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

Systems Research

In 1995, a systems analysis framework was suggested in order to accurately study the complex and interrelated questions that characterize EMS.68 Systems analysis research models are more commonly employed in disciplines such as engineering, economics, and epidemiology where they are used to evaluate complex questions, often involving computer simulation and mathematical models such as nonlinear or multivariate analysis.69,70 In the publication, EMS Systems: Foundations For The Future, members of the SAEM EMS Task Force reviewed the unique aspects of systems-based questions and suggested a shift from the traditional EMS quality assurance model to one based on improving overall system performance.52

An example of systems research is the investigation that showed providing defibrillators to police officers to augment EMS response to sudden cardiac arrest improved survival to hospital discharge.71,72 Another example demonstrated that pain is routinely under-treated in patients with extremity fractures.73 Although partially a clinical issue, certain components of the EMS system, such as the level of training for the caregivers and the procedures for replenishing medication supplies, contributed significantly to the problem. Researchers should approach EMS as a system of care, rather than as an isolated process.