wage cost.
Order Number:	HRP-0003753
Developing Emergency Medical Services. Guidelines for Community Councils.
Chicago, 111.: American Medical Association, Commission on Emergency Medical
Services, 1976.
District Health Council. Emergency Medical Services:	A Plan for Resources
Development. Ardmore Airpark, Okla.:	Southern Oklahoma Development
Association, 1975.
This report identifies emergency medical service resources and problems for a
10-county area of Southern Oklahoma, and develops objectives and implementation
methods for a comprehensive emergency medical services plan. The adequacy of
facilities and personnel in 13 area hospitals and 18 ambulance services is
examined. Demography, transportation, and health characteristics are also dis-
cussed. Shortages of ambulance equipment and trained personnel are major problems
as is the lack of an areawide communications network. Improved financial support
for ambulance services and some critical care services are noted as in need.
Priority ratings are given to needs, and specific methods for achieving objectives
are presented, along with 2-year implementation schedules for each plan component.
Detailed budgets, broken down by time period and expenditure, are provided in
tabular form. General plan evaluation guidelines are also provided. Appendices
contain information regarding planning organization, data gathering methods,
guidelines for ambulance service selection, and a description of a proposed area
communication system. Order Number:	HRP-0003406
"The Economics of Highway Emergency Ambulance Services," Northwest Medicine,
Vol . 68, No. 4 (April, 1 969), 333-338.
EMS Feasibility Study. Aberdeen, S. Dak.:	Fourth Planning and Development
District Commission. Denver, Colo.:	U.S. Department of Health, Education,
and Welfare, Division of Emergency Medical Services, 1974.
An emergency medical services (EMS) feasibility study was conducted in the Fourth
Planning and Development District of South Dakota in order to establish, expand,
or improve an EMS system. The purposes of the study were to determine to what
extent emergency medical services are available to citizens of the district,
determine where gaps in services exist or inadequate services are prov'ided, and
explore a plausible and realistic approach to the elimination or minimization of *
service inadequacies. The general goals of the district's EMS coincide with the
state goal in that it is the intention of any proposed project to reduce mortality
and morbidity associated with serious accidents or in illness. It is the intent
of the district to establish a system that will provide optimum care to the victim
of an accident, injury, or illness during the time in which the victim's life or
limbs are in jeopardy. The EMS feasibility study considers the determination of
need, manpower, facilities and equipment, communications, determination of public
and government support, and demography. The organizational structure of an EMS
system for the Fourth District of South Dakota is discussed, as well as available
8resources, the geographical area served, and existing and contemplated standards.
Statements of support for the EMS project are appended.
Order Number:	HRP-0010871
Emergency Medical Service System Plan. Lubbock, Tex.:	South Plains Association
of Governments, 1975.
Plans to establish an emergency medical services (EMS) system in the 15-county
South Plains State Planning Region are presented, with the objective of reducing
death and disability by linking rural South Plains with the city of Lubbock, Texas,
where highly specialized care facilities and practitioners are located. Fragments
of a system already exist, with every county possessing means to transport emer-
gency patients to an emergency department, and most counties have at least one
physician. The planned system would fill the gaps in the present network and
improve the marginal components in existence. Tables present demographic informa-
tion, business profiles, transportation characteristics, legislative characteris-
tics, and health delivery system characteristics. Ambulance service is described
in detail. A definition and justification of needs section is presented, together
with a description of existing EMS communications. An inventory of health care
personnel is given by county. The implementation approach to achieving planned
objectives is outlined, and priorities are defined. An implementation schedule
is provided together with a regional EMS system office budget and an equipment
budget estimate. Order Number:	HRP-0005726
Emergency Medical Services Communications. Blacksburg, Va.:	Virginia Polytechnic
Institute, Department of Industrial Engineering and Operations Research.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare, Public
Health Service. Radford, Va.:	New River Valley Planning District Commission,
1 974 .
Four alternative plans are presented for the New River Valley Planning District
emergency medical service (EMS) communications system. Because a detailed overall
EMS plan was lacking for the New River area, communications planners developed four
plans to provide for various contingencies. One plan assumes a decision to retain
present low-band radio equipment. The other three assume a decision to go to the
new UHF Federal Communications Commission (FCC) channels assigned for special
emergency radio service. Since the completion of the plans, the district was
awarded a 1-year grant for EMS planning and feasibility studies, and two FCC
directives were issued discouraging new license applications for VHF frequency
allocations. Applications for EMS funding would necessarily relate to UHF
frequencies. The range and coverage of EMS radio equipment is discussed, and the
use of the 911 or alternate emergency telephone numbers are explored. The develop-
ment of a grid system for rapid emergency location and identification is required
for effective operation of EMS, and training is necessary to make the system work.
Specifications are given for base transmitters and receivers, antenna tower, and
transmission lines, as well as for radio equipment in the emergency vehicles, and
telemetry equipment in the vehicles and at the hospitals. The relationship of
EMS communications with other public safety functions is discussed, and sources
of EMS information and funding are listed. Order Number:	HRP-0004514
Emergency Medical Services Communications Systems. Rockville, Md.:	U.S. Depart-
ment of Health, Education, and Welfare, National Center for Health Services
Research, Emergency Medical Services Program, 1972.
A booklet on emergency medical services (EMS) communications systems is presented
as an aid for communities interested in developing a communications network to
serve their emergency medical care needs. The material is'intended for use by
persons with some knowledge of emergency medical services and their operations
9who are ready to plan communications components for local or regional EMS systems
The booklet outlines communications requirements in each stage of the EMS cycle,
and describes training requirements. An EMS communications system for a communitj
of 250,000 is described in detail, including dispatch functions, ambulance and
hospital equipment, and estimated costs. A 'disaster exercise,' on paper, is
suggested as a supplemental device for examining EMS communications needs in a
community. Principles of planning EMS communications are summarized as follows:
(1) define organization, performance standards, and geographical boundaries of thi
system; (2) inventory local resources; (3) determine communications needs requirei
to satisfy the system; (4) assess resources and needs to determine the most
economical method of satisfying system requirements; (5) combine medical, fire,
and police requirements wherever possible; and (6) consider ways of effective
savings, such as making large-scale equipment purchases, and centralizing main-
tenance. The booklet also includes detailed technical information on radio
communications, discussions of biomedical telemetry and the 911 emergency tele-
phone number system, and a list of sources of additional information.
Order Number:	HRP-0006521
Emergency Medical Services:	Everybody's Concern. Madison, Wis.:	Health Plannin'
Council, Inc., 1973.
Characteristics of quality emergency care services are examined as a standard
against which local communities can evaluate their existing services, identify
weaknesses, and plan for improved emergency care. The establishment of local
emergency medical service councils is recommended as an initial step. A 23-point
program is outlined and includes the following specifications for ambulance
services: the necessity of 24-hour service planned for and coordinated on a
hospital service area basis, and located to provide adequate response time to the
population served; the availability of a driver and attendant for each emergency
run; the ambulance must meet U.S. Department of Transportation design specifica-
tions; minimum equipment should be items recommended by the American College of
Surgeons; local government financial support should be supplied if required; and
the use of standardized ambulance records. Basic training for ambulance personne
should include in-hospital experience, and provisions should be made for continui
ambulance attendant and hospital personnel education. Proper training should be
provided for ambulance dispatch personnel, and a policy established on the
attendant's role in providing emergency care at the scene, en route, and in the
emergency department. Radio communications should be developed for use between
ambulance and hospital emergency departments, between hospitals, and with the
capability of telephone patch facilities. The hospital emergency departments
should meet standards fixed by the American Medical Association, and the Joint
Commission of Hospital Accreditation, and a review process should be established.
Order Number:	HRP-0004525
Emergency Medical Services in Michigan, A Statement of Public Policy. Lansing,
Mich.:	Michigan State Health Planning Advisory Council; Michigan Office of
Health and Medical Affairs, 1974.
Policy recommendations developed to establish a state emergency medical service
(EMS) in Michigan are outlined. These recommendations include:	(1) the establis’
ment of organizational responsibilities in the emergency medical service system,
(2) the adoption of improved emergency medical service technology, (3) the
increasing of the skill performance of emergency care personnel, and (4) the
implementation of programs which would support a statewide emergency medical
service. Recommendations concerning organizational responsibilities should give
priority to establishing a single organization within the Department of Public
Health to be responsible for EMS program planning and implementation. Those
dealing with improved technology emphasize the development of a statewide EMS
communication system and the requirement that all emergency vehicles meet U.S.
Department of Transportation standards. Recommendations for improving skill
10performance of personnel urge the adoption of a standardized basic training course
for all EMS and ambulance personnel. Policies for program implementation include
development of an EMS system which includes a network of emergency care centers,
and program evaluation based on a uniform patient reporting system.
Order Number:	HRP-0003420
Emergency Medical Services:	Pierce County. Tacoma, Wash.:	Pierce County Health
Council, Emergency Medical Service Committee, 1975.
Existing emergency medical service (EMS) resources in Pierce County, Washington,
were inventoried, and recommendations to provide an integrated EMS system are
presented in this report of the Pierce County Health Council. All ambulance and
fire companies were surveyed, with 100 percent response, to collect data on
vehicles, equipment, communications, personnel, training, type of emergency
response provided, and the annual number of runs. A description of hospitals and
emergency rooms was prepared previously by a separate committee of the health
council. The primary recommendation of the council is that the county government
accept overall responsibility for the continuing administration of a countywide
EMS system, delegating management authority to the county health officer. A
secure funding base musjt be secured, and establishment of a central communications
and dispatch center is recommended. A major finding of the study is that rural
areas are most in need of additional and improved EMS, and that new vehicles and
equipment are badly needed in two areas. Other suggestions include: adoption
of countywide standards regarding design, equipment, and staffing of emergency
medical vehicles; additional training for EMS personnel and the public; and
establishment of a system which is both publicly and privately supported.
Order Number:	HRP-0005820
Emergency Medical Services Plan for Acadiana. Lafayette, La.:	Acadiana Health
Planning Council, Committee on Emergency Medical Services, 1974.
An emergency health services plan for the eight-parish Acadiana Region of South-
west Louisana is set forth. Long-range plans include increased ambulance service;
helicopter use where justified; improved communication equipment; new training
programs for ambulance personnel, the public, and health professionals in general;
improved ordinances governing emergency vehicles and other facets of the system;
and preparation for large-scale emergencies. The proposed plan is designed as a
reference for planning and program development, as well as for upgrading of
services by institutions and organizations involved in emergency health care
delivery. An emergency system should include an organized method for detecting,
reporting, providing initial care, sorting or triage, transporting, caring for
patients en route, and giving acute definitive care and providing linkage to
continued care and rehabilitation for acutely ill or acutely injured patients.
