Earlier this year, the U.S. Department of Transportation (DOT) released a National Roadway Safety Strategy to bring down the number of people who die in motor vehicle crashes. One of the five key objectives of this plan is post-crash care, emergency response, and trauma care which is critical to the survivability of crashes. Recent research has shown that nearly half of fatal crashes in the United States occur on rural roads. The National EMS Advisory (NEMSAC) Council seeks input from rural emergency medical services (EMS) on their formal submission to DOT’s National Highway Transportation and Safety Administration about the proposed plan. There are two NEMSAC letters for your consideration: the first provides advice on major actions the DOT can take to reduce fatalities; the second calls for the adoption of the National Model EMS Clinical Guidelines (3rd Edition) and the 2021 National Trauma Field Triage Guidelines. Comments and questions must be submitted to NHTSA.NEMSAC@dot.gov by October 21, 2022, at 5 pm ET.