NFPA 450: Guide for Emergency Medical Services and Systems

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Protect lives by designing and evaluating emergency medical services systems using the guidelines and recommendations in the 2013 NFPA 450.

To serve the public and support first responders, effective provision of pre-hospital care requires the coordination and cooperation of disparate elements. To address all the diverse factors, NFPA 450: Guide for Emergency Medical Services and Systems provides guidelines, resources, and recommendations to help those interested or involved in comprehensive EMS systems development and/or design. This document also provides a framework for evaluating systems and making improvements based on that evaluation.

Changes to this latest edition ensure correlation with other federal EMS documents and consistency with commonly used terminology in the EMS community, including:

  • Clarifying the foundation of NFPA 450 and its ties with the EMS Agenda for the Future
  • Clearly defining what on-line and off-line (direct and in-direct) medical direction is, and is not
  • Specifying how medical oversight is to be used in an EMS system

Essential for agencies that are looking to establish an EMS, this document will be useful as a template when developing an EMS system as well as in the evaluation of measurable outcomes. Everyone from local stakeholders to owners and staff of agencies and organizations, needs the latest edition of NFPA 450. (Softbound, 33 pp., 2013)

NFPA® 450 Guide for Emergency Medical Services and Systems 2013 Edition

Chapter 1 Administration
1.1 Scope
1.2 Purpose
Chapter 2 Referenced Publications
2.1 General
2.2 NFPA Publications
2.3 Other Publications
2.4 References for Extracts in Advisory Sections
Chapter 3 Definitions
3.1 General
3.2 NFPA Official Definitions
3.3 General Definitions
Chapter 4 System Regulation and Policy
4.1 General
4.2 Oversight
4.3 Authorization
4.4 Evaluation
4.5 Roles and Responsibilities
4.6 Service Levels
4.7 Management Structure
4.8 Planning
4.9 Authority to Implement Plans
4.10 Resources
4.11 Participation in Policy Development
4.12 Authority for Policy, Procedure, and Operation
4.13 Patient Information Protection
Chapter 5 EMS System Analysis and Planning
5.1 Introduction
5.2 Analysis of System Resources
5.3 Community Needs Analysis
5.4 System Goals and Objectives Analysis
5.5 System Design Analysis
5.6 Essential System Analysis Components
5.7 EMS System Planning
5.8 Continual Risk Assessment and Planning
5.9 System Assessment Cycle
5.10 Current Conditions
5.11 Data Element/Collection/Analysis/Reporting
5.12 Feedback Loop
Chapter 6 Finance
6.1 Determining Cost of System
6.2 Method for Anticipating System Funding Sources
6.3 Use of Revenue and Cost Analysis
6.4 Financial Plans
6.5 Business Analysis
6.6 Additional Financial Issues
Chapter 7 Medical Oversight
7.1 General
7.2 Single Medical Authority
7.3 System Support of Medical Authority
7.4 Medical Authority Role
7.5 Medical Director Responsibilities
7.6 On-Line and Off-Line (Direct and Indirect) Medical Direction
7.7 Medical Director Qualifications
Chapter 8 Quality Management, Clinical Quality, and Data Reliability
8.1 Quality Management Program
8.2 Performance Objectives
8.3 Public Health Outcome Parameters
8.4 Physician Participation
8.5 Patient Confidentiality
8.6 Injury/Illness Reduction and Prevention
8.7 Complaints
8.8 Participation in Studies and Research
8.9 System Review
8.10 Documentation
8.11 Multiple Clocks Within a System
Chapter 9 Public Information, Education, and Relations (PIER)
9.1 Public Education
9.2 Public Education System Goals
9.3 Qualifications of Personnel for PIER Activities
9.4 PIER Activities
9.5 PIER Activities Related to Mass Gatherings
9.6 PIER Activities
9.7 EMS Agenda for the Future
9.8 Disaster Education
9.9 Collaborative Efforts
9.10 Identification of Available Public Media Resources
9.11 Identification of Funding Resources
Chapter 10 Communications
10.1 Introduction
10.2 Access of Emergency Services
10.3 Lead Agency
10.4 Centralized Communication Plan
10.5 Computer-Aided Dispatch
10.6 Capture of Key Data Elements
10.7 Quality Management
10.8 Communications Equipment
10.9 Operability
10.10 Criteria-Based Dispatch
10.11 Training
10.12 Direct Medical Control
10.13 Nonemergency Services
Chapter 11 Equipment and Facilities
11.1 Standard for First Response and Ambulance Transportation
11.2 Replacement Plan
11.3 Response Vehicle Licenses
11.4 Inspecting Emergency Equipment
11.5 Personnel Education and Training
11.6 Maintenance Plans
11.7 Maintenance Personnel for Emergency Equipment
11.8 Response Facilities
Chapter 12 Human Resources
12.1 Introduction
12.2 Recruitment
12.3 Education/Training/Certification
12.4 Retention
12.5 Personnel
12.6 Rules and Regulations
12.7 Health and Safety
Chapter 13 Operations
13.1 Implementation of System Design (Operations)
13.2 System Preparation
13.3 Communications Coordination
13.4 Response Coordination
13.5 Incident Management
13.6 Treatment Guidelines
13.7 Patient Destination (Transport)
13.8 Functional Capabilities of Health Care Facilities
13.9 Coordinated Medical Oversight
13.10 Quality Management/Documentation
13.11 Logistics
13.12 Staff Management
13.13 Public Information, Education, and Relations
13.14 Regulatory Compliance
13.15 Automatic and Mutual Aid
13.16 Alternative Patient Transport
13.17 Training
13.18 Emergency Response Planning
13.19 Joint Coordination and Planning
13.20 Research and Development
Annex A Explanatory Material
Annex B Informational References