Specific recommendations are made for the following emergency medical services
system components:	public education and participation, response mechanisms for
reporting accidents, communications system, transportation, manpower and training,
facilities categorization and upgrading, research in medical emergencies, legis-
lation, records and analysis, funding profiles, and evaluation. Appendices
include a list of requirements for communications equipment purchased and installed
and an ordinance regulating private ambulances. Order Number:	HRP-0003657
Emergency Medical Services. Position Paper. Fresno, Calif.:	Comprehensive
Health Planning Association of Central California, 1972.
Categories of emergency care and emergency facilities are defined and actions for
implementing the emergency medical services (EMS) section of the California State
Plan for Health are recommended in a report prepared by the Comprehensive Health
Planning Association of Central California for statewide consideration. A general
11definition of EMS is stated, and categories of first aid and EMS facilities in
California are delineated. Facility categories include the comprehensive EMS
facility, the major EMS facility, the general EMS facility, the basic EMS facility,
and the first aid and referral facility. Staffing and minimum capability require-
ments are identified for each category. The principles underlying the California
concept for development of a statewide EMS delivery system are reviewed, and
implementation activities are suggested relative to regionalization, consolidation
of resources, unification of communications, the transportation network, and
standardization of training. Procedures for reviewing EMS grant applications are
recommended. The relationships among the state Bureau of Emergency Medical
Services, other state agencies, local jurisdictions, federal agencies, and private
organizations and associations are described, and EMS-related agencies and organi-
zations in California are identified. Special attention is directed to the
relationship between EMS delivery and disaster planning. Supporting documentation,
including relevant excerpts from the California State Plan for Health (1971), is
appended. Order Number:	HRP-0011734
Emergency Medical Services Program Report:	A Conceptual Plan for Colorado.
Denver, Colo.:	Colorado Council on Emergency Medical Services. Rockville,
Md.:	U.S. Department of Health, Education, and Welfare, Health Services and
Mental Health Administration, Regional Medical Programs Service. Denver,
Colo.:	Col orado - Wyoming Regional Medical Program, 1 974.
A statewide plan for emergency medical services (EMS) in Colorado is presented.
The first chapter on background and need emphasizes the difficulties in delivering
emergency health care in Colorado due to the interplay of the folowing: A rapid
and uneven surge of population growth in the past 20 years; inadequate trans-
portation and communication links between inaccessible and sparsely populated
mountain regions; medical personnel shortages and inadequate facilities in rural
areas and overloaded medical facilities with insufficient funding services in the
urban centers; high frequency of accidents in urban centers, but a higher percent-
age of fatalities in rural areas; and the increasing number of highway accidents
and resulting injuries sustained by state residents and the many transients who
visit Colorado each year. Chapter II presents an overview of existing EMS com-
ponents, including a discussion of the organizational structures of various state
agencies and programs and the need for regionalization and decentralization.
Needs and resources are identified in Chapter III, i.e., ambulance services,
facilities, communications, personnel and training, records, consumer input, and
characteristics of rural EMS systems are discussed. Chapters IV through VIII
present the state plan for EMS transportation, personnel training and consumer
education, communications, special services such as toxicology and poison control,
transfer and care of high-risk pregnancies and newborns, mental health emergencies,
child abuse, disaster planning; and standardization of EMS recordkeeping. Pro-
cedural steps for implementing the plan are outlined, and the approach to system
evaluation is described. Appendices include supporting tabular data, categoriza-
tion criteria for emergency care facilities, sample ambulance report forms, a
discussion of emergency care subsystems including an outline of curriculum for
continuing education of rural physicians in management of the critically injured,
a statement of emergency department standards, a course outline for an advanced
emergency medical technician biomedical telemetry course, and other supporting
documents. Order Number:	HRP-0004362
Emergency Medical Services in Superior California. Chico, Calif.:	Superior
California Regional Medical Program, California Medical Education and
Research Foundation, 1975.
A plan for emergency medical services (EMS) is presented for 12 counties in
Northeastern California. The document opens with a brief review of the history
of EMS planning in the area, summary descriptions of each of the counties, and
an outline of the organization and management of emergency medical services in
12the two planning areas served by the Superior California Comprehensive Health
Planning Association. Goals and objectives are then set forth in the areas of
training, communications, transportation, facilities, and public education and
information. In each area, existing resources and factors influencing their
development are pointed out, and recommendations for program implementation are
set forth. The document includes an inventory of training facilities and programs
for EMS personnel in the area, as well as statistics on the supply and distribution
of emergency medical technicians. Summary descriptions are provided of each of
the area's hospitals providing emergency medical services, including indications
of their capabilities for handling different types of patients and summaries of
referral patterns. Maps and supporting data are incorporated throughout the
document. Order Number:	HRP-0011783
Emergency Medical Services Survey and Plan Development. Evaluation and Revision
of Preliminary Guidance Document. Final Report. Menlo Park, Calif.:
Stanford Research Institute, 1970.
The Highway Safety Act of 1966 recognized the importance of emergency services by
requiring that a standard be developed to cover this aspect of highway safety.
Highway Safety Program Standard 4.4.11, Emergency Medical Services, was promulgated
on June 27, 1967. This federal guidance for emergency medical services (EMS)
survey and plan development has been prepared to supplement the guidance contained
in the Highway Safety Program manual and is a revision of the preliminary guidance
document distributed in June 1968. Areas of concern are the organizational and
planning procedures required at the state level, the steps required to implement
a state program, actions required at the local level to facilitate program imple-
mentation, and data needs for EMS evaluation and determination of program priori-
ties. The guidance does not specify rigid procedures to be followed in all states.
Sufficient flexibility is provided to allow for variations in state and local
characteristics while retaining comparability in data collection and general
evaluative techniques. Order Number:	HRP-1000394
Emergency Medical Services Systems Program Guidelines. Hyattsville, Md.:	U.S.
Department of Health, Education, and Welfare, Bureau of Medical Services,
Division of Emergency Medical Services, 1975.
A policy statement is presented by the Health Services Administration of the U.S.
Department of Health, Education, and Welfare to assist applicants in applying
for funds available under the Emergency Medical Services Systems Act of 1973
(Public Law 93-154) in understanding the legislation, regulations, guidelines,
and related administrative procedures. The document also familiarizes the
applicant with application procedures, evaluation, and post-award project ad-
ministration. After an opening discussion of program administration, eligibility
and funding limitations and considerations are discussed. Special program
guidance, such as emergency care issues, regionalization of emergency medical
services (EMS), EMS system components, eva1uation of EMS as a component of the
total health care delivery system, and EMS system management, is offered. Appli-
cation procedures are reviewed, and criteria for evaluation of applications
under Sections 1202, 03, and 04, of the Act are outlined. Post-award administra-
tion is also discussed, and project changes such as costs, payments, income,
credits, and refunds; accounting, records, and audits; reports and reporting
requirements; and publication and publicity are briefly noted. Exhibits
describe the A-95 review process and list regional offices; present the
evaluation factors for applications submitted under each section of the Act; and
quote Federal EMS regulations. A list of references is included. Order Number:
HRP-0005582Emergency Medical Services Systems Research Project Summaries:	Active as of
June 30 , 1 975. Hyattsvi11e , M d.:	U.S. Department of Health, Education, and
Welfare, National Center for Health Services Research, Health Systems Design
and Development Division, 1975.
Emergency Medical Services for an Urban Area. Summary Report. Ann Arbor, Mich.:
University of Michigan, Highway Safety Research Institute, 1970.
A report describing the recent study of Detroit's public ambulance service is
submitted. The report consists of two volumes:	one is a summary while the other
contains the complete details, methods and findings of the project. The types of
service demonstrated included the police and fire rescue squad emergency response
system presently in use, a commercial service which provided data for both a
private franchise service and a public ambulance corps as alternatives to the
present system, and a helicopter ambulance which supplemented the ground systems.
Evaluation was based on the speed of service, the quality of treatment, and the
costs of each of the methods. Order Number:	HRP-1000300
Evaluation of Emergency Medical Devices and Systems, September 1976 (Revised).
Philadelphia, Pa.:	Emergency Care Research Institute, 1977.
Evaluation of Emergency Medical Devices and Systems, December 28, 1976 (Revised).
Philadelphia, Pa.:	Emergency Care Research Institute, 1977.
An Evaluation Methodology for Emergency Medical Services (EMS) Systems. Final
Report. Paramus, N.J.:	Computer Sciences Corporation, 1973.
The object of the program was to study various methods for developing EMS data on
which governmental decision-making might be based. After the study, one method
was chosen and developed into a complete EMS assessment model. Work started with
a baseline questionnaire developed under NATO. This was refined, expanded, and
field-tested in a number of states with the intention that, under NATO, it might
become an international standard for EMS assessment. Appropriate effectiveness
measures are described and a weighting system in which mathematical totals can be
derived is suggested. Order Number:	HRP-1000892.
Feasibility and Planning Application:	Emergency Medical Services System, East
Tennessee. Knoxville, Tenn.:	East Tennessee Health Planninq Council, Inc.,
1 974.
Community involvement in the planning process is stressed in this feasibility study
and planning program for an emergency medical system (EMS) for East Tennessee.
Under the authority of the East Tennessee Health Planning Council, an Emergency
Medical Services Planning Committee was formed to work with a full-time EMS
planner. Encompassing 16 counties, the area to be covered by the system contains
the Knoxville metropolitan area and three other municipalities with more than
10,000 population, as well as rural areas with rugged mountain terrain. Govern-
mental and population characteristics are analyzed, and the special problems posed
to an EMS transportation system by the mountainous terrain are discussed. Legis-
lative requirements dealing with EMS are outlined. An assessment of needs is made
concerning manpower, training, communications, transportation, facilities, critical
care units, and public safety agencies. Topics such as consumer participation,
accessibility to care, standard medical recordkeeping and the transfer of patients
are discussed together with a consideration of disaster planning, an evaluation
14process, mutual aid agreements, and financing of the system. The planning approach
is detailed. The qualifications of the planning council are presented. Appendices
provide supporting data. Order Number: HRP-0004386
Feasibility Planning. Emergency Medical Services System, East Tennessee.
Knoxville, Tenn.:	East Tennessee Health Planning Council, Inc., 1974.
An application for federal funding to support feasibility study and planning for
an areawide system of emergency medical services (EMS) is presented by the East
Tennessee Health Planning Council. The population of the 16-county, eastern
Tennessee area is sparsely distributed over much of the 6700 sq. mi., and the
mountainous nature of the terrain presents particular challenges in the area of
emergency transportation. Following a summary of the population and area
characteristics, needs are assessed for each of 15 EMS components:	manpower,
training, communications, transportation, facilities, critical care units, public
safety agencies, consumer participation, accessibility to care, transfer of
patients, standard medical recordkeeping, consumer information and education,
evaluation, disaster planning, mutual aid agreements, and financing. The planning
approach is described, and objectives are stated in the above areas. From these
objectives, priorities are designated. Among top priorities are the following:
development of full-time emergency room physician coverage at each area hospital;
use of public safety personnel and private citizens to augment EMS personnel;
development of centralized emergency dispatch accessible by single telephone
number; study of ambulance locations; development of specific performance measures;
and others. Appendices include a categorization of hospital emergency capabili-
ties, supporting tabular data and map, a report from the communications task force,
a proposed schedule for planning activities, and letters of endorsement.
