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difficult to obtain, is measurement of the impact on patient care as a
result of utilizing the classification and referral system. The methods
for evaluation of the impact on patient care will be complex and costly
to develop. As the implementation progresses, impact evaluation method-
ologies will be developed. A necessary part of any evaluation of this
program, however, must be measurements of changes in utilization patterns.

Objective :

To develop hospital career programs for EMT-A in three hospitals within
the state by the end of the first year.

Act! VI ties ;

The program staff will visit hospitals and relevant organizations to
foster career development for ambulance personnel in hospi tal -based
services. Emphasis will be placed upon utilizing ex-corpsmen for these
posi tions.

Evaluation ;

Records of the activites of the EMS staff shall reflect these accomplish-
ments. Reports from involved hospital emergency department staff and
administration will provide analysis of the benefits of this program on
a continued basis.

LOCATION SIGNS

Objective ;

To provide the general public with the means to quickly identify and
locate emergency medical facilities.

Activities:



The EMS staff will conduct meetings with hospitals. State Highway Department,
and local EMS councils to encourage the placement of proper location signs
for all medical facilities.

Evaluation ;

Periodic surveys will be made by the EMS staff after the activities
have been accomplished to determine their impact. The design of the
survey will be developed during the first year of implementation in
cooperation with the State Highway Safety Office and the State Highway
Department.



Evaluation/82

CONTJNUED EMS PLANNING
Objective ;

To revise and improve the plan, seek funding for its support, and carry
out public information programs related to the plan.

Activities ;

1= The EMS staff will modify and update the plan on a continual basis
to reflect changing technology, needs, and priorities.

2o The program staff will innovate and evaluate various mechanisms to
measure the impact that the modifications of the emergency medical
services systems are having on the state's mortality and morbidity rates.

3. Grant applications to fund various aspects of the EMS system will
be prepared by the program staff.

4. A monthly newsletter will be prepared for distribution to ambulance
services, hospitals, EMS councils, and other relevant organizations.

PUBLIC TELEPHONES
Objective ;

To assure that public telephones are available, well-placed and adequately
i I luminated.

Activi ties ;

K An evaluation of the location of outdooor public telephones, based
upon the availability to the public, will be made in each community in
Montana. This evaluation will be done by the EMS staff, Communications
Bureau, local EMS councils, and telephone companies.

2. Those public telephones deemed to be ill-placed will be relocated

by local EMS councils, local public agencies, and the telephone companies

with the assistance of the EMS staff and Communications Bureau.

3» The project staff. Communications Bureau, and the communications
committee to the Governor's Adivsory Council on EMS will work with the
telephone companies to place location information of community emergency
medical resources on all public telephones in Montana.

Evaluation ;

The EMS staff will compare the number of public telephones replaced to
the number needing replacement on a yearly basis.



Evaluation/83



ROADSIDE EMERGENCY TELEPHONES
Objective :

To reduce the time from detection of incident to notification of
emergency resources control agency by the placement of roadside
emergency telephones.

Acti vi ties :

lo Project staff will work with Communications Bureau, Highway Traffic
Safety office, and Highway Department in analyzing Rural Accident Clusters
and Rural Accident Analysis programs to determine locations for emergency
roadside telephones.

2. After necessary locations have been determined, the EMS staff will
work with appropriate agencies, local EMS councils, and telephone companies
to place these telephones.

Evaluation :

A reduction in time can be determined by evaluating ambulance trip report
information.

911 SYSTEM

Objective :

To reduce notification time and improve the response of emergency resources
by providing thepublic with an easily remembered and easily dialed tele-
phone number.

Acti vi ties :

1. The EMS staff will meet with local EMS councils and public agencies
to promote the development of 911 systems on a local basis.

2. The EMS staff will perform liaison tasks between the telephone
companies, state agencies, and the local providers on the subject of 91 !•

Evaluation ;

The project staff will evaluate the effectiveness of 911 systems by:
(1) the number of 911 systems installed, and (2) by the number of
emergency calls made on 911 systems.

