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Alabama Department of

Public Health

2018 Annual Report

Office of Emergency Medical Services

January 1, 2018 – December 31, 2018

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Alabama Office of Emergency Medical Services

2018 Annual Report

January 1, 2018 – December 31, 2018

State of Alabama Department of Public Health Scott Harris, M.D., M.P.H., State Health Officer

Office of Emergency Medical Services Stephen Wilson, B.S., NRP, Director

Office of Emergency Medical Services Gary Varner, M.P.H., NRP, Senior Epidemiologist

Office of Emergency Medical Services Augustine M. Amenyah, Ed.D., M.P.H., Epidemiologist

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Mission of the Alabama Office of Emergency Medical Services

OVERVIEW

The Alabama Office of Emergency Medical Services (OEMS) operates under the Alabama

Department of Public Health (ADPH) and is tasked with oversight of emergency medical services

in Alabama. The OEMS is responsible for protecting the health, safety, and welfare of the

public by assuring that emergency medical response agencies, training entities, and emergency

medical services personnel meet or exceed established standards. The mission of the OEMS is

to reduce preventable mortality and morbidity caused by trauma and other emergency medical

conditions.

FORCE OF LAW

The Code of Alabama 1975, §22‐18‐1, set forth the authority of the OEMS to create rules and

regulations. The legislation includes mandates for the State Emergency Medical Control

Committee (SEMCC), and all regulatory processes (licensure, fees, compliance, operations, etc.)

regulated by the OEMS.

ADMINISTRATIVE MISSION

The spectrum of tasks that the OEMS implements for the ADPH and Alabama, at large, includes

but is not limited to:

Facilitation of the prehospital component of the Alabama Incident Management System

(AIMS), which allows the ADPH to monitor hospitals, nursing homes, and ambulance

resources during times of disaster.

Facilitation of the Emergency Medical Services (EMS) staffing of Medical Needs Shelters for

the Center for Emergency Preparedness, during times of disaster.

Facilitation and administration of Alabama’s electronic patient care reporting (ePCR)

entreated by the federal government via the National Emergency Medical Services

Information System (NEMSIS). The OEMS provides free software to facilitate licensed EMS

provider data reporting. The software, Recording of Emergency Medical Services Calls and

Urgent‐care Environment (RESCUE), is compliant with the NEMSIS Version 3 platform for

national EMS reporting. Otherwise, third‐party software vendors are supplied upon request

with the Alabama NEMSIS Version 3 schematron to enable their Alabama EMS provider

service clients’ ePCR process. Data uploaded by EMS provider services is retained in the

Alabama NEMSIS repository and further uploaded to the national NEMSIS repository.

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Facilitation and administration of Alabama’s prehospital EMS provision; including standards,

licensure, and compliance oversight for individuals, services, businesses, and departments

engaged in provision of emergency medical care and/or transport of the sick and injured;

oversight and guidance for universities, colleges, and schools engaged in EMS training; and

the responsibility for quality assurance and quality improvement processes for Alabama

EMS provider services through periodic inspection of deployed EMS vehicles and equipment

and, for individuals and service providers, through definitive complaint investigation and

adjudication.

Facilitation and administration of Alabama’s arrangement with the National Registry of

Emergency Medical Technicians (EMT/NREMT) to oversee and guarantee integrity of the

National Registry of EMTs examination process. National Registry certification is a

prerequisite for licensure at the level of that certification in Alabama.

Facilitation and administration of Alabama’s Acute Health Systems (AHS) which includes the

Alabama Trauma System (ATS) and the Alabama Statewide Stroke System, as well as the

Alabama Trauma Registry (ATR), which also closely monitors head and spinal cord injuries.

The AHS are also currently developing to include data reporting and management of cardiac

data, especially myocardial infarction pathologies. That component of the AHS (the

Alabama ST‐Elevation Myocardial Infarction, or STEMI system) is expected to go online

within 2 years. Much of the data collection and management for AHS is facilitated through

the University of Alabama at Birmingham. In all aspects of the AHS, the OEMS coordinates

with area hospitals to facilitate uniform data recording of provided care to enable data

follow‐up of patients from the prehospital phase until well into the specialty hospital care

process.

Facilitation and administration of the Alabama EMS Regional Agencies. Alabama counties

are assigned to one of six EMS Regions that are tasked by the OEMS with: providing an

initial point of contact for EMS issues or concerns, organizing meetings and providing

effective communication between local communities and the OEMS, assisting constituent

EMS personnel with rules compliance, providing local ongoing credentialing, and

functioning as a clearing house for EMS education activities. Each regional agency also

assists with coordination and implementation of the AHS components.

Facilitation and administration of the federally funded Emergency Medical Services for

Children (EMSC) Program. The purpose of the EMSC is to prevent and reduce child, youth,

and adolescent disability and death resulting from severe illness and injury. To accomplish

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its goal, the program provides education for prehospital providers and ensures that the

American Academy of Pediatrics/American College of Emergency Physicians (AAP/ACEP)

guideline compliant equipment is available on prehospital emergency vehicles that

transport children.

Provision of EMS data management and analysis for the purposes of quality assurance and

improvement, compliance investigations, public health investigations of illness and injury,

and research to drive the development of EMS efficacy in Alabama.

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Purpose and Methods

PURPOSE

The purpose of this report is to present to our stakeholders a systematic overview of EMS calls

occurring in Alabama in 2018. Data for this report was synthesized from the RESCUE database

developed by the Center for Public Safety of the University of Alabama in Tuscaloosa based on

NEMSIS V2 data standards.

METHODOLOGY

RESCUE captures prehospital care through both required and optional reporting elements and

data are validated to meet (NEMSIS‐3) standards. RESCUE captures agency information, patient

demographics, response times, incident location, prehospital treatment, EMS transport,

insurance, and patient disposition.

A total of 812,974 EMS runs were submitted to RESCUE from January 1, 2018, to December 31,

2018, as of February 27, 2019. The OEMS used the 2018 U.S. Census Bureau, Vintage 2018

Population Estimates www.census.gov/programs‐surveys/popest.html figures to calculate EMS

runs per 10,000 Alabama residents.

DISCLAIMER Calculations were done using Microsoft Excel 2016.

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Map of Alabama 67 Counties

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Alabama County Population by Rank

Rank County Population Rank County Population Rank County Population

1 Jefferson 659,460 2 Mobile 414,328 3 Madison 353,213

4 Montgomery 227,120 5 Shelby 208,721 6 Tuscaloosa 204,424

7 Baldwin 203,360 8 Lee 156,597 9 Morgan 119,157

10 Calhoun 115,527 11 Houston 104,108 12 Etowah 103,132

13 Marshall 94,738 14 Lauderdale 92,590 15 Limestone 91,695

16 St. Clair 86,937 17 Cullman 81,703 18 Elmore 80,989

19 Talladega 80,888 20 Dekalb 71,194 21 Walker 64,927

22 Russell 58,480 23 Blount 57,667 24 Autauga 55,036

25 Colbert 54,435 26 Jackson 52,326 27 Coffee 51,073

28 Dale 49,393 29 Chilton 43,805 30 Tallapoosa 40,756

31 Dallas 40,755 32 Escambia 37,621 33 Covington 37,519

34 Chambers 33,895 35 Lawrence 33,288 36 Pike 33,287

37 Franklin 31,507 38 Marion 30,058 39 Geneva 26,572

40 Barbour 26,201 41 Cherokee 25,855 42 Clarke 24,625

43 Winston 23,968 44 Bibb 22,580 45 Randolph 22,530

46 Monroe 21,745 47 Pickens 20,170 48 Butler 20,126

49 Marengo 19,743 50 Macon 19,358 51 Henry 17,110

52 Washington 16,746 53 Fayette 16,657 54 Hale 14,995

55 Cleburne 14,939 56 Lamar 14,021 57 Crenshaw 13,866

58 Clay 13,407 59 Choctaw 13,188 60 Sumter 13,084

61 Conecuh 12,649 62 Coosa 10,955 63 Wilcox 10,919

64 Bullock 10,478 65 Lowndes 10,362 66 Perry 9,680

67 Greene 8,533

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2018 Alabama EMS Annual Report Type of Service Requested (Chart 1)

