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Emergency Medical Services

Emergency medical services provide pre-hospital medical care to out-of-hospital cardiac arrest patients on scene and while transporting to the hospital. In rural areas, the responding emergency medical services’ scope of practice varies from basic life support capabilities, which may be limited to effective chest compressions and use of a bag-mask device, to advanced life support capabilities encompassing a set of interventions and medication treatments intended to support airway, breathing, and circulation.


The evaluation of the emergency medical services cardiac subsystem of care includes:

  1. Mapping of the emergency medical services’ agencies’ response processes to out-of-hospital cardiac arrest calls. The resulting process flow maps in conjunction with time stamp data may assist the emergency medical services’ continuous quality improvement (CQI) efforts. System wide mapping allows the medical director to follow patient care from start to finish on any case.
  2. System-wide exercises to test and improve emergency medical services’ documentation procedures and communication protocols with other subsystems.
  3. Evaluation of a North Dakota emergency medical services pilot project designed to advance emergency medical services’ documentation and quality improvement practices.
  4. Evaluation of a South Dakota pilot project designed to demonstrate the possibilities of real-time flow of patient care data between emergency dispatch centers, emergency medical services, hospitals, and the state’ health information exchange network.

Barriers to Efficiency

  • Rural emergency medical services’ agencies’ dependency on a volunteer workforce presents challenges including recruitment and retention of volunteers.
  • Long hospital transportation times coupled with limited resources are common challenges in rural emergency medical services face that can affect patient care (i.e. high performance cardiopulmonary resuscitation (CPR)).
  • Maintaining adequate medical direction can be difficult for rural emergency medical services.
  • Limited cell phone and radio network coverage can cause issues when communicating with other subsystems.



System Approach

Continuing Education

High Performance CPR

Measuring Performance

  • CARES – Cardiac Arrest Registry to Enhance Survival
  • EMS COMPASS, National Association of State EMS Officials
  • EMS Data, Wyoming Department of Health
  • Minnesota CARES, Minnesota Resuscitation Consortium
  • CODE-STAT – CPR Data Review Software

Police Defibrillation


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