Appendix A. Facility Codes for EMS Region 1

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Appendix A

Facility Codes for EMS Region 1

Code Facility City County Zip

100 Funeral Home

101 Beckley ARH Beckley Raleigh 25801 103 Bluefield Regional Med. Ctr. Bluefield Mercer 24701 104 Heathsouth - Southern Hills Princeton Mercer 24740 105 Princeton Community Princeton Mercer 24740 106 Raleigh General Beckley Raleigh 25801 107 St. Luke’s Bluefield Mercer 24701 109 Summers County ARH Hinton Summers 25951 110 Veterans Administration Beckley Welch 25801 111 Welch Community Welch McDowell 24801 113 Other

114 Home

115 Pinecrest Hospital Beckley Raleigh 25801 116 Nursing Home

117 Doctor’s Office/Clinic 830 No Patient Transported 930 Patient Refused Transport

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Facility Codes for EMS Region 2

200 Funeral Home

201 Cabell-Huntington Huntington Cabell 25701 204 Guyan Valley Logan Logan 25601 206 Mildred Mitchell-Bateman Hospital Huntington Cabell 25701 207 Lakin Hospital Pt. Pleasant Mason 25550 208 Logan General Logan Logan 25601 210 Pleasant Valley Pt. Pleasant Mason 25550

211 Region II Comm. Mental Health Center Huntington Cabell 25701 213 St. Mary’s Huntington Cabell 25701 214 Veteran’s Admin. Medical Center (VAMC) Huntington Wayne 25704 215 Williamson ARH Williamson Mingo 25661 216 Williamson Memorial Williamson Mingo 25661 217 Other

218 Home

219 Nursing Home

220 American Hospital for Rehab. Huntington Cabell 25705 221 Logan Park Care Center

222 HCA Riverpark Hospital Huntington Cabell 25701

223 Pinnacle Care Huntington Cabell 25701 224 Presbyterian Manor Huntington Cabell 25701 225 Chateau Grove N.H. Barboursville Cabell 25504 226 Fairhaven Rest Home Huntington Cabell 25704 227 Mays Riverside Manor Huntington Cabell 25701 228 Wayne Continuous Care Wayne Wayne 25570 229 Lincoln Continuous Care Hamlin Lincoln 25523 230 Chadwicks Personal Care Barboursville Cabell 25504 231 Morris Memorial N.H. Milton Cabell 25541 232 Logan Health Care Village

830 No Patient Transported 930 Patient Refused Transport

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Appendix A

Facility Codes for EMS Region 3/4

300 Funeral Home

301 Boone Memorial Madison Boone 25130 302 CAMC - General Charleston Kanawha 25301 303 CAMC - Memorial Charleston Kanawha 25301 304 Greenbrier Valley Medical Center Fairlea Greenbrier 24902 305 CAMC - Women’s and Children’s Charleston Kanawha 25301 306 Montgomery General Montgomery Fayette 25136 307 Plateau Medical Center Oak Hill Fayette 25901 309 Pocahontas Memorial Marlinton Pocahontas 24954 310 Richwood Area Community Hospital Richwood Nicholas 26651 311 St. Francis Charleston Kanawha 25301 313 Summersville Memorial Summersville Nicholas 26651

314 Thomas Memorial S. Charleston Kanawha 25303 315 Webster Memorial Webster Spngs Webster 26288 316 Nursing Home

317 Clinic/Doctors Office

318 Highland Hospital Charleston Kanawha 25301 319 Home

320 The Eye & Ear Clinic Charleston Kanawha 25301 321 Putnam General Hurricane Putnam 25526 322 Medical Examiner’s Office S. Charleston Kanawha 25303 325 Other

830 No Patient Transported 930 Patient Refused Transport

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Facility Codes for EMS Region 5

400 Funeral Home

401 Camden-Clark Memorial Hospital Parkersburg Wood 26101 402 Minnie Hamilton Health Care Center Grantsville Calhoun 26147 404 Jackson General Hospital Ripley Jackson 25271 405 Roane General Hospital Spencer Roane 25276 406 St. Joseph’s Hospital Parkersburg Wood 26101 407 Sistersville General Hospital Sistersville Tyler 26175 408 Nursing Home

409 Home 410 Other

411 Health South Western Hills Parkersburg Wood 26101 412 Care Haven of Sistersville Sistersville Tyler 26175 830 No Patient Transported

