Post on 06-Aug-2020
Alabama Department of
Public Health
2018 Annual Report
Office of Emergency Medical Services
January 1, 2018 – December 31, 2018
2
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
3
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.
4
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
5
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.
6
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.
7
Map of Alabama 67 Counties
8
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
9
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
10
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
11
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
12
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
13
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
14
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
15
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
percent (n=463,791).
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
16
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
17
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
18
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
19
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
percent (n=466,048).
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
20
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.
21
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
22
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
23
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
24
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
25
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
26
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
27
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
28
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
29
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
30
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
31
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 12 Lead ECGObtained
Cardiac 15 Lead ECGObtained
Cardiac 18 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
33
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
10+ MINUTES TO 15 MINUTES
1+ HOUR TO 1.5 HOUR
15+ MINUTES TO 20 MINUTES
45+ MINUTES TO 1 HOUR
25+ MINUTES TO 30 MINUTES
20+ MINUTES TO 25 MINUTES
30+ MINUTES TO 45 MINUTES
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
1.5+ HOUR TO 2 HOURS
MORE THAN 2 HOURS
1+ HOUR TO 1.5 HOUR
45+ MINUTES TO 1 HOUR
25+ MINUTES TO 30 MINUTES
30+ MINUTES TO 45 MINUTES
20+ MINUTES TO 25 MINUTES
15+ MINUTES TO 20 MINUTES
10+ MINUTES TO 15 MINUTES
LESS THAN 1 MINUTE
1 MINUTE TO 5 MINUTES
5+ MINUTES TO 10 MINUTES
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
2018 Alabama EMS Annual Report Times Elapsed (Chart 32) 01/01/2018 ‐ 12/31/2018
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
1.5+ HOUR TO 2 HOURS
MORE THAN 2 HOURS
1+ HOUR TO 1.5 HOUR
45+ MINUTES TO 1 HOUR
1 MINUTE TO 5 MINUTES
25+ MINUTES TO 30 MINUTES
LESS THAN 1 MINUTE
5+ MINUTES TO 10 MINUTES
20+ MINUTES TO 25 MINUTES
30+ MINUTES TO 45 MINUTES
15+ MINUTES TO 20 MINUTES
10+ MINUTES TO 15 MINUTES
Time Elapsed Time Unit Arrived at Patient to Transfer of EMS Patient Care01/01/2018 ‐ 12/31/2018
41
2018 Alabama EMS Annual Report Times Elapsed (Chart 33) 01/01/2018 ‐ 12/31/2018
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
1.5+ HOUR TO 2 HOURS
MORE THAN 2 HOURS
1+ HOUR TO 1.5 HOUR
45+ MINUTES TO 1 HOUR
LESS THAN 1 MINUTE
25+ MINUTES TO 30 MINUTES
1 MINUTE TO 5 MINUTES
30+ MINUTES TO 45 MINUTES
20+ MINUTES TO 25 MINUTES
15+ MINUTES TO 20 MINUTES
5+ MINUTES TO 10 MINUTES
10+ MINUTES TO 15 MINUTES
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