01/01/2018 ‐ 12/31/2018

Chart 1 shows a breakdown of type of service requested. The predominant was 911 response to scene at 74 percent (n=600,163).

717

1,619

2,955

5,647

55,035

146,838

600,163

0 100000 200000 300000 400000 500000 600000 700000

MUTUAL AID

INTERCEPT

STANDBY

PUBLIC ASSISTANCE/OTHER NOT LISTED

INTERFACILITY TRANSPORT

MEDICAL TRANSPORT

911 RESPONSE (SCENE)

Type of Service Requested01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report

Chief Complaint Anatomic Location (Chart 2) 01/01/2018 – 12/31/2018

Chart 2 shows chief complaint anatomic locations. The predominant was general/global anatomic location complaints at 51 percent (n=417,514).

7,247

43,476

4,674

417,514

18,231

37,208

73,647

17,887

55,991

0 50,000 100,000 150,000 200,000 250,000 300,000 350,000 400,000 450,000

NECK

HEAD

GENITALIA

GENERAL/GLOBAL

EXTREMITY‐UPPER

EXTREMITY‐LOWER

CHEST

BACK

ABDOMEN

Chief Complaint Anatomic Location:01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Call Volume by EMS Region (Chart 3)

01/01/2018 ‐ 12/31/2018

Chart 3 shows call volumes by EMS regions. The predominant was 24 percent (n=199,299) in BREMSS

199,299

88,515

168,241 168,545

125,695

62,679

BREMSS EAST GULF NORTH (AERO) SOUTHEAST WEST

Call Volume by EMS Region01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report CMS Service Level (Chart 4) 01/01/2018 ‐ 12/31/2018

Chart 4 shows CMS service levels. The predominant was ALS, Level 1 Emergency at 36 percent (n=134,386).

8

16

1,936

3,046

6,889

33,118

74,271

117,812

134,386

0 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000

PARAMEDIC INTERCEPT

FIXED WING (AIRPLANE)

ROTARY WING (HELICOPTER)

SPECIALITY CARE TRANSPORT

ALS, LEVEL 2

BLS, EMERGENCY

ALS, LEVEL 1

BLS

ALS, LEVEL 1 EMERGENCY

CMS Service Level01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report EMS Transport Method (Chart 5)

01/01/2018 ‐ 12/31/2018

Chart 5 shows transport methods. The predominant method was ground ambulance at 82

percent (n=663,788).

9

75

180

355

2,261

5,067

39,384

663,788

0 100,000 200,000 300,000 400,000 500,000 600,000 700,000

GROUND‐WHEELCHAIR VAN

WATER‐BOAT

GROUND‐ATV OR RESCUE

GROUND‐BARIATRIC

AIR MEDICAL‐FIXED WING

AIR MEDICAL‐ROTOR CRAFT

GROUND‐OTHER NOT LISTED

GROUND‐AMBULANCE

2018 Alabama EMS Annual ReportEMS Transport Method (Chart 5)

01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report EMS Transport Mode to Scene (Chart 6)

01/01/2018 ‐ 12/31/2018

Chart 6 shows transport mode to scene. The predominant mode was Emergent (Immediate Response) at 72 percent (n=581,361).

581,361

15,579

213,589

2,445

EMERGENT (IMMEDIATE RESPONSE)

EMERGENT DOWNGRADED

NON‐EMERGENT NON‐EMERGENT UPGRADED

Transport Mode to Scene01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report EMS Transport Method Mode from Scene (Chart 7)

01/01/2018 ‐ 12/31/2018

Chart 7 shows transport mode from scene. The predominant was non‐emergent from the scene at 76


131,106

9,699

463,791

2,130

Emergent (ImmediateResponse)

EmergentDowngraded to Non‐

Emergent

Non‐Emergent Non‐EmergentUpgraded toEmergent

Transport Mode from Scene01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report EMS Transport Destination State (Chart 8)

01/01/2018 ‐ 12/31/2018

Chart 8 shows transport destination states. The predominant was Alabama with 585,763

transports.

585,763

6,743

4,353

2,912

2,012

43

11

7

5

4

3

2

1

1

1

1

1

1

0 100,000 200,000 300,000 400,000 500,000 600,000 700,000

ALABAMA

GEORGIA

MISSISSIPPI

FLORIDA

TENNESSEE

LOUISIANA

TEXAS

SOUTH CAROLINA

ILLINOIS

INDIANA

OHIO

OKLAHOMA

ARKANSAS

IOWA

MARYLAND

MICHIGAN

NEW YORK

NORTH CAROLINA

Alabama EMS Transport Destination State01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Patients Gender Category (Chart 9)

01/01/2018 ‐ 12/31/2018

Chart 9 shows gender distribution of patients. EMS provided care to 54 percent females

(n=387,863) and 46 percent males (n=333,775).

Female, 387,863, 54%

Male, 333,775, 46%

EMS Patients Gender01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report EMS Patients by Age Group (Chart 10)

01/01/2018 ‐ 12/31/2018

Chart 10 shows patients by age groups. The predominant was 16 percent (n=131,561) for age

group (66 ‐75).

35,890

43,864

59,45862,079

81,441

116,112

131,561

110,973

63,121

0‐17 18‐25 26‐35 36‐45 46‐55 56‐65 66‐75 76‐85 >86

EMS Patients by Age Group01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report EMS Patients by Race (Chart 11)

01/01/2018 ‐ 12/31/2018

Chart 11 shows the racial categories of EMS patients. Whites were the predominant group at 57


933 2,403

238,383

9,936 813

466,048

AmericanIndian or

Alaska Native

Asian Black orAfrican

American

Hispanic orLatino

NativeHawaiian orOther PacificIslander

White

Patients by Racial Categories01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report EMS Patients by Age and Gender (Chart 12)

01/01/2018 ‐ 12/31/2018

Age Female Male Female

Percentage Male

Percentage

0‐17 13,216 13,301 5% 5%

18‐25 8,911 15,737 3% 6%

26‐35 23,343 22,960 8% 9%

36‐45 24,620 24,371 9% 10%

46‐55 33,795 33,179 12% 13%

56‐65 44,775 47,471 16% 19%

66‐75 52,397 48,430 18% 19%

76‐85 49,368 34,703 17% 14%

>85 34,088 15,436 12% 6%

Total 284,513 255,588 100% 100%

Chart 12 shows age and gender distribution of patients with respective counts and percentages.

