3. Emergency Response Rural issues (from NCHRP 500-15)
Geographical barriers;
Inadequate financial resources;
Aging or inadequate equipment;
Gaps in telecommunications;
Lack of proper medical direction;
Difficulty in maintaining skills due to low call volumes;
Lack of training opportunities close to home;
High reliance on increasingly hard-to-find volunteer staff;
Absence of regionalized systems of specialized EMS care, such as trauma systems; and
Absence of local medical facilities to adequately support effective EMS delivery systems.

4. Education/Public Involvement
From 1946: "This 30-foot neon traffic safety sign at Second and Grand avenues was presented to the city Thursday by the Des Moines Junior Chamber of Commerce. The Roosevelt High school band played at the presentation ceremony."
Source: Des Moines Register