An experimental emergency first-responder system was introduced in 36 small rural Georgia communities as a means for addressing inadequate access to emergency medical services for these communities. A prospective evaluation was designed to address the most efficient and effective means to organize, implement, and administrate such a program on a regional basis. Key to the program were community-selected residents who served as Emergency Medical Coordinators (EMCs) and performed as first responders, information sources on emergency care, and system organizers. The evaluation examined the process of organizing the program through local government versus voluntary group sponsors in terms of response and participation by communities and their ability to select effective EMCs. It assessed the effectiveness of a set of criteria for selecting residents as EMCs against three sets of performance measures encompassing first-responder skills and activities which maintained public awareness and program visibility. Critical to program success was the degree of sponsor involvement in selecting EMCs.

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We address the problem of designing new networks for the delivery of public health care services in the United States. The paper is based on a case study design conducted with the Fulton County Health Department (Atlanta, GA). The research contribution this paper makes is twofold. First, it presents a planning methodology to deliver health care services through a mix of fixed health centers, satellite facilities, and mobile facilities. Second, it gives insights on how to use geographic information systems to design new health care service networks.

A plea is made to begin development of an emergency hyperbaric rescue system for this country. One such candidate system proposed here consists of a light-weight portable hyperbaric chamber, a heavy lift, high-speed rescue helicopter and a shore-based medical facility for comprehensive care. The use of the U.S. Coast Guard HH-3F Helicopter is recommended as the transportation vehicle. A chamber of glass-filament-wound composite material weighing around 1000 pounds will provide the necessary hyperbaric environment. A typical rescue mission is described and flight times estimated. Introduction The United States within a few short years will be faced with an increasingly urgent need for an emergency hyperbaric rescue system. This system must be capable of responding to saturation diving emergencies anywhere on the U.S. Continental Shelf. These medical emergencies will result from the expected exponential rate of growth of saturation diving among the commercial, scientific, military and pleasure diving communities. Signs of these increased diving activities can be seen in many areas. Project FLARE, Florida Aquanaut Research Expedition, began recently off the Coast of South Florida using a 20-ton habitat, the EDALHAB II. The expedition was sponsored by NOAA's Manned Undersea Science and Technology Program and was one of several beginnings to explore the continental shelf as recommended in 1969 by the Commission on Marine Science, Engineering and Resources in its Plan for National Action.(Available In Full Paper) Other research efforts involving saturation diving include the recent TEKTITE program in the Virgin Islands and the planned TEXAS TEKTITE program in the Gulf of Mexico. Commercial interests, especially offshore oil companies, will continue to use more saturation diving as activities expand. The U.S. Navy has had great interest in saturation diving through programs like SEALAB. These interests are expected to continue. Even in sport diving, such efforts as HYDRO-LAB in the Bahamas are examples of a growing interest in saturation diving among amateur divers [2]. These trends in saturation diving, together with the recommended national goal of continental shelf exploration, point to an ever increasing growth in diving ahead. This growth will produce an even faster increase in medical problems due to greater numbers of divers entering the water, many being physically unfit or improperly trained. It is within this framework that a medical rescue system must be developed. This rescue system will be unique in that a pressurized environment must be maintained for the diver whose body has become saturated with breathing gases. This situation then prohibits normal transportation of a diver to shore. The System It is proposed that a system be designed and implemented to respond to diving medical needs. Two altemative approaches are possible medical care and personnel can be brought to the diver, or the diver can be transported to the appropriate medical facilities. While medical care brought to the diver in many cases may be sufficient, there will be instances when the diver must be transported to shore-based medical facilities for comprehensive treatment and observation.