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2018 Alabama EMS Annual Report Top 10 Provider’s Primary Impressions (Chart 13)

01/01/2018 ‐ 12/31/2018

Chart 13 shows the top 10 provider’s primary impressions. At 35 percent (n=129,351), general/other weakness was the predominant impression.

13,954

15,001

15,561

18,734

19,037

19,489

20,027

34,271

86,407

129,351

0 20,000 40,000 60,000 80,000 100,000 120,000 140,000

PAIN ‐ GENERALIZED ABDOMINAL PAIN

PAIN ‐ ACUTE PAIN, NOT ELSEWHERE CLASSIFIED

GENERAL/OTHER ‐ SYNCOPE AND COLLAPSE

PAIN ‐ CHEST (CARDIAC)

RESPIRATORY ‐ RESPIRATORY DISTRESS, ACUTE

INJURY, UNSPECIFIED

NO PATIENT COMPLAINT ‐ ENCOUNTER, ADULT, NO FINDINGS OR COMPLAINTS

COGNITIVE FUNCTIONS/AWARENESS ‐ALTERED MENTAL STATUS

OTHER CODE

GENERAL/OTHER ‐ WEAKNESS

Top 10 Provider's Primary Impressions01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Cardiac Arrests by Regions (Chart 14)

01/01/2018 ‐ 12/31/2018

Chart 14 shows cardiac arrest calls reported by EMS regions. The predominant was 25 percent

(n=1,577) in BREMSS region.

1,444

645

1,577

643

844

1,253

AERO/North East BREMSS West Southeast Gulf

Cardiac Arrests Count by EMS Region01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Top 10 Cardiac Arrests by County (Chart 15)

01/01/2018 ‐ 12/31/2018

Chart 15 shows top 10 cardiac arrest calls by county. The predominant cases were recorded in

Jefferson County at 24 percent (n=845)

170

171

175

186

229

332

352

401

723

845

0 100 200 300 400 500 600 700 800 900

ETOWAH

WALKER

MARSHALL

CULLMAN

SHELBY

TUSCALOOSA

BALDWIN

MADISON

MOBILE

JEFFERSON

Top 10 Cardiac Arrests by County01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Naloxone Administration by Gender (Chart 16)

01/01/2018 ‐ 12/31/2018

Chart 16 shows naloxone administration by gender. The predominant was given to males at 56

percent (n=3,490).

Male, 3,490, 56%

Female, 2,734, 44%

Naloxone Administration by Gender01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Naloxone Administration by Regions (Chart 17)

01/01/2018 ‐ 12/31/2018

Chart 17 shows naloxone administration by EMS regions. The predominant was given in the BREMSS region at 43 percent (n=2,629).

2,629

555 588

1,324

610

449

BREMSS EAST GULF NORTH (AERO) SOUTHEAST WEST

Naloxone Given by Regions01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Top 10 Medications Given (Chart 18)

01/01/2018 ‐ 12/31/2018

Chart 18 presents a breakdown of the top 10 medications given by Alabama EMS. The predominant was oxygen, reported at 47 percent (n=109,877).

4,472

6,155

6,325

9,198

11,162

15,540

16,559

18,550

37,098

109,877

0 20,000 40,000 60,000 80,000 100,000 120,000

D50 (50% DEXTROSE)

NALOXONE

EPINEPHRINE 1:10,000

FENTANYL

ALBUTEROL

ASPIRIN

ONDANSETRON

NITROGLYCERIN

SODIUM CHLORIDE INFUSION SOLUTION

OXYGEN

Top 10 Medications Given01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Top 10 Causes of Injury (Chart 19)

01/01/2018 ‐ 12/31/2018

Chart 19 shows top 10 causes of injuries. The predominant was MVC, traffic‐car accidents at 47 percent (n=18,224).

961

1,511

1,583

1,614

1,815

2,252

2,653

3,404

4,810

18,224

0 2,000 4,000 6,000 8,000 10,00012,00014,00016,00018,00020,000

MVC, TRAFFIC ‐ MOTORCYCLE

MVC, NON‐TRAFFIC ‐ CAR

MVC, TRAFFIC ‐ OTHER

INJURY, UNSPECIFIED

FALL ‐ STAIRS OR STEPS

FALL ‐ CHAIR

FALL ‐ BED

FALL ‐ OTHER

FALL ‐ SLIP, TRIP, OR STUMBLE

MVC, TRAFFIC ‐ CAR

Top 10 Causes of Injury01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Mechanism of Injury (Chart 20)

01/01/2018 ‐ 12/31/2018

Chart 20 shows the mechanisms of injuries of EMS patients. The predominant was blunt force trauma at 62 percent (n=70,185).

Blunt, 70,185, 62%

Burn, 1,134, 1%

Other, 37,254, 33%

Penetrating, 5,254, 4%

MECHANISM OF INJURY01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Top 10 Procedures Performed (Chart 21)

01/01/2018 ‐ 12/31/2018

Chart 21 shows the breakdown of the top 10 procedures performed. Patient assessment was the predominant at 39 percent (n=486,071).

41,321

45,688

51,358

58,615

70,300

75,640

76,682

166,260

184,147

486,071

0 100,000 200,000 300,000 400,000 500,000 600,000

GENERAL ‐ NOT OTHERWISE CLASSIFIED.

GLUCOSE MEASUREMENT, BLOOD (PROCEDURE)

ADULT PAIN ASSESSMENT (PROCEDURE)

CARDIAC MONITORING (REGIME/THERAPY)

EVALUATION PROCEDURE (PROCEDURE)

CARDIAC ‐ 3 LEAD ECG OBTAINED

CARDIAC ‐ 12 LEAD ECG OBTAINED

VASCULAR ACCESS ‐ EXTREMITY VEIN CATHETERIZATION

PULSE OXIMETRY (PROCEDURE)

ASSESSMENT ‐ PATIENT ASSESSMENT

Top 10 Procedures Performed by EMS01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Vital Signs Taken (Chart 22) 01/01/2018 ‐ 12/31/2018

Chart 22 shows the number of times vital signs were taken. The predominant was one (1) vital at 35 percent (n=615,725).

615,725

495,407

205,761

114,737 109,506

69,44644,116 35,513 28,507 19,849 13,768

1 2 3 4 0 5 6 10 OR MORE

7 8 9

Count of Vital Signs Taken by Crew01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Cardiac Procedures (Chart 23) 01/01/2018 ‐ 12/31/2018

Chart 23 shows cardiac procedures performed. Both Cardiac 3 Lead ECG Obtained and Cardiac

12 Lead ECG Obtained procedures were performed at 50 percent each (n=76,749) and

(n=77,377). [Excel calculations].

76,749 77,377

80 5

Cardiac 3 Lead ECGObtained




Cardiac Procedures Performed01/01/2018 ‐ 12/31/2018

32

2018 Alabama EMS Annual Report Airway‐Basic Procedures (Chart 24)

01/01/2018 ‐ 12/31/2018

Chart 24 shows airway‐basic procedures performed. The predominant was airway‐basic suction away at 34 percent (n=3,758).

