Appendix 4: Out-of-hospital/EMS Task Definitions/Elements



Operational readiness


Vehicle operations, staffing, communications network, equipment & supplies, medical oversight, legal/ethical, standard operating procedures/guidelines, Special Ops, rescue; MCI/ICS

Scene management


Environment, hazards, violence, safety & scene stabilization, BSI/PPE, security, additional or specialized resources, access, communications

Pre-arrival care

Home remedies, lay rescuer, EMD, first on scene; AED, on-scene physician

Primary assessment & emergency stabilization

ABCs/qualitative assessment of vital functions, general initial impression, initiate treatment/procedures needed to preserve life

Secondary assessment

ABCs, history & physical exam, mechanism of injury, vital signs, ABGs

Modifying factors

Age, gender, race, ethnicity, weight, special needs/disabilities, communication barriers (language, hearing impairment, etc.), religious beliefs, sexual orientation, underlying disease, mental status, family dynamics or bystanders, environment, available resources

Professional issues

Legal/ethical, jurisdictional, education (primary & CME), CQI/data analysis/research, certification/licensure, interaction with other health care professionals, wellness/stress reduction, disease exposure, impairment issues, team performance, professional associations, health promotion, role in continuum of care, community health, scope of practice, death & dying, DNR, advanced directives, family dynamics, reportable diseases or conditions, applicable regulations

Assessment tools & adjuncts


Stethoscope, sphygmomanometer, BP monitoring devices, ETCO 2 , pulse oximetry, physical exam skills, thermometer, EKG, 12-lead EKG, glucometer, field lab tests

Differential diagnosis and field impression

Based on clinical presentation & assessment identify potential causes. Clinical judgment/critical thinking

Therapeutic interventions

Pharmacological & nonpharmacological therapy, procedures, therapeutic communication/counsel.


On-going assessment, evaluate & re-evaluate effectiveness of interventions



Direct/indirect, patient/family, collaboration (M.D.s, specialty consultants), receiving facility notification, EMTALA, media, dispatch.


Written/verbal patient care reporting, transfer & release of information; reportable diseases/conditions/situations, standardized format (minimum data set), privacy issues, CQI



EMTALA, diversion destination issues, appropriate facility, non-transport issues, specialty transport (aeromedical), dead on scene, termination of resuscitation, community resources

Prevention & education

Injury prevention, public education, community resources (social services, support groups, shelters, mental health), federal/state regulations.

Multitasking & team management

ICS/MCI, risk management, multiple agency response, special operations, ICS, domestic preparedness, homeland security.