DISPATCHING



Objective :



To provide for local dispatching mechanisms which will efficiently and
promptly dispatch and coordinate emergency medical resources.



Evaluat ion/S^i
Act ivi ties :

lo Through local EMS councils and public agencies, the state EMS staff
will promote the establishment of local central dispatching.

2. The EMS staff and the Governor's Advisory Council, acting on recom-
mendations of the communications committee, will develop a dispatcher
checklist which will aid dispatchers in the handling of emergency calls.

3. The EMS staff will meet with local EMS councils and public agencies
to promote first-aid training for EMS dispatchers.

k. The EMS staff will work with Civil Defense to provide central dis-
patch centers with emergency power.

5. The EMS staff will cooperate with Civil Defense in promoting
adequate interface between central dispatch centers and Emergency
Operating Centers.

Evaluation :

The EMS staff will determine the number of dispatch centers established
and gather expert opinion on each center's operations.

AMBULANCE-HOSP I TAL COMMUN I CAT I ONS



Objective :

To insure that a common emergency communication plan is established on
a statewide basis which will provide direct ambulance-hospital com-
munications.

Activities :

I0 The EMS staff will assist Highway Traffic Safety and the Communications
Bureau in establishing a common statewide radio network within three years.

2. EMS staff will meet with local EMS councils and public agencies to
assist in the establishment of local radio networks.

Evaluation :

Each year the increase in radio coverage on the emergency frequencies
will be measured and plotted on maps by the Communications Bureau and
the EMS staff.

AMBULANCE-HOSPITAL RELATIONS

Objective ;

To guarantee better treatment of the emergency patient by establishing
closer ties between the ambulance service and the hospital emergency
department.



Evaluation/85



A!R AMBULANCES



Objective ;



To insure that air ambulances will provide the same quality service
to the emergency patient that is demanded of the ground ambulance.

Activi ties:



1. The EMS staff, in cooperation with the Aeronautics Commission,
will provide guidelines to all air ambulance operators and physicians
in the state within the first year of implementation. These guide-
lines will provide information on minimum aircraft criteria on perform-
ance, dimensions, and equipment carried.

2. The EMS staff will conduct meetings with physicians and the Governor's
Advisory Council on EMS in order to gather medical information pertinent
to air ambulances.

3. The EMS staff will disperse medical information concerning the use
of air ambulances to all physicians within the state.

k. The EMS staff, in cooperation with the Aeronautics Commission, will
determine from on-site observations and expert opinion if air ambulance
guIdeUnes are being followed.

If evaluation indicates that guidelines are ineffectual at the end of
the second year of implementation, the EMS staff will seek legislation
to regulate the operation of air ambulances.

Evaluation :

If legislation is enacted, annual inspections by the EMS staff will
determine whether air ambulances are meeting state requirements.

HELIPORTS

Object i ve :

To provide information on the construction and use of heliports to
all hospitals in Montana.

Activities :

The project staff will assist Montana Aeronautics Commission in the
development of heliports.

Evaluation:

■ ~ ■ B 11 - ^

From on-site inspection, the number of heliports and heliport traffic
wi 1 1 be determined.



Evaluation/86

Activities :

lo The EMS staff will meet with local EMS councils and actively promote
better relations between ambulance services and hospitals.

2. The EMS staff will provide literature and information on ambulance-
hospital relations to all providers of emergency medical services and
interested local citizens' groups within the state.

Evaluation ;

By annual ambulance inspections, the relationship of ambulance services
to hospitals will be determined. From the trip report form, the impact
on the patient resulting from closer ambulance'-hospi tal relations will
be measured.

TRIP REPORT FORM

Objective ;

To provide emergency medical services with a trip report form that will
be of assistance in providing better emergency health care to the
patient.

Activities ;

1. The EMS staff will print and distribute to all ambulance services
trip report forms within the first six months of the implementation
phase.