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Appendix A

Facility Codes for EMS Region 6/7

500 Funeral Home

501 Broaddus Hospital Philippi Barbour 26416 502 Cortland Acres Thomas Tucker 26292 503 Davis Memorial Hospital Elkins Randolph 26241 505 Elkins Regional Convalescent Care Elkins Randolph 26241 506 Fairmont Clinic Fairmont Marion 26554 507 Marion Health Care Hospital Fairmont Marion 26554 508 Fairmont General Hospital Fairmont Marion 26554 509 Braxton County Memorial Hospital Gassaway Braxton 26624 510 Good Samaritan Center Belington Barbour 26250

511 Grafton City Hospital Grafton Taylor 26354

512 Hopemont Hospital Terra Alta Preston 26764 514 Monongalia General Hospital Morgantown Monongalia 26505 515 Nella’s Nursing Home Elkins Randolph 26241 516 Preston Memorial Hospital Kingwood Preston 26537 517 St. Joseph’s Hospital Buckhannon Upshur 26201 518 Stonewall Jackson Memorial Hospital Weston Lewis 26452 519 Tucker Community Care Parsons Tucker 26287 520 United Hospital Center Clarksburg Harrison 26301 522 Veterans Administration Medical Center Clarksburg Harrison 26301

523 Sharpe Hospital Weston Lewis 26452 524 Ruby Memorial Hospital Morgantown Monongalia 26506 525 Clinic Out-Patient

526 Other 527 Home

528 Preston Nursing Home Kingwood Preston 26537 529 Sunbridge Personal Care Home Salem Harrison 26426

530 Americare Nursing Centers Morgantown Monongalia 26505 531 Americare Nursing Centers Glenville Gilmer 26351 532 Arbor’s Health Care Fairmon Marion 26554 534 Clarksburg Continuous Care Center Clarksburg Harrison 26301 536 Crestview Manor Nursing Home Clarksburg Harrison 26301

538 Doris’s Nursing Home Enterprise Harrison 26568 540 Gold Circle Nursing Home Stonewood Harrison 26301 541 Harris Rest Home Philippi Barbour 26416 542 Heartland of Clarksburg Clarksburg Harrison 26301

543 Heartland of Preston County Kingwood Preston 26537 544 Heritage Nursing Home Bridgeport Harrison 26330

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Facility Codes for EMS Region 6/7 (Continued)

538 Doris’s Nursing Home Enterprise Harrison 26568 540 Gold Circle Nursing Home Stonewood Harrison 26301 541 Harris Rest Home Philippi Barbour 26416 542 Heartland of Clarksburg Clarksburg Harrison 26301

543 Heartland of Preston County Kingwood Preston 26537 544 Heritage Nursing Home Bridgeport Harrison 26330 545 Lee’s Home for the Elderly Buckhannon Upshur 26201 546 Lida Clark Nursing Home Clarksburg Harrison 26301 548 Madison House Nursing Home Morgantown Monongalia 26505 549 Meadowview Manor Health Care Bridgeport Harrison 26330 550 Medbrook Medical Center Bridgeport Harrison 26330 551 Mullenax Personal Care Home Belington Barbour 26250 552 Myers Clinic Philippi Barbour 26416 553 Morgan Manor Nursing Home Morgantown Monongalia 26505 554 Nella’s Inc. Crystal Springs Randolph 26241 555 Rest Haven Nursing Home, Inc. Grafton Taylor 26354

556 Rosewood Health Care Center Grafton Taylor 26354

560 Sundale Nursing Home Morgantown Monongalia 26505 561 Wishing Well Health Center Fairmont Marion 26554 562 Country Comfort Personal Care Worthington Marion 26591 563 Grafton Nursing Care Facility Grafton Taylor 26354

565 Holbrook Nursing Home Buckhannon Upshur 26201 566 Our Own Personal Care Clarksburg Harrison 26301 567 St. Barbara’s Nursing Home Monongah Marion 26554 568 Pinecrest Haven Personal Care Gore Harrison 26301 570 MRI Clinic Morgantown Monongalia 26505 571 Nursing Home

572 Physician’s Office

573 Health South Mountainview Hospital Morgantown Monongalia 26505 830 No Patient Transported

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Appendix A

Facility Codes for EMS Region 8/9

600 Funeral Home

601 City Hospital Martinsburg Berkeley 25401 602 Grant Memorial Petersburg Grant 26847

603 Hampshire Memorial Romney Hamphsire 26757 604 Jefferson Memorial Ranson Jefferson 25438 606 Morgan County War Memorial Berkeley Sprgs Morgan 25411 607 Potomac Valley Keyser Mineral 26726

