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All companies should develop a comprehensive emergency response system for medical emergencies. Success depends upon endorsement and support by management at several levels. Once support is provided, the questions of whom to train and which courses are appropriate must be answered. Two approaches to training are common; one increases the general level of education and competence among a large number of employees, while the other focuses on the training of a select number of workers at the site. An important part of the in-house system is the company's relationship with the community emergency medical service (EMS). As long as business looks upon health and safety as a concern to be managed only as problems arise, emergency medical service will remain weak. A commitment to employee health and safety makes good business sense.