2. The EMS staff will provide information on the trip report's use by
staffs of all ambulance services and emergency departments within the
first six months of the implementation phase.

3. The EMS staff and Records and Statistics Bureau, State Department
of Health will establish a computerized program to utilize selected
information from the report by the end of the first year of implementation.

A. At the beginning of the second year of implementation, the EMS
staff will begin collection and analysis of selected information from
the form.

5o During the second year of implementation, the EMS staff will
distribute analyzed information to EMS councils, ambulance services,
local community leaders, and selected public agencies.

Evaluation ;

The EMS staff will analyze information being generated from the form to
determine if; (I) the right kinds of data are being collected; (2) the
information is actually having an impact upon the EMS system; and (3)
analyzed data is producing changes upon the total methods of evaluating
the EMS system.



Evaluation/87

VEHtCLE DESIGN CRITERIA

Objective ;

To insure that all ambulance vehicles meet design critieria necessary
to provide for the safety and well being of the patient.

Activi ties :

lo The EMS staff will continue to inspect and license all ambulance
services on a yearly basis.

2. The project staff will provide vehicle design guidelines to all
ambulance services ahd local EMS councils.

Evaluation :



From annual inspections, it will be determined whether ambulance vehicles
are meeting design criteria.

EQUIPMENT

Objective :

To insure that equipment standards are of sufficient quality and
quantity to provide lifesaving techniques to the emergency patient. .

Act ivi ties :



\, The EMS staff will provide equipment guidelines to all ambulance
services and local EMS councils.

2. Project staff will meet with local EMS councils to promote the use
of the Lettermen Equipment Exchange System.

Evaluation :

The quality and quantity of equipment will be determined from annual
inspections.

HOSPITAL DISASTER PLANNING

Objective :

To insure that all hospitals maintain a disaster plan that will enable
them to respond quickly and effectively to a disaster.

Activi ties:



1. The EMS staff will meet with local EMS councils and hospitals to
promote the development of hospital disaster plans.

2. The EMS staff will meet with local EMS councils and hospitals to
review existing hospital disaster plans and provide for necessary changes.



Evaluation/88

3. The EMS staff will meet with regional EMS councils to provide for
regional coordination and assistance in disaster situations.

k. Pertinent literature will be gathered by project staff on disaster
planning and dispersed to all local and regional EMS councils.

Evaluation ;

By annual on-site inspections, the EMS staff will determine the
adequacy of all hospital disaster plans. The adequacy of these
plans will be determined by comparing them to the suggested plan
found on pages 63-6^.

COMMUNITY DISASTER PLANNING

Objective :

To insure that community disaster plans incorporate all community emergency is not a dated card and the technical
skills in first aid of persons trained more than three years ago may be
questionable.

^More than one member of some families may have taken this training.
Others may have repeated the course and have been counted more than once.
Also, population changes have occurred since the program began which might
affect the percentages. Although the populations of certain counties have
been greatly affected by massive migration of persons due to construction
work or the termination of employment, these changes are estimated not to
exceed k% statewide.