25

73

127

254

432

1,079

2,069

3,172

3,758

0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000

AIRWAY‐BASIC HEIMLICH MAUEVER

AIRWAY‐BASIC FOREIGN BODY REMOVAL

AIRWAY‐BASIC BIPAP

AIRWAY‐BASIC ETCO2 COLORIMETRIC DETECTION

AIRWAY‐BASIC AIRWAY OPENED

AIRWAY‐BASIC NASOPHARYNGEAL AIRWAY INSERTION

AIRWAY‐BASIC CPAP

AIRWAY‐BASIC BAGGED VENTILATION VIA MASK

AIRWAY‐BASIC SUCTION AWAY

Airway‐Basic Procedures01/01/2018 ‐ 12/31/2018

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2018 Alabama EMS Annual Report Airway‐Advanced Procedures (Chart 25)

01/01/2018 ‐ 12/31/2018

Chart 25 shows airway‐advanced procedures performed. The predominant procedure was airway‐advanced intubation (Orotracheal) at 54 percent (n=3,230).

3

181

2,552

3,230

0 500 1000 1500 2000 2500 3000 3500

AIRWAY‐ADVANCED‐CRICOTHYROTOMY NEEDLE

AIRWAY‐ADVANCED ‐ INTUBATION (RAPID SEQUENCE)

AIRWAY‐ADVANCED‐ETCO2 DIGITAL CAPNOGRAPHY

AIRWAY‐ADVANCED‐INTUBATION (OROTRACHEAL)

Airway‐Advanced Procedures01/01/2018 ‐ 12/31/2018

34

2018 Alabama EMS Annual Report Top 10 Select Procedures Performed (Chart 26)

01/01/2018 ‐ 12/31/2018

Chart 26 shows select procedures performed. The predominant was capillary blood glucose

measurement at 24 percent (n=7,731).

2,149

3,012

3,044

3,265

3,611

4,085

5,685

7,731

0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000

CARDIAC DEFIBRILATION (MANUAL)

VASCULAR ACCESS‐INTRAOSSEOUS CANNULATION

MUSCULOSKELETAL‐SPINAL IMMOBILIZATION (FULL)

VASCULAR ACCESS‐VENOUS PUNCTURE FOR BLOOD DRAW

CARDIAC ‐CARDIO PULMONARY RESUSCITATION (MANUAL)

VASCULAR ACCESS‐EXTERNAL JUGULAR VEIN CATHERIZATION

INTRAVENOUS/IRRIGATION MONITORING (REGIME/THERAPY)

CAPILLARY BLOOD GLUCOSE MEASUREMENT

Top 10 Select Procedures Performed01/01/2018 ‐ 12/31/2018

35

2018 Alabama EMS Annual Report Top 10 Protocols Used (Chart 27)

01/01/2018 ‐ 12/31/2018

Chart 27 shows top 10 protocols used. The predominant was general‐universal patient care‐initial patient contact at 69 percent (n=420,382).

6,712

7,429

8,436

15,322

18,826

20,398

22,734

23,192

65,743

420,382

0 100,000 200,000 300,000 400,000

MEDICAL‐STROKE/TIA

INJURY‐EXTREMITY

MEDICAL‐SEIZURE

MEDICAL‐ABDOMINAL PAIN

MEDICAL‐ALTERED MENTAL STATUS

MEDICAL‐RESPIRATORY DISTRESS/ASTHMA/COPD/REACTIVE …

MEDICAL‐CARDIAC CHEST PAIN

GENERAL‐INTERFACILITY TRANSFERS

GENERAL‐INDIVIDUALIZED PATIENT PROTOCOL

GENERAL‐UNIVERSAL PATIENT CARE/ INITIAL PATIENT CONTACT

Top 10 Protocols Used01/01/2018 ‐ 12/31/2018

36

2018 Alabama EMS Annual Report EMS Type of Destination (Chart 28)

01/01/2018 ‐ 12/31/2018

Chart 28 shows where EMS patients were transported. The predominant destination was

hospital emergency departments at 64 percent (n=949,296).

530

490

887

1,023

5,703

4,442

23,316

51,456

64,811

107,850

270,495

949,296

0 200,000 400,000 600,000 800,000 1,000,000

MORGUE/MORTUARY

URGENT CARE

POLICE/JAIL

OTHER EMS RESPONDER (GROUND)

OTHER EMS RESPONDER (AIR)

FREESTANDING EMERGENCY DEPARTMENT

OTHER

MEDICAL OFFICE/CLINIC

HOME

NURSING HOME/ASSISTED LIVING FACILITY

HOSPITAL‐NON‐EMERGENCY DEPARTMENT BED

HOSPITAL‐EMERGENCY DEPARTMENT

EMS Type of Destination01/01/2018 ‐ 12/31/2018

37

.

2018 Alabama EMS Annual Report Times Elapsed (Chart 29) 01/01/2018 ‐ 12/31/2018

Chart 29 shows time elapsed from the time unit arrived on scene to the time patient arrived at

destination. The predominant time was 30+ minutes to 45 minutes at 27 percent (n=153,995).

1,514

2,755

10,246

12,264

15,125

40,928

48,022

68,718

70,071

75,537

79,665

153,995

0 20,000 40,000 60,000 80,000 100,000120,000 140,000160,000180,000

LESS THAN 1 MINUTE

1 MINUTE TO 5 MINUTES

MORE THAN 2 HOURS

5+ MINUTES TO 10 MINUTES

1.5+ HOUR TO 2 HOURS


1+ HOUR TO 1.5 HOUR


45+ MINUTES TO 1 HOUR




Time Elapsed Unit Arrived on Scene to Patient Arrived at Destination01/01/2018 ‐ 12/31/2018

38

2018 Alabama EMS Annual Report

Times Elapsed (Chart 30) 01/01/2018 ‐ 12/31/2018

Chart 30 shows elapsed times between patient’s arrival at destination to time patient received

care. The predominant time was 5+ minutes to 10 minutes at 20 percent (n=101,420).

2,058

2,344

6,514

8,985

21,543

27,702

33,314

51,006

74,435

87,354

91,503

101,420

0 20,000 40,000 60,000 80,000 100,000 120,000


MORE THAN 2 HOURS

1+ HOUR TO 1.5 HOUR







LESS THAN 1 MINUTE



Time Elapsed Patient Arrived at Destination to Destination Patient Transferred Care

01/01/2018 ‐ 12/31/2018

39

2018 Alabama EMS Annual Report Out of Chute Times (Chart 31) 01/01/2018 ‐ 12/31/2018

Chart 31 shows out of chute times. The predominant out of chute time was less than 7 minutes recorded at 92 percent (n=746,837).

3,206

62,931

746,837

0 100,000 200,000 300,000 400,000 500,000 600,000 700,000 800,000

NULL VALUE

7 MINUTES OR GREATER

LESS THAN 7 MINUTES

Out of Chute Times01/01/2018 ‐ 12/31/2018

40


Chart 32 shows elapsed times that unit arrived at patients to transfer of EMS care. The

predominant time was 10+ minutes to 15 minutes at 15 percent (n=10,810).

624

2,233

2,240

3,596

4,868

5,531

6,442

8,090

8,118

8,619

10,268

10,810

0 2,000 4,000 6,000 8,000 10,000 12,000


MORE THAN 2 HOURS

1+ HOUR TO 1.5 HOUR




LESS THAN 1 MINUTE






Time Elapsed Time Unit Arrived at Patient to Transfer of EMS Patient Care01/01/2018 ‐ 12/31/2018

41


Chart 33 shows elapsed time from the time unit arrived on scene to the time unit left scene.