Order Number:	HRP-0004041
Federal Specification-- Ambulance. Emergency Medical Care Vehicle.
D.C.:	General Services Administration, Federal Supply Service,
Washington,
1 975.
Flexer, M., "What Potential for Helicopters in EMS?"
(February 16, 1975), 60-63
Hospitals, Vol. 49, No. 4
Ford, J.D., "Emergency Medical Services. Case
of Capabilities," Hospi tals, Vol. 47, No.
Study. Planning Depends on Analysis
10 (May 1 6, 1 973) , 1 25-1 30.
Fortuna, J.A., "Training the EMS Systems Administrator," Emergency Medical
Services, Vol. 4, No. 4 (July - August, 1 975), 33-39.
Freeark, Robert J., "Surgeon's Role in the Staffing of Hospital Emergency
Departments," Journal of Trauma, Vol. 13, No. 4 (April, 1973), 300-306.
Frey, C.F.; Hinds, R.J.; Dow, R.W.; and Turcotte, J.G., "From Emergency Room to
Emergency Department:	An Evaluation of the Emergency Department,"
University of Michigan Medical Center Journal, Vol. 36, No. 2 (April -June,
1970), 62-64.
15Frey, C.F., and Mangold, K., "The Physcian and the Emergency Health Service
System," Postgraduate Medicine, Vol. 55, No. 1 (January, 1974), 197-204.
Gibson, G., "Emergency Medical Services Research:	Integration or Isolation?"
Health Services Research, Vol. 9, No. 4 (Winter, 1974), 255-269.
-, "Evaluative Criteria for Emergency Ambulance Systems," Social Science
Medi cine, Vol. 7, No. 6 (June, 1 973), 425-454.
-, "Guidelines for Research and Evaluation of Emergency Medical Services,"
Health Services Reports, Vol. 89, No. 2 (March - Apri 1 , 1 974 ), 99-1 1 1 .
Goals and Guidelines for a System of Emergency Facilities for Dade County. Miami,
Fla.:	Comprehensive Health Planning Council of South Florida, Inc., 1974.
Guidelines and criteria for emergency medical services and facilities in Dade
County, Florida, are presented by the Comprehensive Health Planning Council of
South Florida. Following an introductory discussion of the indicators of need for
an emergency medical service system in Dade County, specific criteria are defined
for four levels of emergency capability:	regional emergency center, comprehensive
emergency service, emergency standby and referral service, and outpatient and
clinic services. For each level, criteria are noted in the following areas:
emergency facility status, emergency facility staffing, hospital support capabili-
ty, emergency facility equipment, communications, patient care, financial consid-
eration, heliport, disaster plan, hospital procedures, emergency facilities
planning, and evaluation. A tabular summary of the criteria is included.
Order Number:	HRP-0007428
Golomb, H.M., and Herrold, S.R., "An Alternative Staffing Proposal for Emergency
Rooms. Three-Year Experience in a Rural Hospital," Journal of the American
Medical Association, Vol. 228, No. 3 (April 15, 1974J1 329-331.
Grayson, Lauren H.; Burnett, Lynn; Mewhort, Stephen; and Collins, Michael A.
Paramedic Program Operational Plan. Fresno, Calif.:	Central Valley Heart
Association, Emergency Medical Services Systems Development Program.
Oakland, Calif.:	California Regional Medical Program, 1975.
The organization and operation of a paramedic plan for the Fresno-Clovis,
California, metropolitan area is presented by the Central Valley Emergency Medical
Services Systems Development Program. The need for paramedic programs, and
examples of successful programs currently in operation are discussed, and a list
of definitions and explanations of terminology is provided. Program criteria and
a base of operations for the local program are given together with the established
pilot area of operations. Notification and dispatch procedures, and a schedule
for on-scene activity are presented. Patient transportation and disposition and
on-scene protocol are outlined. A discussion of the selection of prospective para
medic trainees and their training program is followed by procedures for evaluating
the paramedic program, and a description of program equipment including types of
vehicles used, and necessary medical equipment. Vehicle, hospital, training and
medical supply costs, and methods of financing paramedic programs are outlined.
16Appendices present the text of Senate Bill No. 772 , locations of the paramedic
teams, pilot paramedic response areas, and interagency notification and dispatch
procedures. Order Number:	HRP-0004415
Guide to Community Planning in Emergency Medical Services. Winston-Salem, N.C.:
Hall and Powers. Durham, N.C.:	North Carolina Regional Medical Program.
Greensboro, N.C.:	Piedmont Triad Regional Comprehensive Health Planning
Council, 1974.
Guidelines for community development of emergency medical services (EMS) are
presented by the Piedmont Triad Regional Comprehensive Health Planning Council.
An overview presents developments in EMS technology including improvements in
communications, design and capabilities of emergency vehicles, organization and
staffing of hospital emergency departments, and the development of training pro-
grams for all EMS personnel. The components of an EMS system are defined as
follows:	education and training, communications, transportation, facilities, and
planning and administration. A schematic drawing illustrates patient flow within
an EMS system, as well as the planning process behind the system. Each EMS com-
ponent is discussed relative to community planning, and sources of standards,
guidelines, and funding are given. A detailed definition of an EMS system is
provided which identifies 15 functions the system should perform. The medical
self-help course, sponsored by the U.S. Department of Health, Education, and
Welfare's Health Services and Mental Health Administration and the Defense Civil
Preparedness Agency of the U.S. Department of Defense is described briefly. A
bibliography of legislative basis and general information and of publications
relative to each of the EMS system components is included.
Order Number:	HRP-0003856
Guidelines for Emergency Medical Services. Tustin, Calif.:	Orange County Health
Planning Council, 1974.
Points of reference for use in the planning and review of emergency medical
services (EMS) in Orange County, California, are presented by the Orange County
Health Planning Council. The guidelines are intended primarily for use by the
Council's Planning and Review Committees, and include data on current emergency
medical services in the county; trends affecting these services; sources of
National and state standards; information required of agencies desiring grant,
proposal, or program review; an outline of procedures for program planning and
coordination; a description of the scope of services, staffing, and equipment as
foreseen in the Orange County Health Services Plan; record and report requirements;
accessibility standards; and economic feasibility considerations. The functions
and organization of the following elements of the EMS system are outlined:
communications, transportation, fixed location treatment facilities, i.e., first
aid and referral services, standby EMS, basic EMS, major EMS, comprehensive EMS,
and trauma centers, base station hospitals, manpower development, and public
information and education. A bibliography is included. Order Number:	HRP-0004375
Guidelines for Emergency Medical Services in East Central Michigan. Saginaw,
Mich.:	East Central Michigan Comprehensive Health Planning Council, Emergency
Medical Services Committee. Rockville, Md.:	U.S. Department of Health,
Education, and Welfare, Public Health Service, 1974.
Guidelines are presented for the provision of emergency medical services in East
Central Michigan. The guidelines were researched, developed, and adopted by the
East Central Michigan Comprehensive Health Planning Council. Guideline recommen-
dations are based on levels of operation demonstrated to be attainable by pro-
viders of emergency medical services in East Central Michigan. The purposes of
the guidelines are to promote the highest possible quality of emergency medicalcare; link emergency medical service providers into a coordinated, cooperative
system; and serve as the basis for review and comment on applications for grant
assistance. Guidelines are outlined which pertain to accreditation, policies and
procedures, emergency department (room) facilities, professional and supportive
staffing, training, emergency department records, disaster plans, and emergency
department supplies and equipment. These guidelines relate to hospital emergency
service. For ambulance service, the following guidelines are listed:	personnel
and training, communications capability, ambulance run records, and vehicles and
equipment. Order Number:	HRP-0005275
Guidelines for the Planning and Development of Emergency Medical Services in
West Virginia Region X. Wheeling, W.Va.:	Panhandle Health Planning, Inc.,
Board of Directors, 1975.
Guidelines to provide a basis for the planning and development of a community-
oriented system of medical services in the Panhandle Region of West Virginia are
presented. Five major components within an emergency medical services system are
described:	general public information and education; emergency medical communi-
cations system; transportation; regionalized emergency medical services facilities;
and disaster planning. Five types of facilities are defined:	standby treatment
service, basic emergency service, general emergency service, major emergency
hospital service, and comprehensive emergency medical service. Travel time
estimates by radius of operation are provided as guidelines in determining the
need for personnel, equipment, and facilities. A bibliography is included.
Order Number:	HRP-0003666
Guidelines for the Planning and Development of Emergency Medical Services in
Western Pennsylvania. Pittsburgh, Pa.:	Comprehensive Health Planning
Association of Western Pennsylvania, Inc., Regional Plan Development
Committee, 1974.
Following a background discussion and definition of terms, qualitative and
quantitative guidelines for development of a community-oriented emergency medical
service (EMS) system are offered. Five major components of an EMS system are
defined and discussed:	general public information and education; emergency
medical communications systems; transportation; regionalized EMS facilities; and
disaster planning. Capabilities are defined for five categories of emergency
facilities:	life support unit, basic emergency service, general emergency service,
major emergency hospital, and comprehensive emergency medical services. Travel
time estimates by radius of operations are given as aids in determining need for
personnel, equipment, and facilities. The necessity of training large numbers of
people in basic first aid/life support (cardiopulmonary resuscitation, emergency
management of spine injury, and emergency management of massive hemorrhage) to
achieve maximum survival rate is noted. An EMS system checklist presents questions
in the following areas:	communications; ambulance, helicopter, and mobile inten-
sive care unit equipment; emergency response vehicle personnel and training pro-
grams; hospital emergency departments and regionalization; psychiatric emergency
care services; and implementation of guidelines. Community sources from which
representation in an EMS evaluation group might be drawn are suggested. A flow-
chart of the comprehensive health planning process and a bibliography are included.
Order Number:	HRP-0003802
Gunter, Margaret J., and Ricci, Edmund M. Hospital Planning for Emergency Medical
Services:	Organizational Issues and Interrelationships. Pittsburgh, Pa.:
University of Pittsburgh, Health Operations Research Group. Rockville, Md.:
U.S. Department of Health, Education, and Wei fa re, National Center for Health
Services Research, 1974.
