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January 3, 2012

Landmark document offers snapshot of EMS in US

WASHINGTON — A landmark document offers a unique snapshot on the condition of EMS in the United States.

The National EMS Assessment, which was completed over a 24-month period from September 2009, is the first national assessment of Emergency Medical Services that provides comprehensive data aggregated at both the state and national levels.

Authors hope the data will allow the officials responsible for improving EMS systems to benchmark current and future performance and identify areas of strength and weakness.

The report shows there are 19,971 credentialed EMS Agencies in the United States, and an estimated total of 826,111 credentialed EMS professionals at the EMT-Basic, Intermediate, and Paramedic levels.

Of these, 67 percent of the EMS workforce is male, and 70 percent of the EMS workforce is between 20 and 49 years old.

The assessment identifies a number of areas for improvement, particularly in the area of EMS health and safety.

Among the findings are:

  • 12 (24 percent) of states have a formal recommended Wellness and Prevention Program for EMS professionals
  • Only one state currently monitors EMS on-the-job injury data
  • 18 (36 percent) states monitor EMS on-the-job fatalities
  • 11 (22 percent) states monitor EMS vehicle crash data
  • 7 (14 percent) states monitor EMS blood-borne pathogen exposure data

Further expert panel findings include:

  • There is a wide variation in how EMS agencies are defined within each state.
  • Volunteerism has no standard definition from state to state.
  • The ability to measure and monitor EMS vehicle crashes and EMS workforce safety is still at a very early infancy.
  • Regionalized Systems of Care associated with trauma, stroke, ST-Elevation Myocardial Infarction (STEMI), cardiac arrest, etc. are maturing but often with little regulatory guidance, management, data, or standardization.
  • EMS professional education is most commonly a certificate and not a degree. Movement should be toward a degree but cost and access to programs are currently limited.

The purpose of the National EMS Assessment was to identify and analyze existing databases containing information on EMS, EMS emergency preparedness, and 911 systems at the state and national levels.

Authors say because the report is both detailed and comprehensive, it allows states, territories and regions the ability to identify areas where systems may not be as comprehensive as desired. It can also help provide system leaders the information needed to leverage more resources.

Among the other findings are:

  • Only 7 (14 percent) of the states have a requirement for local EMS agencies to hold or participate in a mass casualty exercise.
  • 34 (68 percent) of the states indicated that either local or statewide EMS protocols including triage have been implemented and are currently in use by local EMS. 

The document was sponsored by the Federal Interagency Committee for Emergency Medical Services (FICEMS) and funded by the National Highway Traffic Safety Administration (NHTSA).