608 Veterans Administration Martinsburg Berkeley 25401 609 Other

610 Home

611 Greenhaven Rest Home Fisher Hardy 26818 612 Heartland of Keyser Keyser Mineral 26726 613 Kidwell Nursing Home Romney Hamphsire 26757 614 Knott Nursing Home Charles Town Jefferson 25414 615 Jeffersonian Manor Charles Town Jefferson 25414 616 Hartland of Martinsburg Martinsburg Berkeley 25401 617 Pendleton Nursing Home Franklin Pendleton 26870 618 Shenandoah Nursing Home Ranson Jefferson 25438 619 Valley View Nursing Home Berkeley Sprgs Morgan 25411 620 Dawn View Nursing Home Ft. Ashby Mineral 26719 621 Grant County Nursing Home Petersburg Grant 26847 622 E.A. Hawse Intermediate Facility Care Baker Hardy 26801 623 Care Haven Martinsburg Berkeley 25401 624 Canterbury of Shepherdstown Shepherdstown Jefferson 25443 830 No Patient Transported

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Facility Codes for EMS Region 10/11

700 Funeral Home

701 Ohio Valley Medical Center Wheeling Ohio 26003 703 Reynolds Memorial Glen Dale Marshall 26038 704 Weirton Medical Center Weirton Brooke 26062

706 Wetzel County N. Martinsville Wetzel 26155 707 Wheeling Hospital Wheeling Ohio 26003 708 Other

709 Nursing Home 710 Home

711 Bishop Joseph Hodges Continuous Care Ctr. Wheeling Ohio 26003 712 Brightwood Nursing Home Follansbee Brooke 26037 713 Cameron Health Care Center Cameron Marshall 26033 714 Fox Nursing Home Chester Hancock 26034 715 Good Shepherd Nursing Home Wheeling Ohio 26003 716 Mound View Health Care Moundsville Marshall 26041 717 New Martinsville Health Care Center N. Martinsville Wetzel 26155 718 Valley Haven Geriatric Center, Inc. Wellsburg Brooke 26070 719 Weirton Geriatric Center Weirton Hancock 26062 720 (Altenheim) The Home For the Aged Wheeling Ohio 26003 721 Country Haven Rest Home Beech Bottom Brooke 26030 722 Elmhurst - House of Friendship Wheeling Ohio 26003 723 The Home For Men Wheeling Ohio 26003 724 Icenhower Boarding Home, Inc. Wheeling Ohio 26003 725 Lewis Wetzel Personal Care Home N. Martinsville Wetzel 26155 726 Mound View Health Care, Inc. Moundsville Marshall 26041 727 Serra Retirement Home Weirton Hancock 26062

728 We Care Personal Care Home Chester Hancock 26034 729 Welty Home for the Aged, Inc. Wheeling Ohio 26003 830 No Patient Transported

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Appendix A

Codes for Out-of-State Facilities

State Code Facility City Zip

Kentucky 801 Kings Daughters Hospital Ashland 41101

802 Louisa Community Hospital Louisa 41230 803 University of Kentucky Med Center Lexington 40507 804 University of Kentucky Med Center Moorehead 40351 834 South Williamson ARH So. Williamson

Ohio 805 Belaire Hospital Belaire 43906 806 Children’s Hospital Cincinnati 45202 807 Cincinnati General Cincinnati 45202 808 Cleveland Clinic Cleveland 44101 809 Holzier Medical Center Gallipolis 45631 810 Marietta Memorial Hospital Marietta 45750 811 Martin’s Ferry Hospital Martin’s Ferry 43935 812 Ohio State Univ. Med Center Columbus 43216 813 Ohio Valley Hospital Steubenville 43952 814 Selby General Hospital Marietta 45750 815 St. John’s Hospital Steubenville 43952 827 Pinecrest Gallipolis

828 Heartland So. Point 829 Pulley’s Nursing Home So. Point 831 Pulley’s Care Center So. Point

Pennsylvania 816 Allegheny General Hospital Pittsburgh 15212

817 Children’s Hospital Pittsburgh 15213 818 Mercy Hospital Pittsburgh 15219 819 Mountefire Hospital Pittsburgh 15213 820 Presbyterian Hospital Pittsburgh 15213 821 St. Francis Hospital Pittsburgh 15201 822 Shady Side Hospital Pittsburgh 15232 823 Washington Hospital Washington 15301 824 West Allegheny Hospital Pittsburgh