18The report presents the findings of an exploratory investigation of the various
political and social forces which govern hospital emergency room decisions and also
presents hypotheses concerning the functions of emergency rooms and the issue of
emergency room autonomy. The report contains a discussion of the research
methodology used, a description of the functions of the emergency room in the study
hospitals, and of the strategies used to extend the autonomy of the emergency room
and its ability to acquire necessary resources. The report also specifies a number
of hypotheses derived from the research concerning the ways in which the functions
of emergency rooms and the issue of emergency room autonomy are likely to influence
decisions made regarding emergency care. Order Number:	HRP-1001752
Gunter, Margaret Jane. Comparative Study of Community Planning for Emergency
Medical Services:	The Impact of Social and Political Factors on Program
Implementation. Dissertation. Pittsburgh, Pa.:	University of Pittsburgh.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare,
Bureau of Health Services Research, 1975.
A comparative study on community planning for emergency medical services (EMS) is
reported. The open systems approach to community decision-making and the concepts
of emergency care planning are examined. The changing context of community EMS
planning is explored. Planning processes in two study communities were examined
(Nassau County and Suffolk County, New York). Several qualitative approaches to
the study of community and organizational decision-making were employed in the
study:	loosely structured open-ended interviewing of multiple decision-makers and
other informants, examination of documents, and non-participant observation. The
evolution of EMS planning in the two study communities is discussed in relation to:
(1) the dominant geographic and demographic characteristics of each county; (2) the
state of emergency care development in each county prior to the initiation of
formal planning; (3) the sequence of emergency care planning efforts, with emphasis
on the impetus to planning, mix of interests and their response, and issues in
and obstacles to effective planning; and (4) the status of the EMS system in each
county and prospects for development. The process of community planning for EMS
systems is detailed, and implications of the two-county study results are dis-
cussed. A list of references is included. Order Number:	HRP-0010392
Gupta, R.C., "Disaster Planning for Our Hospitals," Journal of the Indian Medical
Association, Vol . 59, No. 3 (August 1 , 1 972), 1 06-1 09.
Haeck, W.T., "Emergency Medical Services. Case Study. An EMS System that Works,"
Hospi tals, Vol. 47, No. TO (May 1 6 , 1 973), 1 39-1 42.
Hamilton, W.F., "Systems Analysis in Emergency Care Planning," Medical Care,
Vol. 12, No. 2 (February, 1974), 152-162.
Hampton, O.P., Jr., "A Systematic Approach to Emergency Medical Services,"
Archives of Environmental Health, Vol. 21, No. 2 (August, 1970), 214-217.
Handbook for Task Forces on Area Emergency Medical Services. Oklahoma City, Okla.:
Oklahoma Health Planning Commission. Rockville, Md.:	U.S. Department of
Health, Education, and Welfare, Health Services and Mental Health Administra-
tion, Community Health Service. Oklahoma City, Okla.:	Oklahoma State
Legislature, 1974.
19Guidelines are presented for use by citizens of Oklahoma who wish to form task
forces to deal with emergency medical service (EMS) needs in their communities.
Composition and organization of a task force are discussed. Elements of a work
program are outlined in the following areas:	identification of the nature and
extent of the problem, identification of objectives, identification of alternative
solutions, and implementation. Components of an EMS system are discussed, includ-
ing training of the emergency medical technician (EMT), communications , the ambu-
lance and its equipment, the hospital emergency room and its personnel, public
information and public education programs, and ambulance service operators (types
of service and financial considerations). Included are descriptions of the 72-hour
EMT training course, the mobile intensive care technician training program of
Oklahoma, EMT associate degree programs, proposed programs for training EMT
ambulance drivers and EMT dispatchers, and a proposed EMT short-term refresher
training program. The types of ambulance services described include the funeral
home ambulance, the private operator, the municipally-operated service, the
hospital-based service, and the volunteer ambulance service. The complexity of
economic problems affecting ambulance services is emphasized. Sources of consul-
tation and assistance available to Oklahomans interested in EMS planning are
listed, and a bibliography and suggested reading list are provided.
Order Number:	HRP-0004301
Hanlon, John J. Emergency Medical Care as a Comprehensive System. Rockville, Md.:
ll.S. Department of Health, Education, and Welfare, Health Services Adminis-
tration, 1 973.
The contention that the status of all aspects of emergency medical care leaves much
to be desired is elaborated in this paper based on a speech by the 1973 Assistant
Surgeon General and Coordinator for Public Health Programs. The need for more
comprehensive emergency care is demonstrated by the fact that 15 or 20 percent of
accidental highway deaths and 10 to 20 percent of pre-hospital coronary deaths
could be prevented by proper care at the emergency site and en route to the
hospital. There has been duplicative and wasteful proliferation of emergency
rooms, many of which are located in hospitals which are not equipped to handle
all emergencies and which do not have sufficient qualified manpower. At the same
time, the number of patient visits to emergency rooms in the United States con-
tinues to increase, partially because of patients who use the emergency room as an
ambulatory care facility. Serious deficiencies in emergency care are related to
ambulance use:	lack of ambulance coverage, poor vehicular design, inadequate
equipment for treatment, and inadequate communications equipment. Other defici-
encies are in the areas of trained ambulance drivers and attendants and physicians
trained in emergency medicine. An emergency medical services system is proposed
based on five phases of care:	pretreatment, preliminary phase, definitive care
phase at receiving facility, recuperation phase, and rehabilitation phase. Uniform
standards and regulations are suggested for legislation, ambulances, ambulance
personnel, hospital facilities, communications, and supportive actions. Other
aspects of emergency care such as data collection and analysis, public education,
and coordinating councils are discussed. A list of references is included.
Order Number:	HRP-0005574
Hannas, R.R., Jr., "Emergency Department Physician Staffing Patterns and Residency
Training," Illinois Medical Journal, Vol. 143, No. 6 (June, 1973), 525-526.
-, "Guidelines for Staffing the Emergency Department," Registered Nurse,
Vol. 37, No. 4 (April, 1974), 10-12.
-, "Role of the Emergency Physician in a Trauma Center," Journal of T rauma,
Vol. 13, No. 4 (April, 1973), 306-308.
20Hannas, R.R., Jr., "Staffing the Emergency Department," Hospi tals, Vol. 47, No. 10
(May 16, 1973), 83-86.
Harvey, J.C., "The Emergency Medical Service Systems Act of 1973," Journal of the
American Medical Association, Vol. 230 , No. 8 (November 25 , 1 974) , 1 1 39-1 1 40.
-, "Emergency Medical Services. Categorization of Emergency Capabilities,"
Hospitals, Vol. 47, No. 10 (May 16, 1973), 69-72.
-, "Planning for Career Ambulance Profession," Maryland State Medical Journal,
Vol. 23, No. 7 (July, 1 974) , 51 -52 .
Heidt, R.S., "Organization of Emergency Medical Services Councils," Ohio State
Medi cal Journal , Vol. 70, No. 6 (June, 1974), 352-356.
Horoshak, Irene, "Transformation of the ED Nurse. Part 2:	Upgrading Skills and
Status," Registered Nurse, Vol. 38, No. 8 (August, 1975), 35-38.
Horty, J.F., "Emergency Medical Services. Categorization:	A Legal View,"
Hospitals, Vol. 47, No. 10 (May 16, 1973), 75-80.
Hospital Emergency Department as Provider of Emergency and Ambulatory Care in
Suffolk County. Melville, N.Y.:	Nassau-Suffolk Regional Medical Program,
Inc., 1977.
Huntley, Henry C. How Effective Are Our Emergency Services. Rockville, Md. :
U.S. Department of Health, Education, and Welfare, Health Services and Mental
Health Administration, Division of Emergency Health Services, 1971.
Factors influencing the effectiveness of emergency medical services provided by
hospital emergency departments and by ambulance services are considered. Lack of
sufficient training of ambulance attendants and communications deficiencies between
ambulances and hospitals are noted. It is suggested that it is the hospital's
responsibility, through the emergency department, to train ambulance attendants as
emergency medical technicians. The high cost of a wel1-equipped and well-manned
ambulance service is discussed; it is suggested that one way to bring costs within
reach is to employ emergency medical technicians on a full-time basis, assigning
them jobs in the emergency department or elsewhere in the hospital between ambu-
lance runs so that their special skills can be utilized fully. Trends which
account for the significant shift to the emergency department as a source of
primary medical care are noted. State surveys indicating that the Nation's
hospitals are ill-prepared to cope with this increase in emergency patient load
are cited. The tendency of the emergency department to receive low priority in
the hospital pecking order is noted. Several recent developments which should
lead to major improvements in emergency medical care are noted:	requirements for
state planning of emergency medical care systems in order to receive monies from
the highway trust fund; standards developed by the Joint Commission on Accredi-
tation of Hospitals regarding emergency care; formation of the American Medical
Association's Commission on emergency medical services; standards for ambulance
21design, equipment, and personnel training published by the National Academy of
Sciences/National Research Council; and others. Predictions are offered concerning
improvements in emergency medical services and the cost of these services. A
bibliography is included. Order Number:	HRP-0005302
Iott, Robert 0.; Webb, Samuel B.; Thompson, John D.; and Pearson, David A.,
"Emergency Medical Services and the Hospital-- A Statewide Analysis. Part IV.
The Emergency Department-- Can It Be Used to Plan a Hospital-Based Primary
Care Center," Hospital Administration, Vol. 19, No. 1 (Winter, 1974), 63-77.
"The Iowa Emergency Medical Services Communications Plan," Journal of the Iowa
Medical Society, Vol. 63, No. 8 (August, 1973), 387-388.
Jacobs, A.R., and Thurber, C.L., "Emergency Care Crisis Avoided in a Rural
Community," Health Services Reports, Vol. 87, No. 10 (December, 1972),
977-982.
Jenkins, A.L. Emergency Department Organization and Management. East Lansing,
Mich.:	American College of Emergency Physicians, 1975.
This guidebook, designed to improve emergency medical services, contains an over-
view of the field of emergency medicine. Criteria for the establishment of an
emergency department are noted. Emergency medicine is viewed as a specialty field
in terms of meeting and improving the needs of patients. The major role of an
emergency department is identified as the provision of efficient care. Emergency
department design and staffing requirements are addressed, and the role of emer-
gency department nurses in the provision of care is discussed. Consideration is
given to the medical education and training of emergency department staff, depart-
mental policies and procedures, and records and forms. The relationship between
an emergency department and other hospital departments is examined. The effective-
ness of community resources and involvement in the delivery of emergency care is
explored. Disaster planning and transportation and communication aspects of an
emergency department are described. Discussions on efficiency, legal, and
financial parameters to consider in the field of emergency medicine are presented.
Appendices to the guidebook concern contracts, bylaws, and rules and regulations
for emergency departments; standards for emergency departments; and emergency
physician credentialing. Order Number:	HRP-0015213
Johnson, G., Jr., "Priorities for Establishing a Rural Eemrgency Medical Services
System," North Carolina Medical Journal, Vol. 36, No. 5 (May, 1975), 304.