Training Append ix/'97



Medical Self-Help in Montana
Fiscal Years 1962-1972





Number
Trained


Pop. 3
+ 12


Percent
Trained


No. of Fami 1 ies
and Unrelated
Individuals


Percent
Trained


Area #1

Flathead


5.703


29,968


19.0%


12,850


kk.kl


Granite


573


2,156


26.6%


1,010


56.7%


Lake


1.658


11,133


IA.9%


^♦,782


3'^.7%


Lincoln


3.515


13,237


26.6%


5,562


63.2%


Mineral


IQk


2,193


9.3%


921


22.1%


Missoula


10,753


^♦5,078


23.9%


21,691


^♦9.6%


Powe 1 1


738


s,m


IA.2%


2.071


35.6%


Sanders


7^0


5M5


13.5%


2.396


30.9%


Raval 1 i


A, 395


11,329


38.8%


5.030


87.4%


Sub Total


29.382


125,760


23.^^%


57,213


51.3%


Area #1

Beaverhead


1.A71


6,376


23.1%


3,252


45.2%


Broadwater


202


1,956


10.3%


828


2k. k%


Oeerlodge


'♦.'♦70


12. '♦'.6


35.9%


5,006


89.3%


Gal latin


3,231


26,177


12.3%


13,915


23.2%


Jefferson


^♦^7


4,080


10.9%


1,509


29.6%


Lewis 6 Clark


6.130


25.630


23.9%


12,028


51.0%


Madison


886


A, 012


22.1%


1,786


49.6%


Meagher


177


1,66A


10.6%


788


22.5%


Si Iver Bow


2,905


32. /♦16


9.0%


l'^,687


19.8%


Sub Total


19,919


1H,757


17.^^%


53.799


37.0%



^Source: "Population 12 Years Old and Older by County of Residence." Montana,

1970 (Census date) ,

^Source: "Income and Poverty Status in I969 for Counties," Montana, 1970 (Census
date).



Training Appendix 98











No. of Fami 1 ies






Number


Pop.


Percent


and Unrelated


Percent




Trained


+ 12


Trained


Individuals


Trained


Area #3












Bighorn


1,107


7.17^


15.4^


2.786


39.7%


Carbon


698


5.793


12.0^


2.712


25.7%


Golden Val ley


87


Ilk


11.2%


342


25.4%


Musselshel 1


955


3,018


31.6%


1.308


73.0%


Park


2,011


9,082


22.1%


4,086


49.2%


Sti 1 Iwater


ifOO


3,722


10,7%


1.613


24.8%


Sweet Grass


639


2,419


26.4%


1.079


59.2%


Wheatland


625


2,014


31.0%


939


66.6%


Yel lows tone


17.156


67,301


25.5%


30,290


56.6%


Sub Total


23.678


101,297


23.4%


45.156


52.4%


Area #i»












Custer


2,83'»