825 West Penn Pittsburgh 15224 826 McGee’s Women’s Hospital Pittsburgh 15213 832 Veteran Administration Hospital Pittsburgh 15206 833 Greene County Memorial Waynesburg 15370

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Codes for Out-of-State Facilities (Continued)

State Code Facility City Zip

Washington DC 901 Metro DC Hospital Washington DC 20000

915 Veteran’s Administration Washington DC 20000

Maryland 902 Garrett Memorial Oakland 21550

903 Memorial Cumberland 21502 904 Sacred Heart Cumberland 21502 905 Shock-Trauma Unit Baltimore 21233 906 Washington County Hagerstown 21740

Virginia 907 Allegheny Regional Lowmoor 24426

908 Carilion - Roanoke Community Roanoke 24001 909 Carilion - Roanoke Memorial Roanoke 24001 910 Rockingham Memorial Harrisburg 22801 911 Medical College of Virginia Richmond 23219 913 Winchester Memorial Winchester 22601 916 University of Virginia Charlottesville 22902 917 Bristol Regional Medical Center Bristol 24201 918 Buchanan General Grundy 24614 919 Clinch Valley Medical Center Richlands 24641 920 Tazewell Community Hospital Tazwell 24651 923 Giles County Hospital Pearisburg 24134 924 Veteran’s Administration Salem 24153 925 Augusta Medical Center Fishersville 22939 926 Lewis Gale Medical Center Salem 24153

North Carolina921 Bowman-Gray Baptist Hospital Winston-Salem 27103

922 Duke University Hospital Durham 22710

General Use 830 No Patient Transported 930 Patient Refused Service

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Appendix B

Codes for Regional Medical Command Centers

Code # Region Medical Command Center Name

01 Region 1 Regional Command (Beckley) 02 Region 2 Huntington Medical Command 03 Region 3/4 Charleston MedBase

04 Region 5 West Central Medical Command Center (WESTCOM) 05 Region 6/7 WVU Medical Command

06 Region 8/9 WVU Medical Command 07 Region 10/11 WVU Medical Command

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Squad Codes for EMS Region 1

Region County Squad

Code Code Code Squad Name

1 24 01 Widener’s Ambulance Services 55 03 Brenton Volunteer Fire and Rescue 24 04 Jan Care Ambulance - McDowell County 28 05 HealthNet V

55 06 STAT Ambulance Service - Wyoming

24 07 McDowell Co. Emergency Ambulance Authority 28 08 Bluefield WV Rescue Squad

55 09 Oceana Volunteer Fire Department 28 10 Princeton Rescue Squad

32 11 Union Rescue/Monroe Transport 12 Sweet Springs Rescue Squad

41 13 US Dept. of Interior - National Park Service 14 Ghent Area VFD & Ambulance

15 General Ambulance 16 Best Transport Ambulance 17 Trap Hill Volunteer Fire & Rescue

45 18 Green Sulphur District Volunteer Rescue Squad

55 19 Mullens Fire Department

45 20 Summers County EMS

24 21 Iaeger Ambulance Service 41 22 Beckley Fire Department 24 23 STAT - McDowell County 28 24 STAT - Mercer County 32 26 Peterstown Fire Department

41 27 Jan Care Ambulance Service - Raleigh Co. 55 29 Jan Care Ambulance Service - Wyoming Co. 36 Upper Laurel VFD

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Appendix C

Squad Codes for EMS Region 2

Code Code Code Squad Name

2 06 01 Special Metals 02 Cabell County EMS

03 Cabell Huntington Hospital Pt. Transport Service 27 05 Mason County Emergency Amb. Service Authority 06 06 Jan Care - Cabell County

50 07 Medical Transportation Service 08 Portsmouth Ambulance Service 30 09 STAT Ambulance Service

10 MedFlight of East Kentucky 22 13 STAT - Lincoln County 14 Lincoln EMS

30 15 Appalachian First Response 16 Stafford EMS

50 22 STAT - Wayne County 23 Ceredo VFD

24 Fort Gay VFD

25 Sunoco Chemical - Neal Plant 26 Kenova VFD

27 Lavalette VFD 28 Prichard VFD 29 Wayne VFD

30 Dunlow VFD and Rescue

23 31 LEASA (Logan Co. Emergency Amb. Svc. Authority) 06 38 Healthnet III

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Squad Codes for EMS Region 3/4