The predominant time was 10+ minutes to 15 minutes at 26 percent (n=166,596).

1,163

2,159

4,816

10,266

11,990

38,054

39,484

42,168

68,925

117,841

142,911

166,596

0 20,000 40,000 60,000 80,000 100,000120,000140,000160,000180,000


MORE THAN 2 HOURS

1+ HOUR TO 1.5 HOUR


LESS THAN 1 MINUTE








Time Elapsed Unit Arrived on Scene to Unit Left Scene01/01/2018 ‐ 12/31/2018

42

2018 Alabama EMS Annual Report Top 10 Transport Providers (Chart 34)

01/01/2018 ‐ 12/31/2018

Chart 34 shows the top 10 transport providers in 2018. HEMSI provided the most at 21 percent

(n=65,423).

15,808

15,834

19,710

23,821

23,997

25,167

27,122

37,896

59,246

65,423

0 10,000 20,000 30,000 40,000 50,000 60,000 70,000

RPS ‐ WALKER

RPS ‐ SHELBY

LIFEGUARD AMBULANCE SERVICE ‐ MOBILE

BIRMINGHAM FIRE & RESCUE SERVICE

MOBILE COUNTY EMS

NORTHSTAR PARAMEDIC SERVICES ‐TUSCALOOSA

LIFEGUARD AMBULANCE SERVICE LLC D/B/A MEDSTAR

RPS ‐ JEFFERSON

MOBILE FIRE RESCUE DEPARTMENT

H E M S I

Top 10 Transport Providers01/01/2018 ‐ 12/31/2018

43

2019 Alabama EMS Annual Report Patient Drug Use Indicators (Chart 35)

01/01/2018 ‐ 12/31/2018

Chart 35 shows EMS patients drug use indicators. The predominant indicator was when

patients admitted to alcohol use at 48 percent (n=9,771).