Kaufman, T.; Vorzimer, J.J.; and Metz, D., "The POMR in an ED," Hospitals,
Vol. 48, No. 21 (November 1, 1974), 59-62.
Keller, G.B., and Keller, M.D., "Concepts of Sensitivity and Specificity in the
Evaluation of Emergency Medical Services," Social Science and Medicine,
Vol. 7, No. 11 (November, 1973), 861-864.
22Leatherwood, Richard. Assessment of Emergency Medical Systems Adequacy, Final
Evaluation Report. Atlanta, Ga.:	Transactions Systems, Inc. Rockville, Md.:
U.S. Department of Health, Education, and Welfare, Health Services Administra-
tion, 1 974.
The study reports on the adequacy of emergency medical services (EMS) resources
(ambulances, personnel, emergency departments, communication systems) by planning
district within states, by HEW region and nationally. It also reports on the
adequacy of private EMS systems, using a model to assess system adequacy. The
results are presented in tabular form and narratively. The appendix provides a
delineation of EMS service area identification, EMS resources by health planning
district, and demographic data. Order Number:	HRP-1001492
Lepper, R.L.; Cayten, C.G.; and Naples, M., "An Overview of Rural EMS," Emergency
Medical Services, Vol. 4, No. 5 (September - October, 1 975), 26-32 .
Lifton, J.G., "Eight Ways to Provide Physician Coverage of the Emergency Room and
How to Tell Which is Best," Modern Hospital, Vol. 121, No. 4 (October, 1973),
79-82.
Main, Keith, and Purcell, Ruth. Implementation and Coordination of Emergency
Medical Services in the Green River Region, Kentucky. A Plan. Evansvi11e,
Ind.:	Tri-State Area Health Planning Council, Inc. Rockville, Md.:	U.S.
Department of Health, Education, and Welfare, Public Health Service, 1974.
Plans for the implementation of an emergency medical service (EMS) system in a
seven-county, primarily rural area of Western Kentucky are presented. Organization
for EMS implementation, including authority, staff structure, functional identifi-
cation, EMS planning area identification, advisory groups, and legislation are
described with the aid of organizational charts. Tables and charts are used in a
description of the program area population and of the current status of EMS
resources. EMS standards such as organizational, operational, personnel training,
ambulance and equipment specifications, response time, communications, and hospital
facilities are detailed. Broad goals and specific program objectives are given,
and methodology for implementation of the program, together with a schedule for
program activities, is presented. A program resource summary, listing objective/
activity (manpower, training, communications, etc.), specific need, and resource(s)
available to meet that need, is included as is a similar table identifying the
agency or person responsible for carrying out specific program activities. A
budget schedule and program evaluation are included. Appendices include job
descriptions for an EMS systems coordinator and a regional trauma physician, state
legislation relating to emergency ambulance services, a plan of operation for an
EMS communication network for the area, letters of intent to participate in the
EMS system, a financial plan narrative, and other supporting documents.
Order Number:	HRP-0003780
Mangold, K.G., "The Financial Realities of EMS." Hospitals, Vol. 47, No. 10
(May 1 6 , 1 973) , 89-96.
McDermott, S., "Planning for Emergency Medical Services Communications,"
Emergency Medical Services, Vol. 2, No. 6 (November - December 1 973), 34-37.
23McLeod, Kathryn A,, "Transformation of the ED Nurse. Part I:	Learning to Take the
Trauma of Triage," Registered Nurse, Vol. 38, No. 7 (July, 1975), 22-27.
Methods for Determining	and Projecting	Demands	for Emergency Medical Services.
Washington, D.C.:	Young (Arthur)	and Co.	Rockville, Md.: U.S. Department
of Health, Education, and Welfare, Bureau of Health Planning and Resources
Development, 1975.
Emergency medical services (EMS) is described and elements in an EMS system are
defined for planning. Need and demand issues related to EMS are examined.
Criteria for analyzing methods for use in determining and projecting demands for
EMS are outlined. The responsiveness of demand determination methods to key EMS
issues is addressed. Summary descriptions and analyses of five methods for
determining and projecting demands for EMS are presented:	(1) formula method for
estimating the number of ambulances; (2) computer program method for determining
the number and location of ambulances; (3) comprehensive regional EMS planning
method; (4) two-stage method for assessing basic and advanced life support EMS;
and (5) demand/utilization assessment method. A comparative analysis of the five
methods is included. Adapting and integrating methods for determining and pro-
jecting demands for EMS are noted. Supporting data are tabulated on EMS resources,
demand assessments, and utilization and resource requirements.
Order Number:	HRP-0016895
Milam, J.T., "Guidelines to Increase Efficiency of the Hospital Emergency Depart-
ment," Journal of the Mississippi State Medical Association, Vol. 11, No. 2
(February, 1970), 61-64.
Morgan, D.M., "New Innovations in Emergency Design," Dimensions in Health Service,
Vol. 51, No. 4 (April, 1974), 60-63.
-, "Special Education for Emergency Nurses," Dimensions in Health Service,
Vol. 52, No. 10 (October, 1975), 10-12.
Murphy, S.P., "Organization and Management of Emergency Ambulance Care and
Emergency Hospitals," International Anesthesiology Clinics, Vol. 9, No. 1
(1971), 189-218.
Nachlas, Joel Anthony. Regional Planning of Critical Emergency Medical Care.
Pittsburgh, Pa.:	University of Pittsburgh, School of Engineering, 1976.
Nahum, A.M., "Emergency Medical Care Systems," Journal of the American Medical
Association, Vol. 217, No. 11 (September 13^ 1971), 1530-1532.
Objectives of EMS Communications System. Miami, Fla.:	Comprehensive Health
Planning Council of South Florida, Inc., 1973.
Communication needs of the emergency medical service (EMS) system in Dade County,
Florida, are outlined. Five basic communication needs are identified:
24(1) medical rescue-- physician consultation, coordination, ambulances, and backup
assistance; (2) medical faci 1 ities-- interhospital and intrahospital coordination
and hospital (physician) to field communication procedures; (3) ambulance service
--notification and dispatching procedures and links to medical facilities;
(4) disasters-- resource gathering and resource coordination; and (5) public
access. Links among various EMS communications system components are noted and
illustrated in a flow chart. Order Number:	HRP-0007426
"Open Forum:	The Private Operator," Emergency Medical Services, Vol . 2, No. 2
(March - Apri 1 , 1 973), 24-27.
"Open Forum:	The Role of the Federal Government in Emergency Medical Services,"
Emergency Medical Services, Vol. 2, No. 1 (January- February, 1973), 10-13.
An Overview of Emergency Medical Services in Los Angeles County. Interim Report.
Los Angeles, Calif.:	Los Angeles Countywide Coordinating Council on Emergency
Medical Servies. Rockville, Md.:	U. S. Department of Health, Education, and
Welfare, Health Resources Administration, Division of Regional Medical
Programs. Oakland, Calif.:	California Regional Medical Program, 1974.
An interim planning document is presented in which problems are defined, working
assumptions about system design are articulated, and an ordered set of planning
tasks are described. The report includes sections on policies and practices;
inventory of facilities and services; perceptions of users and providers; impres-
sions and issues regarding system description and documentation; training programs;
and a publication 'A Socio-Technical Approach to Planning of Emergency Medical
Services' (EMS). The approximately 190 hospital emergency departments in Los
Angeles County receive an estimated 2,400,000 visits a year. The county encom-
passes 4083 sq. mi., has over 7,000,000 people in 78 cities plus additional urban,
rural, beach, mountain and desert areas. Transportation and varying levels of
medical services are provided by 29 private ambulance companies, 51 mobile inten-
sive care units and 350 county and city rescue vehicles. Implementation of
planning will be the responsibility of each agency involved in the countywide EMS
system. Order Number:	HRP-1000133
Pellecchia, Joseph; Falgout, Ronald F.; and Edwards, A. Jack. Louisiana Emergency
Medical Services Plan. Final Report. Baton Rouge, La.: Louisiana Health and
Social and Rehabilitation Services Administration, Emergency Medical Services
Planning Committee. New Orleans, La.:	Louisiana Regional Medical Program.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare, Public
Health Servi ce , 1 974.
A comprehensive emergency medical services (EMS) plan for the state of Louisiana
is presented. The plan is intended as a guide for upgrading of EMS at the state
and local levels. The background of the plan is described. Weaknesses in the
existing system for delivery of EMS transportation or ambulance service, the
apparent concentration of hospital emergency services and facilities in major
metropolitan areas and the statewide lack of effective EMS communications are
noted. An additional problem is lack of public awareness of present inadequacies
and of the need for improving services. Results of studies of ambulance service,
hospital facilities, and communications capabilities are summarized. Recommenda-
tions are stated, primary among which is the development of legislation to insure
standardization of minimal levels of service statewide. The organization of the
EMS program is outlined, including state, local, and areawide responsibilities.
A four-stage plan for implementing recommendations is presented. With the aid of
tables, graphs, and maps, individual chapters describe the current status of EMS
25transportation, hospital emergency services, and EMS communications in Louisiana.
Appendices include supporting tabulated data, a model patient record form, a
summary of EMS legislation in Louisiana. Demographic data, system specifications
and dial directory of the Louisiana Hospital Association Emergency Medical
Communications Network recommended for statewide use, and copies of the ambulance
and hospital survey forms. A three-page bibliography is included.
Order Number:	HRP-0003869
Penterman, D.G., "A Case Study in Telecommunications," Emergency Medical Services,
Vol . 3, No. 3 (May-June, 1 974), 1 6-21.
Pizzano, Winifred A.; Flashner, Bruce A.; and Adams, Salisbury. Evaluation Work-
book for Emergency Medical Services. Final Report. Washington, D.C.:
Young (Arthur) and Co. Rockville, Md.:	U.S. Department of Health, Education,
and Welfare, Health Services Administration, Office of Planning, Evaluation
and Legislation, 1976.
The evaluation workbook for emergency medical services (EMS) has been developed as
a guide to HEW/EMS grantees across the country to evaluate the efficiency and
effectiveness of their programs. The workbook is divided into five major areas:
introduction, narrative description of the program, general emergency care,
critical care and outcome evaluation. The introduction provides an overview of
EMS evaluation and instructions on the use of the workbook. The narrative section
provides a detailed outline for a qualatative description of the EMS system. The
sections on general emergency and critical care require quantative data for com-
pletion. Specific measurement criteria including inventory process and compliance
measures are established. Strict definitions and parameters of data elements are
set as well as the methodology for measurement. The outcome evaluation section
outlines measurements and methodologies for patient outcomes in terms of morbidity
and mortality. The workbook can be used both for internal management as well as
impact evaluation. It takes into consideration the differences in program
sophistication as well as varying management systems. Order Number:	HRP-1002013
Plaas, Hyrum; Dodson, Don C.; King, Herschell; Pike, David H.; and Shipley,
Frederic B. The Evaluation of Pol i c.y-Rel ated Research in Emergency Medical
Services:	Volume I. A Selected and Critical Annotated Bibliography. Final
Report-- Sep. '73 - Sep. '74. Knoxville, Tenn.:	University of Tennessee,
Bureau of Public Administration. Washington, D.C.:	National Science
Foundation, Division of Advanced Productivity Research and Technology, 1974.