3 03 01 Spruce River VFD 40 02 Duff Transport

03 03 Whitesville Ambulance Service

08 04 Clay County Emergency Ambulance Authority 10 05 K & B Behavioral Health Services

06 General Ambulance Service

07 Jan Care Ambulance Service (Fayette) 08 Fayette County OES

09 Sheltering Arms, Inc.

13 10 Anthony Creek VFD & Rescue Squad 11 Greenbrier County Emergency Amb. Service 12 Northern Greenbrier Ambulance Service 13 White Sulphur Springs Rescue Squad 14 Williamsburg Volunteer Rescue Squad 15 Peacemaker Medical Response 20 16 Charleston Fire Department

18 Cedar Grove VFD

20 Sky Hawk Traffic, Inc./dba Alert 1 21 Kanawha County Emerg. Amb. Authority 10 26 STAT - Fayette County

34 27 Redi-Care

38 31 Bartow-Frank-Durbin Fire & Rescue 32 Hillsboro Rescue Squad

33 Marlinton VFD 40 35 Putnam County EMS

13 41 Alderson Fire Department EMS 03 42 Boone County Ambulance Authority

43 Van VFD

13 44 Quinwood Ambulance Service 45 STAT - Greenbrier County

34 52 Jan Care Ambulance Service (Nicholas) 51 53 STAT - Webster County

20 54 Healthnet II

51 54 Webster Memorial EMS 20 55 Dow Chemical Company

38 56 Snowshoe Mountain Response Team 57 Cass Volunteer Fire & Rescue

58 Shavers Fork Fire/Rescue 59 STAT - Pocahontas County 20 63 Bayer Crop Science EMS

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Appendix C

Squad Codes for EMS Region 5

4 07 01 Calhoun County EMS 18 02 Jackson County EMS

37 03 Cytec Industries - Willow Island 04 Pleasants Co. Emergency Ambulance Authority 43 05 Ritchie County Ambulance Authority

44 07 Roane County Emergency Squad 48 08 Tyler Co. Emergency Squad - Alma

10 Tyler Co. Emergency Squad - Middlebourne 11 Sistersville General Hospital Ambulance Service 53 12 Wirt County Emergency Squad

54 13 Camden-Clark Ambulance Service 14 Wood County Emergency Services 15 Pond Creek Volunteer Fire Department

16 MJS Enterprises/dba St. Joseph=s Ambulance Services 18 G. E. Plastics

18 19 Pechiney Rolled Products 54 20 Washington Bottom VFD

21 General Ambulance Service - Wood County 07 23 Minnie Hamilton Health Care Center ETS 48 24 GE Silicones WV LLC

54 25 Blennerhassett Volunteer Fire Department 26 Deerwalk Volunteer Fire Department 27 Eastwood Volunteer Fire Department 28 Lubeck Volunteer Fire Department 29 Parkersburg Fire Department

30 Mineral Wells Volunteer Fire Department 31 Waverly Volunteer Fire Company 32 Williamstown Volunteer Fire Company 37 33 St. Marys Volunteer Fire Department

34 Belmont Volunteer Fire Department

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Squad Codes for EMS Region 6/7

5 01 01 Barbour County Emergency Squad 02 Belington Emergency Squad

04 03 Braxton Co. Emerg. Amb. Svc. Authority - Burnsville 05 Braxton Co. Emerg. Amb. Svc.. Authority - Sutton 09 06 Doddridge County Emergency Squad

11 07 Gilmer County Ambulance Service 17 08 Anmoore EMS (VFD)

09 Bridgeport Fire Department

10 Harrison Co. Emerg. Squad - Clarksburg 11 Salem VFD

21 12 Lewis County Emergency Amb. Svc. Authority 25 13 Fairview VFC 14 Grant Town VFD 15 MCRS/Fairmont - Station 20 16 MCRS/Mannington - Station 25 17 MCRS/Whitehall - Station 32 31 19 Monongalia EMS

39 20 KAMP Central Ambulance Service 21 Bruceton Community Ambulance Service 22 Mountaineer Ambulance Service

23 Rowlesburg Volunteer Ambulance Service 24 Terra Alta Community Ambulance Squad 25 Tunnelton Community Ambulance Service 26 Union Ambulance Service