848

1,170

1,370

1,541

5,816

9,771

0 2,000 4,000 6,000 8,000 10,000 12,000

POSITIVE LEVEL KNOWN FROM LAW ENFORCEMENT OR HOSPITAL RECORD

DRUG PARAPHERNALIA AT SCENE

ALCOHOL CONTAINERS/PARAPHERNALIA AT SCENE

SMELL OF ALCOHOL ON BREATH

PATIENT ADMITS TO DRUG USE

PATIENT ADMITS TO ALCOHOL USE

Patient Drug Use Indicators01/01/2018 ‐ 12/31/2018

44

2018 Alabama EMS Annual Report List of Active EMS Agencies

Appendix A (Chart 36) 01/01/2018 ‐ 12/31/2018

Appendix A

List of Active EMS Agencies: 01/01/2018 – 12/31/2018

Provider Name License County Region Level

A‐MED AMBULANCE SERVICE ‐ ETOWAH Etowah East ALS1

A‐MED AMBULANCE SERVICE ‐ MARSHALL Marshall North ALS1

ABBEVILLE FIRE RESCUE Henry Southeast ALS1

ADAMSVILLE FIRE AND RESCUE Jefferson BREMSS ALS1

ADVANCED EMS, INC Covington Southeast ALS1

ADVANTAGE EMERGENCY MEDICAL SERVICES LLC Etowah East ALS1

ADVANTAGE EMERGENCY MEDICAL SERVICES, LLC. ‐ JEFFERSON Jefferson BREMSS ALS1

AIR EVAC EMS, INC. ‐ COLBERT Colbert North ALS1 CC

AIR EVAC EMS, INC. ‐ CORINTH, MS Out of State Out of State ALS1 CC

AIR EVAC EMS, INC. ‐ CULLMAN Cullman North ALS1 CC

AIR EVAC EMS, INC. ‐ DEMOPOLIS Marengo West ALS1 CC

AIR EVAC EMS, INC. ‐ FAYETTE Fayette West ALS1 CC

AIR EVAC EMS, INC. ‐ JACKSON Jackson North ALS1 CC

AIR EVAC EMS, INC. ‐ MANCHESTER, TN Out of State Out of State ALS1 CC

AIR EVAC EMS, INC. ‐ MARSHALL, TN Out of State Out of State ALS1 CC

AIR EVAC EMS, INC. ‐ SAVANNAH, TN Out of State Out of State ALS1 CC

AIR EVAC EMS, INC. ‐ WAYNESBORO, TN Out of State Out of State ALS1 CC

AIR EVAC LIFETEAM ‐ CARROLLTON, GA Out of State Out of State ALS1 CC

AIR EVAC LIFETEAM ‐ LAGRANGE, GA. Out of State Out of State ALS1 CC

AIR EVAC LIFETEAM. ‐ LAWRENCEBURG, TN Out of State Out of State ALS1

AIR LIFE GEORGIA ‐ CARROLLTON Out of State Out of State ALS1 CC

AIR LIFE GEORGIA ‐ ROME Out of State Out of State ALS1 CC

AIRHEART 2 ‐ MARIANNA, FLORIDA Out of State Out of State ALS1 CC

ALABAMA FIRE COLLEGE Tuscaloosa West ALS1

ALABASTER FIRE DEPARTMENT Shelby BREMSS ALS1

ALBERTVILLE FIRE & RESCUE Marshall North ALS1

ALEXANDER CITY FIRE DEPARTMENT Tallapoosa East ALS1

ALLGOOD VOLUNTEER FIRE AND RESCUE Blount BREMSS ALS1

AM/NS CALVERT Mobile Gulf ALS1

AMSERV EMS ‐ BIBB Bibb West ALS1

AMSTAR EMERGENCY MEDICAL SERVICES ‐ MARENGO Marengo West ALS1

45

AMVAC CHEMICAL CORPORATION Mobile Gulf ALS1

ANNISTON EMERGENCY MEDICAL SERVICES, INC. Calhoun East ALS1

ANNISTON FIRE ‐ RESCUE Calhoun East ALS1

ARAB FIRE RESCUE Marshall North ALS1

ARGO FIRE & RESCUE St. Clair BREMSS ALS1

ARITON RESCUE SQUAD Dale Southeast BLS

ARJENNA PARABASIC TRANSPORT LLC Shelby BREMSS BLS

ASAP AMBULANCE ‐ ESCAMBIA Escambia Gulf ALS1

ASAP AMBULANCE ‐ WASHINGTON Washington Gulf ALS1

ASAP EMS ‐ CLARKE Clarke Gulf ALS1

ASAP EMS ‐ MONROE Monroe Gulf ALS1

ASAP EMS ‐ PERRY Perry West ALS1

ASAP EMS ‐ SUMTER Sumter West ALS1

ASHFORD AMBULANCE AND RESCUE SQUAD Houston Southeast ALS2

ASHVILLE FIRE & RESCUE St. Clair BREMSS ALS1

ATHENS LIMESTONE EMS Limestone North ALS1

ATMORE AMBULANCE, INC Escambia Gulf ALS1

ATTALLA FIRE & RESCUE Etowah East ALS1

BAKER HILL FIRE / RESCUE Barbour Southeast ALS1

BALDWIN EMERGENCY MEDICAL SERVICES Baldwin Gulf ALS1

BAPTIST LIFEFLIGHT 1 Out of State Out of State ALS1 CC

BAPTIST LIFEFLIGHT 3 ‐ CONECUH Butler Southeast ALS1 CC

BASF CORPORATION Washington Gulf ALS1

BESSEMER FIRE DEPARTMENT Jefferson BREMSS ALS1

BIRMINGHAM FIRE & RESCUE SERVICE Jefferson BREMSS ALS1

BIRMINGPORT FIRE DEPARTMENT Jefferson BREMSS ALS1

BLOUNT EMS, INC. Blount BREMSS ALS1

BOAZ FIRE / RESCUE Marshall North ALS1

BRANTLEY FIRE & RESCUE Crenshaw Southeast ALS1

BROOKSIDE FIRE RESCUE Jefferson BREMSS ALS2

BROOKWOOD VOLUNTEER FIRE DEPARTMENT Tuscaloosa West ALS1

CAHABA VALLEY FIRE ‐ JEFFERSON Jefferson BREMSS ALS1

CAHABA VALLEY FIRE ‐ SHELBY Shelby BREMSS ALS1

CALERA FIRE DEPARTMENT Shelby BREMSS ALS1

CARE AMBULANCE ‐ AUTAUGA Autauga Southeast ALS1

CARE AMBULANCE ‐ CHILTON Chilton BREMSS ALS1

CARE AMBULANCE ‐ DALLAS Dallas West ALS1

CARE AMBULANCE ‐ LOWNDES Lowndes Southeast ALS1

CARE AMBULANCE ‐ MACON Macon Southeast ALS1

CARE AMBULANCE ‐ MONTGOMERY Montgomery Southeast ALS1 CC

CARE AMBULANCE ‐ PERRY Perry West ALS1

46

CARE AMBULANCE ‐ RUSSELL Russell Southeast ALS1 CC

CENTER POINT FIRE AND RESCUE Jefferson BREMSS ALS1

CHELSEA FIRE & RESCUE Shelby BREMSS ALS1

CHEROKEE EMERGENCY MEDICAL SERVICES, INC Cherokee East ALS1

CHEROKEE RESCUE SQUAD Colbert North ALS1

CHILDERSBURG AMBULANCE SERVICE Talladega East ALS1

CHOCTAW COUNTY AMBULANCE SERVICE Choctaw West ALS1

CITY OF LANETT FIRE AND EMS Chambers East ALS1

CITY OF SLOCOMB EMS Geneva Southeast ALS1

CLANTON FIRE DEPARTMENT Chilton BREMSS ALS1

CLAY COUNTY RESCUE SQUAD Clay East ALS1

CLEBURNE COUNTY EMERGENCY MEDICAL SERVICES Cleburne East ALS1

CLIO RESCUE SQUAD Barbour Southeast BLS

COLLINS CHAPEL FIRE & RESCUE Chilton BREMSS ALS1

COLUMBIA AMBULANCE & RESCUE EMERGENCY SQUAD Houston Southeast ALS1

CONCORD FIRE DISTRICT Jefferson BREMSS ALS1

CONECUH COUNTY EMS Conecuh Gulf ALS1

CORDOVA VOLUNTEER FIRE DEPARTMENT Walker BREMSS ALS1

CORNER VOLUNTEER FIRE & RESCUE SERVICE, INC. Jefferson BREMSS ALS1

COTTONWOOD AMBULANCE & RESCUE SQUAD Houston Southeast BLS

CRAWFORD VOLUNTEER FIRE DEPARTMENT, INC Russell Southeast ALS1

CROSSVILLE FIRE & RESCUE Lamar West ALS3

CULLMAN EMERGENCY MEDICAL SERVICES Cullman North ALS1 CC

CULLMAN FIRE RESCUE Cullman North ALS1