The purpose of this 12-month study was to review the research in emergency medical
services (EMS) and to systematically evaluate the usefulness of such research for
policy-making. The purpose of this annotated bibliography is to provide an assess-
ment and critical review of policy-related studies and research which have been
undertaken in the field of emergency medical services. It concentrates on research
items completed from 1968 to the present and excludes research of a clinical nature
other than that which deal with basic resuscitation and maintenance of life. The
bibliography emphasizes research materials in transportation, and EMS planning,
system models and performance measures. Additional areas such as the hospital
emergency department and pre-hospital care are covered but they are not exhaustive
and do not represent a clear sample of the available literature on these topics.
The bibliography contains 322 citations. Order Number:	HRP-1000107
The Evaluation of Policy-Related Research in Emergency Medical Services:
Volume II. Planning, System Models, and Performance Measures (A Biblio-
graphic Review). Final Report-- Sep. '73 - Sep. '74. Knoxville, Tenn.:
26University of Tennessee, Bureau of Public Administration. Washington, D.C.:
National Science Foundation, Division of Advanced Productivity Research and
Technology, 1974.
The report examines the basic concepts of planning as they relate to emergency
medical services (EMS) planning. The intent is to identify tools which may be use-
ful in the planning process and to examine the manner in which a sampling of state
and regional or areawide plans address questions relating to the establishment and
performance of EMS systems. The report addresses the following topics:	(1) the
concept of planning; (2) the environment of EMS planning; (3) planning activities;
(4) system models; (5) data-based planning and use of models; (6) EMS planning at
the state level; (7) EMS planning at the regional and local levels; (8) a review
of planning guides. There is a bibliography of 76 citations.
Order Number:	HRP-1000106
Planning and Implementing Community and County Emergency Medical Services Systems.
San Antonio, Tex.:	Southwest Research Institute. Austin, Tex.:	Texas
Regional Medical Program, 1974.
Guidelines for development of an emergency medical services (EMS) system in a small
community or a rural area are presented. One topic included is planning organi-
zation, which deals with preliminary considerations, the community EMS committee,
and personnel, transportation, emergency health care, communications, finance, and
organization subcommittees. Also discussed is the development of an EMS plan,
including managing the planning process, personnel planning, transportation
planning, health care industry coordination, communications planning, organiza-
tional and financial planning, and implementati on scheduling. Approval of the EMS
plan by health care providers, local government, and consumers is also considered.
Coordination with regional and state planning agencies is discussed. Elements of
plan implementation are presented as follows:	management for implementation and
operation, which concerns selection of an operational manager, implementation
steering committee, and the implementation process; personnel selection and train-
ing, which covers the selection of volunteer and paid ambulance personnel, and
training ambulance crews; equipment purchase and installation, dealing with
ambulance vehicles, medical supply and equipment, and communication equipment;
negotiation of contracts, including insurance, intergovernmental relationships,
and equipment maintenance contracts; and operational procedures such as budgeting,
purchasing, billing procedures, public information, and education. Selected
bibliographies are included. Order Number:	HRP-0004238
Prybil, L., "Size and Scope of 911 Systems," Hospital Progress, Vol. 56, No. 3
(March, 1975), 51-54.
Raithaus, L.; Scribner, R.; and Ivanov, P., "Emergency Medical Service in the
Soviet Union," Critical Care Medicine, Vol. 2, No. 2 (March - Apri 1 , 1 974 ),
64-67.
Recommendations of the Conference on the Guidelines for the Categorization of
Hospital Emergency Capabilities. Chicago, 111.:	American Medical
Association, Commission on Emergency Medical Services, 1971.
Suggested guidelines for the categorization of hospital emergency capabilities,
developed by a multi-disciplinary conference held under the auspices of the
Commission on Emergency Medical Services of the American Medical Association,
are presented. The suggested guidelines distinguish among four categories:
27comprehensive emergency service; major emergency service; general emergency
service; and basic emergency service. For each category, the scope of capabilities
is defined, the requirements for the emergency department (essential staff, capa-
bilities, and equipment) and for the hospital (staff, blood bank, laboratory and
radiological service, operating rooms, post-operative recovery units, intensive
care units, communications equipment, and helicopter landing facilities) are
noted. In addition, guidelines common to all four categories are outlined relative
to hospital records, poison control, and drug abuse, continuing education programs,
audits and reviews, periodic comprehensive review, mass casualty preparations,
emergency care references, responsibility to the public, and accessibility and
transportation. Problems that might be encountered in implementing a system of
categorization for hospital emergency capabilities are outlined. One such problem
is predicted to be the determination of the optimum mix of emergency facilities of
each category for a specific community, given that not all locales need all
categories of facilities. A table summarizing the staffing and other requirements
of each category of hospital emergency capabilities is provided.
Recommendations for an Initial Emergency Medical Service System Plan for the
Northeast Texas State Planning Region. Austin, Tex.:	Centron Research.
Texarkana, Tex.:	Ark-Tex Council of Governments, 1975.
Recommendations are presented for emergency medical services (EMS) planning in the
Texas portion of the Arkansas - Texas Council of Governments region. The study area
consists of nine counties and 32 cities in Northeastern Texas; 51.6 percent of the
population is classified as rural. The organizational structure for the Ark-Tex
Council of Governments EMS System Planning and Implementation program is described,
and the planning process is outlined. EMS standards and program objectives are
specified, and recommendations for implementing specific objectives are presented.
An implementation schedule and budgetary forecasts are included. The approach to
be taken for evaluation of the operation of the system's components is outlined.
There are at present 17 operations which provide ambulance services within the
region and 13 hospitals which offer emergency services. The latter lack the
sophistication or personnel to provide a comprehensive range of emergency care.
Recommendations are based on the division of the Ark-Tex region into three sub-
regions for planning purposes and the establishment of EMS councils in each of the
subregions, with the existing EMS county task force committees forming the organi-
zational base. Establishment of a permanent on-going emergency personnel training
program (EMT) in each subregion is one immediate objective; other objectives in
the areas of communication, critical care units, consumer participation, standard
recordkeeping, consumer education, mutual aid agreements, public safety agencies,
access, patient transfer, manpower, transportation, facilities, and disaster
planning are presented. Appendices include state EMS legislation, the Texas State
Department of Health communications plan, and supporting tabular data and maps.
Order Number:	HRP-0003980
Regional Planning of Critical Emergency Medical Care. Pittsburgh, Pa.:	University
of Pittsburgh, School of Engineering, 1976.
Ringer, J.H., "The Development of an Emergency Medical Program in Industry."
Occupational Health Nursing (New York), Vol. 23, No. 9 (September, 1975)
20-22.
Rourke, A.J., "Your New E.R. Plans Should Include Six Areas," Modern Hospital,
Vol. Ill, No. 6 (December, 1968), 100.
28Rozovsky, L.E., "Ambulance Service and the Law," Dimensions in Health Services,
Vol. 52, No. 2 (February, 1975), 31-33.
Rumage, W.T., Jr., "Your Community Emergency Medical Services Council," Archi ves
of Environmental Health, Vol. 21, No. 2 (August, 1970), 211-213.
Rural Emergency Medical Services. Selected Bibliography. Hyattsville, Md.:
U.S. Department of Health, Education, and Welfare, Bureau of Medical Services,
Division of Emergency Medical Services, 1975.
Literature concerning rural emergency medical service (EMS) systems is cited in a
selected, annotated bibliography directed to health planners, hospital administra-
tors, physicians, community EMS councils, and all others involved in regional EMS
planning. The bibliography represents an effort to include material which is
easily available and which documents concepts and techniques, methodologies,
innovations, and adaptations of local resources to EMS purposes. The 34 journal
articles and reports cited and abstracted were published between 1971 and 1975.
In the introduction to the bibliography, it is observed that although the materials
represent differing viewpoints on the best way to implement a rural EMS system,
there is a consensus in favor of new patterns of organization which depend upon
local resources available and on formulation of community EMS councils to co-
ordinate, cooperate, and communicate with those involved in providing health
services. An author index is provided. Order Number:	HRP-0010873
Sadler, Alfred M.; Sadler, Blair L.; and Webb, Samuel B. Emergency Medical Care--
The Neglected Public Service. The Connecticut Experience. Boston, Mass.:
Massachusetts General Hospital, 1977.
Safar, P., "Here are Standards for Ambulance Service," Modern Hospital , Vol. 113,
No. 2 (August, 1969), 97.
Saltzman, Ben N., "Are We Prepared," Journal of the Arkansas Medical Society,
Vol. 67, No. 5 (October, 1970), 162-165.
A rural emergency medical services plan approved by the American Medical Associa-
tion provides the basis for a discussion of emergency medical services in rural
areas at an Arkansas conference. The criteria for a complete emergency medical
system developed by the National Highway Safety Bureau are outlined and discussed.
A few first aid procedures and related equipment are described as a form of pre-
paredness. Following this general overview of the question of emergency care
preparedness, the conference broke into small groups to discuss emergency services
preparation in various communities.
Shanholtz, M.I., "Law Affecting Emergency Medical Services and Rescue Squads,"
Virginia Medical Monthly, Vol. 101, No. 7 (July, 1974), 577-579.
29Shuman, Larry, and Wolfe, Harvey. The Implementation Prospects of Operations
Research in Regional Health Planning:	A Case Study of the Integration
of an OR Team into the Emergency Medical System PIannincf Environment.
Pittsburgh, Pa.:	University of Pittsburgh, Health Operations Research Group.
Rockville, Md.:	U.S. Department of Health, Education, and Welfare, National
Center for Health Services Research, 1974.
The purpose of the paper is to describe how Operations Research (OR), when it is
properly applied, has a role in the planning of health systems. This is an his-
torical case study of the introduction and integration of OR into the planning for
an emergency medical care system in Allegheny County. The OR team used the tra-
ditional OR approach:	orientation, problem formulation, model building, data
gathering, solution, and implementation. After discussing some common short-
comings in present health OR work, the report describes the OR team's experience
during the first two phases of the process. The authors describe, qualitatively,
the methods to be used in the later phases of the project.