27 Valley District Ambulance Service 42 28 Randolph Co. Emerg. Squad - Elkins

29 Randolph Co. Emerg. Squad - Harmon 30 Randolph Co. Emerg. Squad - Mill Creek 46 33 Taylor Co. Emergency Squad

47 34 Tucker County EMS - Davis - Station II 35 Tucker County EMS - Parsons - Station I

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Appendix C

Squad Codes for EMS Region 6/7 (Continued)

5 49 36 Upshur County EMS 46 44 Flemington Area EMS, Inc. 31 46 HealthNet I

17 48 Lambert’s Ambulance Service - Harrison Co. 50 Harrison Co. Emergency Squad - Shinnston 47 51 Tucker Co. EMS - Canaan - Station III 17 52 Jan Care - Harrison County

25 53 Jan Care - Marion County 31 55 Jan Care - Monongalia County 25 56 Fairmont Fire Department 17 57 Clarksburg Fire Department 39 58 Masontown VFD

31 59 Crompton Med 25 60 Monongah VFD

39 62 Preston Memorial Hospital 49 63 Selbyville VFD

39 65 Terra Alta VFD 67 Tunnelton VFD

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Squad Codes for EMS Region 8/9

6 02 01 Berkeley Co. EAA - Bedington VFD 02 Berkeley Co. EAA - Hedgesville VFD 03 Ryneal Fire Company

04 Berkeley Co. EAA - South Berkeley VFD & Rescue 12 05 Grant County Ambulance - Mt. Storm

06 Grant County Ambulance - Petersburg 19 07 PNGI Charles Town Gaming

14 08 Augusta Volunteer Rescue Squad 09 Capon Bridge Rescue Squad 10 Romney Volunteer Rescue Squad 11 Springfield Area Rescue Squad 16 12 Fraley Ambulance Service

13 Mathias/Baker Emergency Squad 14 Wardensville Volunteer Rescue Squad 19 15 Friendship Fire Company

16 Independent Fire Company 17 Shepherdstown VFD 29 18 Burlington VFD

19 Elk District Ambulance Service 20 Fort Ashby VFC

21 Keyser EMS 22 Ridgley VFC

33 23 Morgan County Rescue 24 Paw Paw VFC

36 25 Pendleton Co. Emerg. Rescue - Franklin 26 Pendleton Co. Emerg. Rescue - North Fork 27 Pendleton Co Emerg. Rescue. - Sugar Grove 28 Pendleton Co. Emerg. Rescue - Upper Tract 02 29 Berkeley Co. Emergency Ambulance Authority

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Appendix C

Squad Codes for EMS Region 8/9 (Continued)

6 19 33 BSR, Inc.

02 35 Berkeley Co. EAA - Back Creek VFD 33 38 Morgan County - Great Cacapon 36 39 NSGA Fire Department

12 40 Valley Medical Transport - Grant 02 41 Valley Medical Transport - Berkeley 14 44 Lamberts Ambulance Service - Romney 29 45 Valley Medical Transport - Mineral 14 46 Valley Medical Transport - Hampshire 29 47 Lambert=s Ambulance Service - Keyser

48 Capon Springs Volunteer Fire & Rescue 49 Slanesville Volunteer Ambulance Service 19 50 Blue Ridge Mountain VFC

02 51 Lamberts Ambulance Service - Hedgesville 29 52 Fountain VFC

53 New Creek VFD

19 54 Jefferson County Ambulance Authority 29 55 Patterson Creek VFC

56 Short Gap VFC

57 Tri Towns Ambulance and Rescue 02 58 Martinsburg Fire Department

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Squad Codes for EMS Region 10/11

7 15 00 Weirton Steel Company

05 01 Brooke County Ambulance Service 02 Bethany VFD

35 03 Mozart Fire Department 04 West Liberty VFD

05 Emergency Medical Transport 06 Wheeling Island Gaming Inc. 15 07 New Manchester VFD

08 New Cumberland Ambulance

09 Weirton Area Ambulance & Rescue Squad 26 10 Bayer Corporation

11 Marshall County Sheriff=s Office 12 Benwood VFD

13 Cameron Volunteer Emergency Squad 14 Glen Dale VFD

15 Limestone Regional EMS 16 McMechen VFD

17 Tri-State - Marshall County

18 Fork Ridge Community VFD & EMS 35 19 Bethlehem VFD 26 20 Dallas VFD 35 21 Clearview VFD 23 Stone Church VFD 24 Triadelphia EMS 25 Tri-State Ambulance 26 Valley Grove VFD

