Index
Abstract
Dedication
Preface
Definition of EMS for this Document
Federal Agencies Can Help Advance EMS Research
Executive Summary
Introduction
History of EMS Research
The Present State of EMS Research
Overcoming the Barriers to EMS Research
Summary
Appendix A: The National EMS Research Agenda Writing Team
Appendix B: Organizations Invited to Participate in the National Review Team
Appendix C: Ethical Standards and IRB Requirements
Appendix D Inclusion Of Women And Minorities In Research Study Populations Involving Human Subjects
Inclusion Of Children As Participants In Research Involving Human Subjects
Appendix E: Bibliographic List of Internet Links
Appendix F: Published EMS Randomized Clinical Trials
References

Summary

The National EMS Research Agenda makes the following recommendations:

1.       A large cadre of career EMS investigators should be developed and supported in the initial stages of their careers. Highly structured training programs with content directed toward EMS research methodologies should be developed.

2.       Centers of Excellence should be created to facilitate EMS research. These Centers will bring together experienced investigators, institutional expertise and resources such as budgetary and information systems support. Centers will develop and maintain strong working relationships with local and regional EMS providers. As the focal point of these resources, Centers of Excellence will be the catalyst for collaboration between EMS systems and investigators. Such an environment will enable collaborative research to flourish.

3.        Federal agencies that sponsor research should acknowledge their commitment to EMS research.

4.        States, corporations, and charitable foundations should be encouraged to support EMS research.

5.        The efforts of EMS professionals, delivery systems, academic centers, and public policy makers should be organized to support and apply the results of research.

6.        EMS professionals of all levels should hold themselves to higher standards of requiring evidence before implementing new procedures, devices, or drugs.

7.        There should be standardized data collection methods at local, regional, state, and national levels. These data must be devoid of information that allows individual patient identification. All EMS provider agencies should adopt the Uniform Prehospital Data Elements for data collection.

8.        The Food and Drug Administration (FDA) and the Office for Human Research Protections (OHRP) should work with EMS research stakeholders to evaluate the current requirements for exception from informed consent in emergency situations and to identify those requirements that are serious impediments to conducting EMS research. The FDA, OHRP, and EMS research stakeholders should work together to develop and propose EMS-specific consent strategies as well as appropriate revisions to the existing regulations to reduce the impediments to research while continuing to adequately protect research subjects.

An investment in EMS research infrastructure is necessary to overcome the obstacles currently impeding EMS research. Funding is needed to train new researchers and to establish their careers. Increased financial support is necessary to develop effective prehospital treatment for the diseases that drive the design of the EMS system, including injury and sudden cardiac arrest. Innovative strategies to make EMS research easier to accomplish in emergency situations must be legitimized and implemented. Researchers must have access to patient outcome information so that the impact of prehospital patient care can be evaluated and improved. Incorporating standard scientific methodology into the evaluation of biomedical and technical advances in prehospital care is crucial. Research is the key to maintaining an appropriate focus on improving the overall health of the community in a competitive and cost conscious health care market. Most importantly, research is essential to ensure that the best possible patient care is provided in the prehospital setting.