7,466


37.9%


4,134


67.7%


Carter


177


1,517


11.7%


665


22.6%


Dawson


3.250


8,397


38.7%


3,570


91.0%


Fa 1 Ion


1,098


3,014


36.4%


1,301


84.4%


Powder River


285


2,114


13.5%


895


31.8%


Prairie


175


1,451


12.1%


636


27.5%


Rosebud


740


4,451


16.6%


2,007


36.9%


Treasure


158


824


19.2%


322


49.1%


Wibaux


^♦02


1,122


35.8%


486


82.7%


Sub Total


9.119


30.356


30.0%


14,066


64.8%



Training Appendix/99





Number
Trained


Pop.
+ 12


Percent
Trained


No. of Fami 1 ies
and Unrelated
Individuals


Percent
Trained


Area #5
Daniels


530


2,467


21.5^0


1.034


51.3%


Garfield


480


1,371


35.0^


550


87.3%


McCone


523


2,186


23.9%


877


59.6%


Petroleum


217


529


41.0%


255


85.1%


Phillips


737


4,103


18.0%


1.805


40.8%


Richland


1,654


7,501


22.1%


3,122


53.0%


Roosevelt


1,401


7,680


18.2%


3,157


44.4%


Sheridan


1,252


4,507


27.8%


1,941


64.5%


Valley


2,882


8,526


33.8%


3,710


77.7%


Sub Total


9,676


38,870


24.9%


16,454


58.8%


Area #6
Blaine


2,189


5,029


45.5%


2,137


102.4%


Cascade


13.791


61,257


22.5%


28,362


48.6%


Choteau


1,800


5,051


35.6%


2,237


80.5%


Fergus


3,050


9,803


31.1%


4,204


72.5%


Glacier


2,022


7,705


26.2%


3,195


63.3%


Hill


2,325


13,269


17.5%


6,081


38.2%


Judith Basin


170


2,116


8.0%


891


19.1%


Liberty


433


1,796


24.1%


687


63.0%


Pondera


1,382


5.015


27.6%


2,116


65.3%


Teton


1,237


4,776


25.9%


2,018


61.3%


Toole


945


4,522


20.9%


1,910


49.5%


Sub Total


29,344


120,338


24.4%


53,831


54.5%


TOTAL


122,197


542,677


22.5%


240,519


50.8%



Training Appendix/ 100
BUREAU OF MINES



First-aid training was not considered seriously in the United States
untii 1897, when several railroad companies furnished first-aid packets
and books of instruction to some of their men. In I9IO, the American
Red Cross established a separate First Aid Department, and the Bureau of
Mines started active training of miners.

First-aid training by the Bureau of Mines in Montana, was probably
begun in the mining community of Butte around I9II or 1912. Since that
time, the Bureau's instructors have conducted training in the mining
areas of the state at the request of the mining companies.

In 1926, a cooperative first-aid training plan was developed to
meet the large number of requests for training. Through this plan, the
entire personnel of mines and plants could be trained quickly in a single
campaign by utilizing Bureau-trained company employees. All classes were
conducted under the supervision of a Bureau of Mines representative.
Various mining companies in Montana have utilized the cooperative plan
in training their personnel.

in Montana, the Anaconda Company has been influential in maintaining
active interest in first aid by holding contests between first-aid teams.
The company's facilities at Great Falls have been the site of an inter-
company first-aid contest for nearly 30 years, and similar contests were
held annually in Butte by the Anaconda Company until 1967-

During the past three years, 933 persons have been trained in Bureau
of Mines first aid in Montana. This training was cortducted through the
cooperative plan, and for the most part, was given in Butte, Great Falls,
Libby, and Fort Peck, Montana. The Bureau of Mines estimates that approxi
mately 500 first-aid cards will be issued during the first six months of
1973. In addition, an estimated I6OO cards will have been issued between
1972 and 1976.

The cooperative training plan is structured on a continuing basis.
Because there are only nine instructors to cover six states in the
training center area, the Bureau of Mines first-aid training activities
are somewhat limited. It is necessary, therefore, to rely upon the
qualified instructors from the various communities that participate in
the cooperative training plan for teaching personnel.



Training Appendix/ loi
MONTANA HEART ASSOCIATION

The Montana Heart Association has several training programs designed
for both professional medical personnel and the general public. The major
emphasis of the Heart Association is to provide training materials and
instruction for nurses. The Montana Heart Association has a large inventory
of training equipment, slides, and films which have been made available
to the hospitals throughout the state. By using these materials, the
Montana Heart Association trains approximately 475 nurses in the state per
year. In addition, the association provides funding to send nurses out
of state for further advanced training.

The Heart Association has recognized that public education is vital
in reducing heart attack deaths. It offers to the general public a
large number of publications and training aids relevant to broad-based
training for coronary problems. Also, the Heart Association, In coopera-
tion with the American National Red Cross, is currently developing criteria
for a CPR training program.

Efforts are now being made to improve the coordination of Montana
Heart Association activities with Regional Medical Programs, the State
Department of Health, and the American National Red Cross. In the event
that a policy is adopted which advocates CPR training for the general
public, further cooperation and coordination between these agencies will
be required.



NATIONAL SKI PATROL SYSTEM, INC.
FACTS AND FIGURES
Training, First Aid



Every patroler must maintain a current American Red Cross Advanced
First Aid Certificate, and attend an 8 hour refresher annually plus k
hours of annual on-the-hill training. Approximately 10^ of the patrol-
ers in the Northern Division holds an American Red Cross First Aid
Instructor Certificate. Some have completed EMT courses.

Current Membership

and E;rope"r25,OOo'"''''' """''"' ''' continental United States, Alaska

Total Fractures Handled

In 1971-72, the total number of fractures handled was 84,000.
Headquarters

Colorldo.^^^'^''"^''^^'" ^°' ^^^ National Ski Patrol System, Inc. are in Denver,
Year Founded

The Patrol was founded in 1938.