27 Wheeling Fire Department 52 28 New Martinsville Fire Department

29 Grandview Unit - WCEAA 30 New Martinsville Unit - WCEAA 31 Folsom Volunteer Fire Department

32 Shortline Unit - WCEAA 33 United Unit - WCEAA

34 Med Assist Ambulance Service, Inc. 26 35 Moundsville Fire Department

36 PPG Industries 15 37 Life Team EMS

38 Tri County Ambulance Service 39 City of Weirton Fire Department 40 Newell Volunteer Fire Department 05 41 Beech Bottom Volunteer Fire Department

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Appendix D

State Approved Drugs/Solutions

Code Drug/Solution 01 Atropine Sulfate 02 Calcium Chloride 03 Dexamethasone (Decadron) 04 Dextrose 5% in Water (D5W) 05 Dextroxe 50% (D50W) 06 Diazepam (Valium) 07 Digoxin (Lanoxin) 08 Diphenhydramine HCL (Benadryl) 09 Dopamine HCL (Intropin) 10 Epinephrine (1:1,000) 11 Furosemide (Lasix) 13 Isoproterenol HCL (Isuprel) 14 Lactated Ringer=s 15 Lidocaine (Xylocaine) 16 Meperidine HCL (Demerol) 18 Morphine Sulfate 19 Naloxone HCL (Narcan) 20 Nitroglycerin (Nitrostat)

21 Pentazocine Lactate (Talwin)

22 Promethazine HCL (Phenergan)

23 Sodium Bicarbonate

24 Sodium Chloride 0.9% (Normal Saline)

25 Bretylium Tosylate (Bretylol)

26 Epinephrine (1:10,000) 27 Activated Charcoal 28 Aminophylline 30 Glucagon 31 Haloperidol (Haldol) 33 Propanolol HCL (Inderal) 34 Mannitol (Osmitrol) 35 Phenobarbital

36 Plasma Protein Fraction

37 Procainamide HCL (Pronestyl) 38 Steroids (Solu-Cortef) 39 Steroids (Solu-Medrol) 41 Tetanus Toxoid 43 Nalbuphine HCL (Nubain) 44 Dextrose 10% in Water (D10_W) 50 Verapamil HCL (Isoptin) 51 Oxytocin (Pitocin) 52 Terbutaline (Brethine) 53 Thiamine HCL 54 Nitroglycerine Spray 55 Nitrous Oxide 56 Procardia 57 Albuterol 58 Heparin 59 Adenosine 60 Magnesium Sulphate 61 Nitroglycerine Infusion 62 Tagamet 63 Aspirin

64 Oral Glucose Gel

65 Ibuprofen 66 Tylenol 67 Integrilin 68 Dextrose 25% in Water (D25W) 69 Amiodorone (Cordarone) 70 Diastat

71 Atrovent (Ipratropium Bromide)

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State Approved Drugs/Solutions

Drug/Solution Code Activated Charcoal 27 Adenosine 59 Albuterol 57 Amiodorone (Cordarone) 69 Aminophylline 28 Aspirin 63 Atropine Sulfate 01

Atrovent (Ipratropium Bromide) 71

Bretylium Tosylate (Bretylol) 25

Calcium Chloride 02 Dexamethasone (Decadron) 03 Dextrose 5% in Water (D5W) 04 Dextrose 10% in Water (D10W) 44 Dextrose 50% in Water (D50W) 05 Dextrose 25% in Water (D25W) 68 Diastat 70 Diazepam (Valium) 06 Digoxin (Lanoxin) 07 Diphenhydramine HCL (Benadryl) 08 Dopamine HCL (Intropin) 09 Epinephrine (1:1,000) 10 Epinephrine (1:10,000) 26 Furosemide (Lasix) 11 Glucagon 30 Haloperidol (Haldol) 31 Heparin 58 Ibuprofen 65 Integrilin 67 Isoproterenol HCL (Isuprel) 13 Lactated Ringer=s 14 Lidocaine (Xylocaine) 15 Magnesium Sulphate 60 Mannitol (Osmitrol) 34 Meperidine HCL (Demerol) 16 Morphine Sulfate 18 Nalbuphine HCL (Nubain) 43 Naloxone HCL (Narcan) 19 Nitroglycerine Infusion 61 Nitroglycerine (Nitrostat) 20 Nitroglycerine Spray 54 Nitrous Oxide 55

