Out of Hospital


Trauma Performance Improvement Case Review Tool

The Trauma PI Tool is offered to EMS agencies to provide a case review tool for trauma cases. The tool can be modified to fit the needs of your service. The tool covers scene time, trauma triage, destination determination, and transport decision. The form can also be used to forward cases to the medical director.  CLICK HERE to download the form and begin using it.

NCRTAC Helicopter EMS Position Statement

In January 2013, the NCRTAC General Membership approved the Out of Hospital Committee's Position Statement on the Use of Helicopter EMS in the region. The position statement serves as a starting place for EMS agencies and their medical directors to determine how to best use helicopters in their area. The document is considered a guideline but reflects the consensus of NCRTAC members and guidelines developed by national organizations such as the National Association of EMS Physicians.

Learn more about Helicopter EMS units available in the NCRTAC.

Office of Rural Health EMS Assessment Tool and Workbook

The Wisconsin Office of Rural Health recently developed an assessment tool that identified the "18 Attributes of a Successful Rural Ambulance Service.” They conducted a state-wide assessment of services and then created a companion workbook to help services improve their scores. The assessment tool and workbook are great resources for services to use in strategic planning and process improvement. Check out all the details on the Wisconsin Office of Rural Health website.

Wisconsin MCI Plan

In 2010 the Wisconsin EMS Advisory Board approved a revised version of the Wisconsin Mass

Casualty Incident Response Planning Guide. The document is intended to be used by local EMS

services to update their response plans to make them ICS compliant and "fit" with the plans of

services around them.

Selective Spinal Immobilization

After the State of Wisconsin implemented protocols allowing all levels of transporting EMTs to perform selective spinal immobilization assessment. Soon after, the trauma centers began reporting increasing numbers of patients transported without spinal immobilization when it was indicated.

The Out of Hospital Committee developed an educational presentation and quality improvement materials for services to use.

Trauma Training Equipment

To better support trauma training courses in the region, the NCRTAC has purchased a set of equipment and supplies to be available for use in EMS and hospital trauma courses.
The set includes

  • 4 sets of spinal immobilization gear (board, straps, CID, collars, Back Rafts)
  • 4 trauma jump bags (scissors, BR cuff, stethoscope, BVM, O2 masks, bandaging supplies, etc.)
  • 1 Chest decompression manikin
  • 1 set of extremity splints
  • 1 full body trauma manikin
  • 1 moulage kit

Contact RTAC Coordinator Michael Fraley to check out any of the supplies

EMS Documentation

Following feedback from hospitals that they often do not get timely documentation after EMS brings patients to them, the state implemented new rules directing ambulance services to leave some form of temporary chart or worksheet at the time they drop off the patient and then submit their complete chart within 24 hours. The State developed a form to be used as the worksheet. A Best Practice is to print the worksheet on 2-ply carbonless paper. One copy can be left with the patient and the crew keeps one to use as notes when completing their full PCR.

Trauma Triage Guidelines

​In 2021, the American College of Surgeons lead a multidisciplinary expert panel to update the “Guidelines for the Field Triage of Injured Patients.” For three decades, the Guidelines have been widely adopted by trauma systems in the United States to support decision making by EMS clinicians in transport destination determinations for injured patients. The goal has been to ensure that seriously injured patients are transported to the most clinically appropriate trauma centers.

The 2021 revision was based on a scientific literature review conducted by Oregon Health and Science University as well as the results from a broad stakeholder feedback tool, which aimed to capture the perspective from those in the field.

The Wisconsin State Trauma Advisory Council (STAC) and the Wisconsin EMS Advisory Board have recently endorsed the Guidelines and charged Regional Trauma Advisory Councils (RTACs) with the distribution of and education on the guidelines. 
EMS agencies are encouraged to implement the Guidelines into their service patient care protocols. 

Find more information about the revision of the document including supporting literature, educational slide sets and performance measures HERE.

*** An UPDATED version of this guide is due out the summer of 2024.

The Out of Hospital Committee is made up of EMS transport services, first responder agencies, critical care transport and helicopter services and hospital EMS Coordinators.

The Committees projects include:

  • Trauma Performance Improvement Case Review Tool
  • Stop the Bleed Hemorrhage Control Awareness
  • M-I-S-T Patient Hand-Off Format
  • Trauma Triage Protocol
  • Selective Spinal Immobilization

 Scroll down to learn more about our projects.

M-I-S-T Patient Report Format

The NCRTAC regularly hears from area hospitals how important early and efficient patient reports are to them so that they can alert and organize their trauma teams to receive patients. We also know that the first few minutes after a patient’s arrival in the emergency department are critical and many team members have work to do all at once.

EMS providers can help make these important phases in patient care go smoother by using an organized format in their patient care reports. An organized format assures that the report is quick and includes all the critical elements while saving the less important details for the written patient care report.

Check out the M-I-S-T format of radio and bed side reporting in action in this quick YouTube video.