South Dakota's Emergency Medical Services (EMS) volunteer participation is declining, and projected to further decrease over the next decade. To minimize this deficit, South Dakota's Department of Health recommends that rural firefighters assist EMS in high-acuity calls to decrease the burden on EMS personnel in an effort to improve volunteer retention. Bridging the Gap from Rural Trauma to Rural Healthcare aimed to create educational training opportunities for firefighters when assisting EMS. A focus group including EMS personnel, firefighters, and the fire chief from communities surrounding and including Parkston, South Dakota, identified a list of skills where knowledge deficits existed; this list included backboard technique, tourniquets, field dressings, splints, Lund University Cardiopulmonary Assist System (LUCAS) device application, triage procedure, stair chair utilization, oxygen administration, familiarization with ambulance supplies, limb recovery in the field, EMS communication and report, extrication scenarios/problem-solving, cardiopulmonary resuscitation (CPR) re-familiarization, decontamination procedures, and a tour of Parkston's rural emergency department. These skills were divided into three nights of hands-on learning sessions. Pre- and post-session surveys were administered to measure the firefighters' confidence levels regarding each skill. Firefighters demonstrated a statistically significant change in confidence levels in nearly all skills that were taught, with LUCAS device application, decontamination location, and decontamination procedure demonstrating a mean increase in confidence levels of greater than 100%. Typically, firefighters are on location for many rural, high-acuity calls. If trained to assist EMS, firefighters may enhance the South Dakota Department of Health's goals to improve EMS volunteer retention over the next decade.

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