Oral Glucose Gel 64

Oxytocin (Pitocin) 51

Pentazocine Lactate (Talwin) 21

Phenobarbital 35

Plasma Protein Fraction 36

Procainamide HCL (Pronestyl) 37

Procardia 56

Promethazine HCL (Phenergan) 22

Propanolol HCL (Inderal) 33

Sodium Bicarbonate 23

Sodium Chloride 0.9% (Normal Saline) 24

Steroids (Solu-Cortef) 38 Steroids (Solu-Medrol) 39 Tagamet 62 Terbutaline (Brethine) 52 Tetanus Toxoid 41 Thiamine HCL 53

Toradol (Ketralac Tromethamine) 72

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Appendix E

WV OEMS Patient Care Record

Submission Form

Use a separate form for each month. Directions:

1. Separate yellow copies by month, then Emergency ALS, Emergency BLS, Non-Emergency Transports, and No Transports.

2. Complete the information below.

3. Please do not submit partial months. All records are to be in the TSN Field Office by the 15th

of the month for the previous month. Example: January forms need to be in the office by the 15th_{of February.}

4. Attach this from as a cover sheet to your yellow copies. 5. Send to the appropriate WV EMS TSN Field Office.

************************************************************************************************************************ ******

Squad Name:_______________________________________________Squad Number:_________________ Month:______________________________Year:__________Date Sent to TSN:_______________________ Total Runs:____________________Emergency ALS Runs:___________Emergency BLS Runs:___________ Non-Emergency Transports:_________No Transports:_________

Prepared for Submission By:_____________________________________________________________ ************************************************************************************************************************ *

FOR TSN FIELD OFFICE USE ONLY

Dave Received:____________________

Date Entered:____________________Entered By:____________________________________________ File Date and Name:____________________________________________________________________

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WV EMSTSN

Headquarters

WV EMS TSN, Inc. PO Box 100 Elkview, WV 25071-01--Joe E. Richards, MA, QMRP II

Chief Executive Officer E-Mail address:

[email protected]

Office: (304) 965-0573 (304)965-0542 (fax)

WV EMS TSN

Field Office for Region 3/4

PO Box 100 Elkview, WV 25071-0100 304-965-6617 304-965-0542 (Fax)

Program Director: Vacant Interim Program Director: Pam Carte

E-Mail addresses:

[email protected]

Boone, Clay, Fayette, Greenbrier, Kanawha, Nicholas, Pocahontas,

Putnam, Webster

WV EMS TSN

919 Mull Center Wheeling, WV 26003 304-233-4440 304-233-4402 (Fax) Program Director: Allisynne Dunlap Program Assistant: Sondra S. Nagle

E-Mail addresses:

[email protected] [email protected]

Brooke, Hancock, Marshall, Ohio, Wetzel WV EMS TSN

200 Fairmont Ave. Suite 205 Fairmont, WV 26554-2700 304-366-8764 304-366-5091 (Fax)

Program Director: Gail Dragoo Program Assistant: Marsha Myers

E-Mail addresses:

Barbour, Braxton, Doddridge, Gilmer, Harrison, Lewis, Marion, Monongalia, Preston, Randolph,

Taylor, Tucker, Upshur

WV EMS TSN

82 Sue Court Martinsburg, WV 25401-2911 304-263-4913 304-263-2302 (Fax)

Program Director: Marianne Perry Program Assistant: Vacant

E-Mail addresses:

[email protected]

Berkeley, Grant, Hampshire, Hardy, Jefferson, Mineral, Morgan, Pendleton

WV EMS TSN

Field Office for Region 5

603 29th St. Vienna, WV 26105 304-295-0111 304-295-0113 (Fax) Acting Program Director: Allisynne Dunlap

Program Assistant: Carol Robinson E-Mail addresses:

Calhoun, Jackson, Pleasants, Ritchie, Roane, Tyler, Wirt, Wood WV EMS TSN

PO Box 7005 Huntington, WV 25774-7005 304-523-9102 304-523-7800 (Fax)

Program Director: Jim Donathan Program Assistant: Arisba Fink

E-Mail addresses:

Cabell, Lincoln, Logan, Mason, Mingo, Wayne

WV EMS TSN

PO Box 39 Alderson, WV 24910 304-445-2022 304-445-2087 (Fax)

Program Director: Jerry Kyle Program Assistant: Toni Hall

E-Mail addresses:

McDowell, Mercer, Monroe, Raleigh, Summers, Wyoming