Order Number:	HRP-1001751
Smalley, Harold E. Ambulance Placement Strategies for Emergency Medical Systems.
Final Report. 1972-74. Atlanta, Ga.:	Georgia Institute of Technology,
Health Systems Research Center. Rockville, Md.:	U.S. Department of Health,
Education, and Welfare, National Center for Health Services Research, 1974.
The report is a programmed planning guide for emergency medical planners in
determining ambulance placement strategies. It provides a comprehensive plan of
technical systems capabilities for identifying problems associated with the pro-
visions of emergency medical services (EMS) in the metropolitan Atlanta area.
It discusses the requirement for number, types and geographical positioning of
emergency vehicles; a recommendation of an organization for coordination, oper-
ation, and control of the EMS system component; a communication subsystem design;
a comprehensive set of procedures for performing the dispatch and control function;
recommendation for training EMS personnel; a scheme for evaluation; EMS system
performance; and recommendation for financing of the EMS system.
Order Number:	HRP-1001595
Smith, L.R., "New Training Program for Hospitals," Hospitals, Vol . 47, No. 1
(January 1 , 1 973), 41 -44.
"Some Ways to Pinpoint ED Delays--and Reduce Them," Registered Nurse, Vol. 37,
No. 11 (November 1974), 7.
Southeastern Wisconsin Emergency Medical Services Plan. Milwaukee, Wis.:
Comprehensive Health Planning Agency of Southeastern Wisconsin, Inc.;
Wisconsin Regional Medical Program, 1975.
An emergency medical services (EMS) plan for a seven-county area in Southeastern
Wisconsin is presented which is based on data from several state agencies. The
need for emergency services in general and for emergency communications, ambulance
and rescue services, personnel and training facilities, and education is documented
from an historical perspective. Background information is given on the establish-
ment of the Comprehensive Health Planning Agency of Southeastern Wisconsin, the
agency responsible for an EMS system. The functions and components of an EMS
system are described. The proposed plan is based on six components:	communica-
tions, personnel training, transportation, hospital emergency facilities, public
information and education, and regional system development and operation. Each
program component is defined, goals are set, and specific objectives to meet the
30overall goals are suggested. The present status of the program component is ana-
lyzed, and recommendations for improving services are presented. Recommendations
for implementation and evaluation of the plan are included. Appendices contain a
roster of the Wisconsin Emergency Medical Services Council, organizational and
operational guidelines, a discussion of central dispatch and universal entry
points, description of the emergency telephone number, emergency services legis-
lation, essential ambulance equipment, the Wisconsin ambulance reporting system,
and data from a 1973 study report by the Wisconsin Department of Health and Social
Services Division of Health. Order Number:	HRP-0004078
"Spatial Design Provides Efficient Emergency-Outpatient Department," Hospitals,
Vol. 47, No. 18 (September 16, 1973), 36f.
Steele, Richard. Development of a Minimum Data Set for Emergency Medical Services
Patient Recordkeeping. Final Report. Silver Spring, Md.:	Macro Systems Inc.
Rockville, Md. :	U.S. Department of Health, Education, and Welfare, Health
Services Administration, 1974.
The report presents the results of a federal initiative to upgrade emergency
medical service (EMS) systems in the United States. The report emphasizes the
section of the Emergency Medical Service Systems Act of 1973 that requires a
standardized patient recordkeeping system. HSA determined that the requirements
of the law could be met by instructing each EMS systems grantee to collect a
specified and limited list of data items. The report discusses the approach and
methodology of a minimum EMS data set. Order Number:	HRP-1001491
Stevenson, Keith A., and Willemain, Thomas R. Attitudes and Perceptions of Groups
Engaged in the Provision of Emergency Medical Services. Innovative Resource
Planning in Urban Public Safety. Systems. Technical Report No. 11-74.
Cambridge, Mass.:	Massachusetts Institute of Technology, Operations Research
Center. Washington, D.C.:	National Science Foundation, Research Applied to
National Needs, 1974.
A study of the perceptions and attitudes of planners, providers, and recipients of
emergency medical services in Massachusetts concerning innovative elements of pro-
posed models of emergency medical service delivery is reported. The study, part
of a multi-disciplinary research project on innovative resource planning in urban
public safety systems, was particularly concerned with the notions of regionaliza-
tion and categorization of services, increased training and responsibility for
ambulance attendants, incorporation of paramedics into the emergency department,
physician and patient education, and alternative methods of paying for ambulance
services. A questionnaire was distributed to 2,540 physicians, hospital adminis-
trators, ambulance operators and attendants, health planners, interested citizens,
public representatives, and other public agency operators in Massachusetts;
1,176 responses were received and analyzed. There was substantial agreement among
the groups on all issues although it was clear that respondents frequently were
uncertain about the dimensions of problems outside their own areas of interest or
expertise. The responses indicate wide support for the basic elements of pro-
gressive reforms proposed in the Emergency Medical Services Systems Act of 1973
(Public Law 93-154). However, resistance indicated by some respondents, usually
concerning the issues with which they are most directly involved, suggests possible
modifications of legislative requirements. Supporting data and a copy of the
survey instrument are included. Order Number:	HRP-0015611
31Stonehi11 , R.B., "The Development of a Voluntary Rural Emergency Ambulance
Service," Journal of the Indiana State Medical Association, Vol. 64, No. 9
(September, 1971), 1021-1022.
Summary of the Regional Emergency Medical Services Plan for the East Texas
Planning Region. Kilgore, Tex.:	East Texas Council of Governments.
Austin, Tex.:	Texas State Department of Health, Emergency Medical Services
Division, 1975.
The major components of the emergency medical services (EMS) plan for the East
Texas Planning Region are described in a document intended to acquaint citizens
of the predominantly rural region with the concept of an EMS system. The summary
opens with an outline of the scope and broad objectives of the plan, including a
description of the role of the East Texas Council of Governments, a statement of
the problem addressed by the plan, and general and specific objectives of the plan.
Health delivery system characteristics in the region (personnel and training,
communications, transportation, facilities) are then summarized. Standards,
priorities, and cost estimates are presented relative to personnel and personnel
training for EMS, communications, transportation, and facilities. It is noted in
the concluding chapter that emergency medical services in the East Texas region
are operated on a random basis. Some counties and cities have ambulance services
that would meet any recommended standards, but most do not. Ways in which a
regional plan for EMS can be implemented are suggested, including assumption of
responsibility by the State Department of Health, the hiring of a regional co-
ordinator to oversee the effort, or the delegation of responsibility for imple-
menting the plan to each local government. Supporting data are included.
Order Number:	HRP-0004216
Taubenhaus, L.J., "Planning Today's Emergency Department," American Journal of
Nursi ng, Vol. 72, No. 11 (November, 1 972), 2050-2053.
Thompson, John Larkin. Third Party Involvement in Emergency Medical Serviced.
Boston, Mass.:	Blue Shield of Massachusetts, Inc., 1975.
Third-party involvement in emergency medical services (EMS) need not be confined
to the traditional role of reimbursement for covered services. Medicare, Blue
Cross, Blue Shield, and commercial insurers can effectively, creatively, and
positively impact the EMS delivery system. In this report, data related to benefit
coverages are briefly reviewed; but, more importantly, innovative approaches to
third-party involvement in legislation, training, and public education are identi-
fied. Based primarily on the experience of Blue Shield of Massachusetts, but also
incorporating the activities of other third-parties, the report explores the inter-
face between third-party payers and the public and private ambulance community.
Further, the report describes the cooperative working arrangement that existed in
Massachusetts between government and private industry in the planning, implementa-
tion, and evaluation of a statewide EMS system. Finally, the intent of this work
is to provide a model for other communities to more fully utilize third-parties
as an integral resource in the development of EMS systems throughout'the country.
Order Number:	HRP-0006643
Thorpe, D.P., "A 'Time Study' Approach to the Evaluation of Emergency Room
Activities," Journal of the Maine Medical Association, Vol. 63, No. 9
(September, 1972), 197-199.
32Towle, Leland H. Emergency Medical Services Survey and Plan Development. Final
Report. Volume 1. Menlo Park, Calif.:	Stanford Research Institute, 1970.
The contents are as follows:	summary of emergency medical services (EMS) system
implementation and preliminary guidance document utilization (selection of states
to participate in EMS data system implementation, assessment of extent of utili-
zation of EMS guidance, problems of data system implementation, data system
scheduling, staffing, and costs); preliminary guidance document revision; National
EMS program recommendations (program policy and administration, EMS standard
revision, program evaluation); suggested outline for state applications to
participate in EMS data system field test project; 'model' project description for
states to use in drafting a project application to implement an EMS data system;
selected state and local profiles on EMS activities; EMS inventory data summary
report; sample computer printout format of state EMS inventory data.
Order Number:	HRP-1000369
"Use of Military Aircraft in EMS Systerns -- M.A.S.T . ," Journal of the Medical
Association of the State of Alabama, Vol. 43, No.-9 (March, 1 974), 581 -582.
Vogt, F.B., "Communication Systems for Emergency Medical Services," Emergency
Medical Services, Vol. 1, No. 1 (November - December, 1 972), 18-21.
-, "Communication Systems for Emergency Medical Services -- Part II,"
Emergency Medical Services, Vol. 2, No. 5 (September - October, 1 973), 1 8-21.
Waller, J.A., "Emergency Health Services in Areas of Low Population Density,"
Journal of the American Medical Association, Vol. 207, No. 12 (March 24,
1969), 2255-2258.
-, "Rural Emergency Care-- Problems and Prospects," American Journal of Public
Health, Vol. 63, No. 7 (July, 1973), 631-634.
-, "The Smaller Hospital in the Health Care System. A Rural EMS Categoriza-
tion System," Hospitals, Vol. 48, No. 19 (October 1, 1974), lll-112f.
Waters, J.M., "Problems of Municipal Emergency Medical Systems," Emergency Medical
Services, Vol. 3, No. 4 (July - August, 1 974 ), 1 0-1 5.
-, "A Synopsis of Emergency Medical Services for a Large City," Journal of
Trauma, Vol. 12, No. 1 (January, 1 973), 95-96.
Webb, S.B., Jr., and Lawrence, R.W., "Emergency Services:	Physician Staffing and
Reimbursement Trends," Hospitals, Vol. 46, No. 19 (October 1, 1972), 69-72f.
33Winfield-Smith, P., "An EMT-- An Evaluation Approach," Emergency Medical Services,
Vol. 2, No. 5 (September - October, 1 973), 22-28.
Wolford, D.A., "Hospital-Based EMS Program Serves Rural Conty," Hospitals,
Vol. 49, No. 21 (November 1 , 1 975 ), 51 -52f.
The planning and implementation of a hospital-based emergency medical service
(EMS) in Noble County, Indiana, is described. .Design of the service followed the
announcement by the county funeral directors that they would no longer provide
ambulance service and non-emergency transportation service after Jaunary 1, 1974.
Public meetings held with the county commissioners led to the appointment of the
local hospital's administrator and a local funeral director to draft a plan. The
plan was approved by the State Board of Health and was funded by the county
council. The hospital operates the EMS program, which has six ambulances, two at
the hospital and four located strategically in the county, and one invalid coach.
The hospital is part of the state hospital emergency radio network, and has
arranged for countywide use of the WATS line by citizens needing an ambulance.
A 24-hour dispatcher is maintained at the hospital; and when a call is received,
he dispatches the ambulance nearest to the emergency. Each ambulance is equipped
with a four-channel, two-way radio, which can communicate with the hospital,
police and fire departments and police cars. A staff of emergency medical
technicians was set up, and other employees were encouraged to take the training
course when possible. The major advantage of a hospital-based EMS program is
that the hospital's medical recordkeeping system and patient accounting system
can be utilized by the EMS at minimal cost.
Wood, J.; Prybil, L.; and Simpson, J., "An Approach to Studying Emergency Depart-
ment Utilization," Virginia Medical Monthly, Vol. 101, No. 6 (June, 1974),
458-464.
Wooding, S.H., "Legal Aspects of the Hospital Emergency Department," Medi co-Legal
Bulletin, Vol. 199, (November 1969), 1-6.
34INDEX
Acadiana Health Planning Council, 11
Achilli, R. , 3
Adams , S., 1
Adams, Salisbury, 26
Airports, 1
Alb in, S.L., 1
Aldrich, C.A., 1
Allen, A.B., 2
Ambulance Service Systems, 1, 7, 8, 15,
16, 24, 29, 30, 32
American Medical Association, 1, 8, 27
American Society of Anesthesiologists,
6
Arkansas Health Systems Foundation, 2,
6
Armi ngton, C . L . , 2
Arthur Young and Company, 24
Bachrach, Peter, 2
Baker, S.P. , 3
Baltzan , M.A. , 3
Barnard, B.G. , 2
Bastnagel , G., 3
Bautsch , C., 3
Becker, Robert E., 3
Bell, B. , 1
Benson , D.M., 3
Bible, B.L., 3
Bibliography, 26, 29
Blum, Marc S. , 3
Bohn G . S . , 4
Boyd, D.R. , 4
Brimmer, Pauline F., 4
Bromberg , M.J. , 4
Brook , R.H., 4
Buck, Gary L . , 4
Bucki ngham , R.E. , Jr. , 4
Burnel1 , Lynn , 16
Caldwel1 , Elaine, 5
California State Department of Health,
5
Capability Analysis, 15, 21, 27
Case Study, 19, 29, 30
Categorization and Regionalization of
Facilities, 3, 4, 11, 21, 27
Cayten , C.G. , 23
Central Midlands Regional Planning
Council, 5
Centron Research, 28
Chamberlin, R.T., 5
Coleman, Robert R., 5
Collins, Michael A. , 16
Colorado Council on Emergency Medical
Services, 12
Communications, 6, 7, 9, 22, 23, 24,
26, 27, 33
35Comprehensive Health Planning Agency
of Southeastern Wisconsin, Inc.,
30
Comprehensive Health Planning Associa-
tion of Central California, 11
Comprehensive Health Planning Associa-
tion of Western Pennsylvania, 18
Comprehensive Health Planning Council
of South Florida, 16, 24
Comprehensive Planning, 20, 24, 33
Computer Sciences Corporation, 14
Consumer Information, 6, 10
Cooper , A.B. , 3d., 7
Cooper, Carole, 7
Cowely, R.A., 7
Cristiano, P.J. , 3
Demonfort, Sister, 7
Disaster Planning, 19
Division of Emergency Medical Services,
29, 32
Dodson , Don C., 26
Dow, R.W. , 15
Dunea , M.M. , 4
East Central Michigan Comprehensive
Health Planning Council, 17
East Tennessee Health Planning Council,
Inc. , 14, 15
East Texas Council of Governments, 32
y
Edward, A. Jack, 25
Emergency Care Research Institute, 14
Emergency Department Evaluation, 2, 3,
15, 20, 21, 22, 24, 31, 32, 34
Emergency Medical Services, 25
Emergency Medical Services Councils,
21, 29
Emergency Room, 1, 3, 4, 7, 16, 18, 28,
32
Evaluation of Effectiveness, 2, 3, 4,
5, 8, 13, 14, 21, 22, 23, 26, 30,
34
Falgout, Ronald F. , 25
Falk, W., 2
Federal Government Role, 25
Financial Considerations/Reimbursement,
23, 32, 33
Flashner, Bruce A., 1, 4, 26
FIexer , M., 15
Ford , J . D . , 15
Foreign Emergency Medical Services, 27
Fortuna, J.A., 15
Fourth Planning and Development District
Commission, 8
Freeark, Robert J., 15
Frey, C.F., 15, 16
General Services Administration, 15
Gibson, G., 16
Gill, W. , 7
Golomb, H.M., 16
Grayson, Lauren H., 16
Gunter, Margaret Jane, 18, 19
Gupta , R . C . , 19
Haeck, W.T. , 19
Hami1 ton , W.F. , 19
Hampton , 0.P. , Jr. , 19
Health Planning Council, 10
Hanlon, John J. , 20
Herrold , S.R . , 16
36Hannas, R.R., Jr., 20, 21
Harvey, J . C., 21
Heidt, R.S., 21
Helicopter Programs, 5, 7, 15
Higgs, E.R., 2
Highway Safety Research Institute, 14
Hinds, R.J., 15
Hisserich, J.C., 1
Horoshak, Irene, 21
Horty , J . F. , 21
Hospitals, 31
Hudson , F. , 7
Huntley, Henry C., 21
Impact of Systems, 3
Industry, 28
Iott, Robert 0., 22
Ivanov, P., 27
Jacobs , A.R., 22
Jacobsen , S., 1
Jenki ns, A.L. , 22
Johnson, G., Jr. , 22
Journal of the Iowa Medical Society, 22
Journal of the Medical Association of
the State of Alabama, 33
Kaufman, T. , 22
Keller, G.B. , 22
Keller, M.D. , 22
King, Herschel1 , 26
Kuhn A.0. , 7
Laily, R . J . , 7
Lave , L.B. , 1
Lawrence , R.W., 33
Leatherwood, Richard, 22
Legal Implications, 2, 4, 21, 29, 34
Le-per, R . L . , 23
Li fton, J.G . , 23
Long, W. , 7
Los Angeles Countywide Coordination
Council on Emergency Medical
Services, 25
Main, Keith, 23
Mangold, K.G., 16, 23
McCracken , J . G . , 2
McDermott, S. , 23
McLeod, Kathryn A., 24
Metz, D. , 22
Mewhort, Stephen, 16
Michigan State Health Planning Advisory
Council, 10
Mid-South Medical Center Council for
Comprehensive Health Planning, 7
Milam, J.T. , 24
Military Aircraft, 33
Morgan, D.M. , 24
Murchie, P.A., 4
Murphy , S.P. , 24
Nachlas, Joel Anthony, 24
Nahum, A.M. , 24
Nap!es, M., 23
Nassau-Suffolk Reqional Medical Program,
21
37National Center for Health Services Research, 9, 13	Regional Service Planning, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, 19, 21, 23, 24, 25, 27, 28,
National Highway Traffic Safety Administration, 6	30 Registered Nurse, 30
North Carolina Regional Medical Program, 17	Research in Emergency Medical Services, 4, 14, 16, 30
Northwest Medicine, 8	Ricci, Edmund M., 18
Nurses , 1, 3, 21, 24	Richie, C.G., 4
Office of Telecommunications, 6	Ringer, J.H., 28 Rourke , A.J. , 28
Oklahoma Health Planning Commission, 19	Rozovsky, L.E. , 29
Orange County Health Planning Council, 17	Rumage, W.T., Jr., 29 Rural Service Delivery, 2, 3, 5, 16, 22, 23, 29, 32, 33, 34
Panhandle Health Planning, Inc., 18	
Paramed, Inc . , 5	Sadler, Al.f'Kfed M. , 29
Paramedics, 16	Sadler, Blair L., 29
Patient Recordkeeping, 1, 31	Safar P., 3, 29
Pearson , David A., 22	Satlzman, Ben N., 29
Pellecchia, Joseph, 25	Scanlan , E., 7
Penterman, D. G . , 26	Scher1 is, L., 7
Physicians, 15, 16, 20, 23, 33	Schiller, A., 1
Pierce County Health Council, 11	Scribner, R., 27
Pike, David H., 26	Severi n , Nelda K., 3
Pizzano, Vinifred A., 1, 4, 26	Shanholtz , M. I. , 29
Plaas, Hyrum, 26	Shipley, Frederic B., 26
Powel1 , Mel D., 7	Shuman, Larry, 30
Private Operator, 25, 32	Simpson, J., 34
Program Guidelines, 13, 17, 18	Simulation, 4
Prybil , L., 27, 34	Smal1ey , Harold E., 30
Purcell, Ruth, 23	Smi th, L.R. , 30
Putzier, Lois T., 4	South Plains Association of Goverments, 9
Rai thaus , L., 27	Southern Oklahoma Development Association, 8
38Southwest Research Institute, 27
Wasserthei1-Smoller, S., 1
Stanford Research Institute, 13
Webb, S.B., Jr., 33
Steele, Richard, 31
Webb, Samuel B., 22, 29
Stevenson, Keith A., 31
Willemain, Thomas R., 31
Stevenson , R.L. , 4
Winfield-Smith, P., 34
Stone, Linda S., 3
Stonehill, R.B., 32
Wolfe, Harvey, 30
Wolford, D . A . , 34
Superior California Regional Medical
Wood , J., 34
Program, 12
Systems Analysis, 19
Wooding, S.H., 34
Taubenhaus, L . J. , 32
Thompson, John D., 22
Thompson, John Larkin, 32
Thorpe , D.P. , 32
Thurber , C.L. , 22
Towle, Lei and H., 33
Towson , D.E. , 7
Training of Personnel, 3, 15, 20, 30,
34
Trimarco, Josephine, 5
Tulsa Area Health and Hospital
Planning Council, 2
Turcotte , J . G . , 15
University of Pittsburgh, 28
Urban Service Delivery, 1, 14, 31, 33
Virginia Polytechnic Institute, 9
Vogt, F.B., 33
Vorzimer, J.J., 22
Waller, J.A. , 33
Waters , J.M . , 33
39
☆ U.S. GOVERNMENT PRINTING OFFICE : 1979 0-287-485	
	
	
	
	
	
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	U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
Public Health Service
Health Resources Administration
Bureau of Health Planning
DHEW Publication No. (HRA) 79-14000
C028718557