D. W. MCMILLAN EMS Escambia Gulf ALS1

DALE EMS & RESCUE SQUAD INC Dale Southeast ALS2

DALEVILLE POLICE VOLUNTEER RESCUE Dale Southeast ALS2

DAPHNE FIRE DEPARTMENT Baldwin Gulf ALS1

DAUPHIN ISLAND FIRE AND RESCUE Mobile Gulf ALS1

DAVIS LAKE FIRE DISTRICT St. Clair BREMSS ALS2

DECATUR FIRE & RESCUE Morgan North ALS1

DEKALB AMBULANCE SERVICE Dekalb North ALS1

DEMOPOLIS PUBLIC SAFETY D/B/A DEMOPOLIS FIRE/RESCUE DEPT. Marengo West BLS

DESOTO RESCUE SQUAD Dekalb North ALS3

DIRECTORATE OF PUBLIC SAFETY, FIRE & EMERGENCY SERVICES DIVISION Dale Southeast ALS1

DOTHAN AMBULANCE SERVICE ‐ HOUSTON Houston Southeast ALS1

DOTHAN FIRE DEPARTMENT Houston Southeast ALS1

47

EAST ALABAMA EMERGENCY MEDICAL SERVICES, LLC Lee Southeast ALS1

EAST ALABAMA FIRE DISTRICT Chambers East ALS1

ECHO EMS Dale Southeast ALS1

ECLECTIC FIRE DEPARTMENT EMS Elmore Southeast ALS1

ELITE INDUSTRIAL SERVICES Mobile Gulf ALS1

EMERGENCY MEDICAL TRANSPORT, LLC Randolph East ALS1

EMS CARE AMBULANCE Russell Southeast ALS1

ENTERPRISE FIRE DEPARTMENT Coffee Southeast ALS2

ENTERPRISE RESCUE, INC. Coffee Southeast ALS1

ESCAMBIA COUNTY EMS Out of State Out of State ALS1

EUFAULA RESCUE SQUAD Barbour Southeast ALS1

EXCELSIOR AMBULANCE SERVICE, INC. ‐ MONTGOMERY Montgomery Southeast ALS1

FAIRVIEW VOLUNTEER FIRE & RESCUE Chilton BREMSS ALS1

FAYETTE COUNTY EMS Fayette West ALS1

FIRST RESPONSE ‐ DECATUR Morgan North ALS1 CC

FLOYD EMS ‐ CHEROKEE Cherokee East ALS1

FORESTDALE FIRE DISTRICT Jefferson BREMSS ALS1

FORT PAYNE FIRE DEPARTMENT Dekalb North ALS1

FORT RUCKER EMERGENCY MEDICAL SERVICE Dale Southeast ALS1

FULTONDALE FIRE & RESCUE Jefferson BREMSS ALS1

GADSDEN FIRE DEPARTMENT Etowah East ALS1

GALLANT VOLUNTEER FIRE DEPARTMENT Etowah East ALS3

GANTT AREA VOLUNTEER RESCUE SQUAD Covington Southeast BLS

GARDENDALE FIRE & RESCUE Jefferson BREMSS ALS1

GEMS AMBULANCE Butler Southeast ALS1

GENEVA RESCUE SQUAD Geneva Southeast ALS1

GOODWATER AMBULANCE SERVICE Coosa East ALS2

GRAYSVILLE FIRE & RESCUE Jefferson BREMSS ALS1

GREEN POND FIRE & RESCUE Bibb West ALS1

GREENE COUNTY EMS Greene West ALS1

GREENVILLE FIRE DEPARTMENT Butler Southeast ALS1

GREG'S AMBULANCE SERVICE Lawrence North ALS1 CC

GULF SHORES FIRE RESCUE Baldwin Gulf ALS1

GUNTERSVILLE FIRE & RESCUE Marshall North ALS1

H E M S I Madison North ALS1

HALE COUNTY EMS Hale West ALS1

HALEBURG RESCUE SQUAD Henry Southeast ALS1

HARPERSVILLE FIRE DEPARTMENT Shelby BREMSS ALS1

HARTFORD FIRE RESCUE Geneva Southeast ALS1

HAYNES AMBULANCE ‐ AUTAUGA Autauga Southeast ALS1

48

HAYNES AMBULANCE ‐ BULLOCK Bullock Southeast ALS1

HAYNES AMBULANCE ‐ COFFEE COUNTY Coffee Southeast ALS1

HAYNES AMBULANCE ‐ MACON Macon Southeast ALS1

HAYNES AMBULANCE ‐ MONTGOMERY Montgomery Southeast ALS1

HAYNES AMBULANCE OF ELMORE COUNTY, LLC Elmore Southeast ALS1

HAYNES AMBULANCE OF OPP COVINGTON Covington Southeast ALS1

HAYNES AMBULANCE OF TROY, LLC Pike Southeast ALS1

HAYNES LIFE FLIGHT ‐ PIKE COUNTY Pike Southeast ALS1 CC

HAYNES LIFE FLIGHT, LLC Elmore Southeast ALS1 CC

HEADLAND FIRE RESCUE Henry Southeast ALS1

HELENA FIRE DEPARTMENT Shelby BREMSS ALS1

HIGHLAND HOME VOLUNTEER FIRE & RESCUE DEPARTMENT, INC. Crenshaw Southeast ALS1

HIGHLANDS MEDICAL CENTER AMBULANCE SERVICE Jackson North ALS1

HILLSBORO AREA VOLUNTEER FIRE & RESCUE Lawrence North ALS3

HOMEWOOD FIRE AND RESCUE SERVICE Jefferson BREMSS ALS1

HOOVER FIRE DEPARTMENT ‐ JEFFERSON Jefferson BREMSS ALS1

HOOVER FIRE DEPARTMENT ‐ SHELBY Shelby BREMSS ALS1

HUEYTOWN FIRE & RESCUE Jefferson BREMSS ALS1

HUNTSVILLE FIRE & RESCUE Madison North ALS2

HUNTSVILLE MEDFLIGHT ‐ MADISON Madison North ALS1 CC

INDIAN FORD FIRE DISTRICT Jefferson BREMSS ALS1

INTERNATIONAL PAPER Autauga Southeast ALS1

IRONDALE FIRE DEPARTMENT Jefferson BREMSS ALS1

JACKSONVILLE FIRE DEPARTMENT Calhoun East ALS1

JEFFERSON COUNTY SHERIFF'S OFFICE TACTICAL UNIT Jefferson BREMSS ALS2

JEMISON FIRE AND RESCUE Chilton BREMSS ALS1

KELLER EMS ‐ COLBERT Colbert North ALS1

KELLER EMS ‐ FRANKLIN COUNTY Franklin North ALS1

KELLYTON FIRE & RESCUE Coosa East ALS1

KIMBERLY FIRE AND RESCUE Jefferson BREMSS ALS1

LAFAYETTE FIRE AND EMS Chambers East ALS1

LAMAR AMBULANCE SERVICE INC Lamar West ALS1

LEEDS FIRE & RESCUE Jefferson BREMSS ALS1

LIFECARE OF ALABAMA ‐ JEFFERSON Jefferson BREMSS ALS1

LIFECARE OF ALABAMA ‐ TUSCALOOSA Tuscaloosa West ALS1

LIFEGUARD AMBULANCE SERVICE ‐ BALDWIN Baldwin Gulf ALS1

LIFEGUARD AMBULANCE SERVICE ‐ JEFFERSON Jefferson BREMSS ALS1

LIFEGUARD AMBULANCE SERVICE ‐ MOBILE Mobile Gulf ALS1

LIFEGUARD AMBULANCE SERVICE ‐ MORGAN Morgan North ALS1

49

LIFEGUARD AMBULANCE SERVICE LLC D/B/A MEDSTAR Baldwin Gulf ALS1 CC

LIFEGUARD AMBULANCE SERVICE, LLC D/B/A MEDSTAR/ESCAMBIA Escambia Gulf ALS1

LIFESAVER 2 ‐ ETOWAH Etowah East ALS1 CC

LIFESAVER 3 ‐ CHAMBERS Chambers East ALS1 CC

LIFESAVER 4 ‐ TALLADEGA Talladega East ALS1 CC

LINCOLN FIRE & RESCUE Talladega East ALS1

LITTLEVILLE FIRE & RESCUE Colbert North ALS1

LIVINGSTON FIRE & RESCUE Sumter West ALS1

LOCUST FORK FIRE AND RESCUE Blount BREMSS ALS1

LOUISVILLE FIRE & RESCUE Barbour Southeast BLS

LUVERNE RESCUE SQUAD, INC. Crenshaw Southeast ALS1

MADISON FIRE & RESCUE Madison North ALS1

MARION COUNTY EMS Marion West ALS1

MARSHALL MEDICAL CENTER ‐ BOAZ Marshall North ALS1

MCADORY FIRE DEPARTMENT Jefferson BREMSS ALS1

MCCALLA AREA FIRE DISTRICT Jefferson BREMSS ALS1

MED‐TRANS CORP DBA SHANDSCAIR 6 Out of State Out of State ALS1 CC

MED‐TRANS CORPORATION D/B/A MEDSTAR AIR CARE Baldwin Gulf ALS1 CC

MEDCARE EMERGENCY MEDICAL SERVICE, INC. Wilcox West ALS1

MIDFIELD FIRE DEPARTMENT Jefferson BREMSS ALS1

MIDLAND CITY FIRE RESCUE Dale Southeast BLS

MILLBROOK FIRE DEPARTMENT Elmore Southeast ALS1

MINOR HEIGHTS FIRE DISTRICT Jefferson BREMSS ALS1

MOBILE COUNTY EMS Mobile Gulf ALS1

MOBILE FIRE RESCUE DEPARTMENT Mobile Gulf ALS1

MONTEVALLO FIRE & RESCUE SERVICE Shelby BREMSS ALS1

MONTGOMERY FIRE / RESCUE DEPARTMENT Montgomery Southeast ALS1

MOODY FIRE & RESCUE St. Clair BREMSS ALS1

MOUNT OLIVE FIRE AND RESCUE DISTRICT Jefferson BREMSS ALS1

MOUNTAIN BROOK FIRE DEPARTMENT Jefferson BREMSS ALS1

MUD TAVERN VOLUNTEER FIRE RESCUE Morgan North ALS1

NECTAR FIRE DEPARTMENT Blount BREMSS ALS1

NEW SITE VOLUNTEER FIRE AND AMBULANCE SERVICE Tallapoosa East BLS

NEWMAN'S MEDICAL SERVICES INC Mobile Gulf ALS1

NIXON CHAPEL VOLUNTEER FIRE DEPARTMENT Marshall North ALS2

NORTH BALDWIN EMS, LLC Baldwin Gulf ALS1

NORTH CHILTON VOLUNTEER FIRE DEPARTMENT Chilton BREMSS ALS1

NORTH LAMAR EMERGENCY MEDICAL SERVICES Lamar West BLS

50

NORTH SHELBY FIRE DEPARTMENT Shelby BREMSS ALS1

NORTHPORT FIRE RESCUE Tuscaloosa West ALS1

NORTHSTAR PARAMEDIC SERVICES ‐ JEFFERSON Jefferson BREMSS ALS1

NORTHSTAR PARAMEDIC SERVICES ‐ TALLADEGA Talladega East ALS1

NORTHSTAR PARAMEDIC SERVICES ‐ TUSCALOOSA Tuscaloosa West ALS1

ODENVILLE FIRE & RESCUE St. Clair BREMSS ALS1

OKALOOSA MEDFLIGHT Out of State Out of State ALS1 CC

ONEONTA FIRE AND RESCUE Blount BREMSS ALS1

OPELIKA FIRE RESCUE Lee Southeast ALS1

OPPORTUNITY EMS, INC. Covington Southeast ALS1

ORANGE BEACH FIRE RESCUE Baldwin Gulf ALS1

OXFORD EMERGENCY MEDICAL SERVICES, INC. Calhoun East ALS1

OZARK EMS Dale Southeast ALS1

OZARK FIRE DEPARTMENT Dale Southeast ALS1

PALMERDALE FIRE DISTRICT Jefferson BREMSS ALS1

PELHAM FIRE DEPARTMENT Shelby BREMSS ALS1

PELL CITY FIRE & RESCUE SERVICE St. Clair BREMSS ALS1

PHIL CAMPBELL RESCUE SQUAD Franklin North ALS1

PICKENS COUNTY AMBULANCE SERVICE Pickens West ALS1

PIEDMONT RESCUE SQUAD Calhoun East ALS1

PINE MOUNTAIN VOLUNTEER FIRE AND EMS DISTRICT, INC Blount BREMSS ALS1

PINTLALA VOLUNTEER FIRE DEPARTMENT Montgomery Southeast ALS2

PLEASANT GROVE FIRE & RESCUE SERVICE Jefferson BREMSS ALS1

PRATTVILLE FIRE DEPARTMENT Autauga Southeast ALS1

PROGRESSIVEHEALTH, LLC Montgomery Southeast ALS1

RAGLAND RESCUE SERVICE St. Clair BREMSS ALS3

RAINBOW CITY FIRE & RESCUE Etowah East ALS1

RAINSVILLE FIRE & RESCUE Dekalb North ALS2

REGIONAL AIR MEDICAL SERVICES, INC.‐ WALKER Walker BREMSS ALS1 CC

REHOBETH VOLUNTEER RESCUE Houston Southeast ALS2

RIVERSIDE FIRE & RESCUE St. Clair BREMSS ALS1

ROCKY RIDGE FIRE DEPARTMENT Jefferson BREMSS ALS1

ROSA VOLUNTEER FIRE & RESCUE Blount BREMSS ALS1

RPS ‐ CHILTON Chilton BREMSS ALS1

RPS ‐ CULLMAN Cullman North ALS1

RPS ‐ JEFFERSON Jefferson BREMSS ALS1

RPS ‐ MARION Marion West ALS1

RPS ‐ SHELBY Shelby BREMSS ALS1

RPS ‐ ST. CLAIR St. Clair BREMSS ALS1

RPS ‐ TALLADEGA Talladega East ALS1

51

RPS ‐ WALKER Walker BREMSS ALS1 CC

RPS ‐ WINSTON Winston BREMSS ALS1

RUSSELLVILLE FIRE AND RESCUE Franklin North ALS1

SAMARITAN EMS, INC ‐ MORGAN Morgan North ALS1

SAMARITIAN EMS, INC ‐ ARAB Marshall North ALS1

SAMSON VOLUNTEER RESCUE SQUAD Geneva Southeast ALS1

SARALAND FIRE RESCUE DEPARTMENT Mobile Gulf ALS1

SAVES FIRE & RESCUE Morgan North ALS1

SCOTTSBORO FIRE DEPARTMENT Jackson North ALS1

SHOALS AMBULANCE ‐ COLBERT Colbert North ALS1

SHOALS AMBULANCE ‐ JEFFERSON Jefferson BREMSS ALS1

SHOALS AMBULANCE ‐ LAUDERDALE Lauderdale North ALS1

SIMMONS EMS Monroe Gulf ALS1

SKIPPERVILLE VOLUNTEER RESCUE SQUAD Dale Southeast BLS

SMITHS STATION FIRE & RESCUE Lee Southeast ALS1

SNEAD FIRE AND RESCUE Blount BREMSS ALS1

SOUTHEAST SHELBY COUNTY RESCUE Shelby BREMSS ALS1

SOUTHERN AMBULANCE TRANSPORT, INC. Randolph East ALS1

SOUTHFLIGHT Mobile Gulf ALS1 CC

SOUTHSIDE FIRE DEPARTMENT Etowah East ALS1

SPRINGVILLE FIRE AND RESCUE St. Clair BREMSS ALS1

STEELE FIRE AND RESCUE St. Clair BREMSS ALS1

SUMITON FIRE AND RESCUE SERVICE Walker BREMSS ALS1

SURVIVAL FLIGHT, INC. ‐ HENRY Henry Southeast ALS1 CC

SYLACAUGA AMBULANCE SERVICE Talladega East ALS1

SYLVAN SPRINGS FIRE DEPARTMENT Jefferson BREMSS ALS1

TALLAPOOSA EMERGENCY MEDICAL SERVICES Tallapoosa East ALS1

TARRANT FIRE AND RESCUE Jefferson BREMSS ALS1

THORSBY FIRE DEPARTMENT Chilton BREMSS ALS1

TIDE EMS Tuscaloosa West ALS1

TOWN OF CLAYTON ‐ CLAYTON FIRE AND RESCUE Barbour Southeast ALS1

TROY FIRE DEPARTMENT Pike Southeast ALS1

TRUSSVILLE FIRE AND RESCUE Jefferson BREMSS ALS1

TUSCALOOSA COUNTY SHERIFF'S OFFICE Tuscaloosa West ALS1

TUSCALOOSA FIRE & RESCUE SERVICE Tuscaloosa West ALS1

U S STEEL Jefferson BREMSS ALS1

VESTAVIA HILLS FIRE DEPARTMENT Jefferson BREMSS ALS1

VINEMONT PROVIDENCE FIRE DEPARTMENT Cullman North ALS2

VINES AMBULANCE SERVICE Chambers East BLS

WARRIOR FIRE DEPARTMENT Jefferson BREMSS ALS1

WEST BLOUNT VOLUNTEER FIRE & RESCUE Blount BREMSS ALS2

52

WEST JEFFERSON FIRE & RESCUE Jefferson BREMSS ALS2

WESTOVER MUNICIPAL FIRE DEPARTMENT Shelby BREMSS ALS1

WICKSBURG FIRE RESCUE Houston Southeast ALS1

WINTERBORO VOLUNTEER FIRE AND RESCUE INC Talladega East ALS1

53

Appendix B: Map of EMS and Trauma Regions

Documents

Alabama Department of Public Health › ems › assets › 2018.EMS... · The Alabama Office of Emergency Medical Services (OEMS) operates under the Alabama Department of Public Health