EMS CONTACT FILE

Thanks to take a few minute to complete this form to help me to build one of the first database on EMS structures around the world, the data will be study and the results will be presented on www.emsworldtour.com and available for anyone who will ask for them.
If you have any ideas of research, tells me and we could integrate it in this form.
You can use this form for a first use but also just to complete or sending one information.

Thanks for your help and i hope you'll enjoy working on this project.

* means necessary field

COUNTRY*
NAME*
SERVICE*
FONCTION
EMAIL*
WEBSITE
WEB SITE TYPE
SIREN TYPE or
LIGTHS TYPE
EMERGENCY PHONE NUMER or or
EXPLAIN YOUR ORGANISATION
LEVEL OF EMERGENCY
(for example code 3: life threatning, code 2: urgent calls, call 1: non urgent code)
EXPLAIN THE TASK OF DOCTORS
IS PARAMEDIC WORKS ON PROTOCOLS ? YES
NO
THE NON MEDICAL OR NON PARAMEDICAL (EMT-B) STAFF IS IT TRAINED TO MEDICAL ? YES
NO
RATE OF PART OF POPULATION TRAINED TO Basic Life Support IN YOUR COUNTRY ?
(for example, in France nearly 6% of the population is trained to BLS)
%
PROGRAM OF BLS PUBLIC TRAINING
DOES EMS ARE WORKING WITH AED YES
NO
DOES PUBLIC WORKS WITH AED YES
NO
TYPE OF CREW
BLS : 1st MEMBER 2nd MEMBER 3rd MEMBER
ALS: 1st MEMBER 2nd MEMBER 3rd MEMBER
MICU: 1st MEMBER 2nd MEMBER 3rd MEMBER
HELICOPTER: 1st MEMBER 2nd MEMBER 3rd MEMBER
DOCTOR CAR:1st MEMBER 2nd MEMBER 3rd MEMBER
PROGRAM OF TRAINING:
JOIN A PICTURE:
JOIN A LINK: