Table 5.

Key themes, their frequency, and selected quotes from the responses to the needs assessment survey

Themes	Description	Frequency (%)	Selected quotes from survey responses
Retraining of life support-related courses	A need for refresher courses on EVOC, courses such as ATLS, PHTLS, AMLS, ACLS, and PALS and hands-on/practical training	133 (29.8)	“…need EMT courses, PHTLS, AMLS, ACLS, PALS. No NE Nebraska Regional Coverage for these courses [are provided] at regular intervals. [We] only get 1 shot per year, [which is] not conducive to unit member’s schedules...”
Debriefing of protocols	Further education on protocols, paperwork, record keeping	62 (13.9)	“...Multi agencies protocols i.e. hospital, and critical access’ protocols…”
Conducting rescue operations from fire- and water-based emergencies	Training on conducting rescue operations due to fire- and water-based emergency events	57 (12.8)	“...Any type of training that is geared towards fire and rescue...” and “…more information on search and rescue (at least training per year) ...”
Trauma	Training on helping during traumatic injuries	54 (12.1)	“...Essentially: stabilizing trauma for transfer (car accidents, sport injuries, etc.); caring for patients in the middle of a heart attack or stroke (what can we do to keep them alive); Caring for patients who may not be getting enough oxygen to survive the 20 minute ride with us to get definitive care...”
Substance use-related emergencies	Training in helping patients suffering from drug or alcohol misuse	34 (7.6)	“... narcotic/illegal drugs- what symptoms, for what days, how to combat…”
Farming- and agriculture-related injuries	Training on emergency events arising from farming or agriculture-related injuries or damage	31 (6.9)	“...Extrication training for vehicles used for farming and Agriculture...”
Administering medications and adverse drug reactions	Training on administering Narcan (naloxone), insulin, and other complex drug delivery systems; drug-drug interaction-related and adverse drug reactions; pharmacology to be adapted during complex differential diagnoses	28 (6.3)	“...would like capabilities to do IV’s administer Narcan and insulin I did not become paramedic because I would have had to move to have enough work. I live in very rural area I carry oxygen and airway masks, AED, Kings airways etc. in my personal vehicle...”
Intubation and breathing difficulties	Training in performing intubation and management of airway/breathing difficulties	28 (6.3)	“...Procedural skills: I would like to have an avenue to practice intubation periodically, particularly the medication used in rapid sequence intubation…”
Training tailored for rural areas	Training tailored for rural areas	20 (4.5)	“...More training on rural areas- how to get patient out and long transport. We do not have an ambulance in our town- only 3 volunteer EMTs- closest ambulance is 13 miles away…”

The frequency is calculated per comment obtained to the question, “What other training do you think you need?” by respondents