of that was simply the course for firefighters, retitled for EMS, ensuring most of the scenarios did not adequately describe EMS-centered response. Therefore, the use of dedicated education by the professional field cannot be understated in its importance to preparing responders to deal with an MCI. In addition, time lost at a job is a significant consideration for volunteers, who make up a large part of rural responders (described in Chapter 4). Government needs to find ways to use distance learning and technology to provide ICS training to EMS. DeTienne also reiterated the point that the workforce and infrastructure must be able to adequately handle the everyday emergency response if it is to ever be able to handle mass casualties. Dawson brought the point further to bear insisting that invention, evaluation, and deployment of new technologies is another area where the federal government can play an important role.

Zanker concurred, commenting that as important as technology is, without the proper training it is of limited use (the government’s role in technology was discussed in Chapter 3). Zanker advocated funding programs that broaden the basic skills of responders who are not paramedics, such that their training in combination with guided instructions from onboard telemedicine technologies, for instance, could increase a whole response unit’s ability to save lives quickly. As stated by participants in previous chapters, skill retention should be considered a crucial aspect of any authority’s education responsibilities.


Participants discussed the roles of local, state, and federal governments, the private sector, and other organizations in improving rural MCI response capabilities. In the noted absence of a single dedicated federal agency, the responsibility falls to a coordinated effort across multiple agencies, all sectors, and involving all stakeholders.

Addressing the pervasive communications challenges is a priority, posited workshop chair Robert Bass. A variety of telecommunications technologies and initiatives were discussed, such as Next Generation 9-1-1, satellite communications, broadband, and telemedicine. Several participants suggested that a way to bring these technologies to rural and frontier areas and increase connectivity is needed. Incentivizing and engaging the private sector were suggested as possible approaches.

Although funding is essential, and a variety of available grants and funding sources were discussed, funding is not the only issue and is not exclusively the responsibility of agencies of the federal government. Bass emphasized that a coordinated federal vision for the role of EMS in rural environments should be developed, aligning funding and activities at the federal level across the various agencies (e.g., HHS, DOT, DHS).

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