State and Federal regulations were reviewed, underground coal mines were visited, meetings with medical and safety experts were conducted, and accident and injury statistics for 1972 to 1975 were analyzed to identify the emergency medical resources required in underground coal mines. Recommendations were made concerning which first aid supplies should be kept, how and where they should be stored, and how often they should be inspected. Personnel staffing and training procedures were discussed, including the design of a basic first aid course for the miners. Procedures were developed for integrating emergency medical services with existing medical resources. Guidelines were included for communications between mine operators and health care, provide transportation of injured miners, memoranda on higher level medical care, disaster linkages, and program evaluation. Excerpts from the code of federal regulations, lists of surveyed states and panel participants, coal accident and injury data, grants for emergency medical services in 1977, ambulance design criteria, and specifications for essential ambulance equipment are provided.