Training Appendix/ 102



NATIONAL SKI PATROL SYSTEM. INC.
NORTHERN DIVISION



MONTANA PATROLS



Patrol Name

Administrative
(Div. Off. & Adv.)

Anaconda

Bear Canyon

Bear Paw
Bear Tooth
Belmont
Big Mountain
Bridger Bowl
Beef Trail
Corona Lat<e
Deep Creek
Grassy Mountain
Great Falls
Lost Trai 1
Missoula

Maverick Mountain
Si Iver Mountain
Snow Bowl
Turner Mountain
Z-T



Location

Statewide

Anaconda

Bozeman

Havre

Bi 1 1 ings

Helena

Whitefish

Bozeman

Butte

Plains

Wise River

Townsend

Great Fal Is

Hami 1 ton

Missoula

Di 1 Ion

Lew i s town

Missoula

Libby

Butte



Total Members (1971-72)
13

Not registered in 1972 with
N.S.P.S.

28
72
28
12
86
10
11
2k
8

kS
15
A5
22
3k
43
29
22



TOTAL



19 (excl . admin. )



561



Training Appendix/103

NATIONAL SKI PATROL SYSTEM
NORTHERN DIVISION



Registered Si<j Patrols 1972-1973

Anaconda Ski Patrol N-1

Ed Guay, I9IA Haggin, Anaconda, MT 59711, Leader

Ed Forwood, 1220 W, 3rd, Anaconda, MT 59711, Ass't Leader

Antelope Butte SkS Paf oi N-2

Bob Duncan, 1014 Burton, Sheridan, WY 828OI, Leader

Andy Smith, Shell, WY 82441, Ass't Leader

Bear Canyon Ski Patrol N-3

Ronald L, Nichelln, Rto 2, Box 174B, Bozeman, MT 59715, Leader

Rene Nichelin, " " " • Ass't Leader

Bear Paw Skt Patrol N-4

Robert Rector, 18 Hidden Valley, Havre, MT 59501, Leader

Walter Warrick, Havre, MT 59501, Ass't Leader

Beartooth Ski Patrol N-5

Alf Lecaptaln, 2404 Sunnyvlew Lane, Billings, MT 59102, Leader

Charles Jerabek, 13^3 Granite, Billings, MT 59102, Ass't Leader

Beimont Ski Patrol N-6

Bill VoHmer, jgil Highland, Helena, MT 596OI, Leader

Mike Griff, c/o Union Bank, Helena, MT 59601, Ass't Leader

Big Mountain Ski Patrol N-7

Tom Unger, c/o The Big Mountain, Whitefish, MT 59937, Leader

Gene Evans, c/o The Bag Mountain, Whitefish, MT 59937, Ass't Leader

Bridget Bowl Ski Patrol N-8

Duain Bowles, 809 S, 3rd, Bozeman, MT 59715, Leader

Kim MsHs, 11 W, College, Bozeman, MT 59715, Ass't Leader

Beef Trai I Sk! Patrol N-9

James Lester, 928 Hornet, Butte, MT 59701, Leader

Bill Woody, 703 N Excelsior, Butte, MT 59701, Ass't Leader

Casper Mountain Ski Patrol N-10

Gay Nations, 115 Northway, Casper, WY 82601, Leader

Oda Sulley, 3740 S. Coffman, Casper, WY 82601, Ass't Leader

Ken Hoff, 1250 Nc Center, Casper, WY 8260 1 , Ass't Leader

Circle A Ski Patrol N~28

Larry Street, 67 Poppy, Casper, WY 826OI , Leader

Cody Ski Patrol N-ll

Timothy Comstock, Rto 1, Cody, W^ 82414. Leader

Jack Eckley, 2108-lOth, Cody, WV 82414, Ass't Leader



Training Append ix/loA


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