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Home > Topics > EMS Advocacy

Landmark document offers snapshot of EMS in US

The assessment identifies a number of areas for improvement, particularly in health and safety

By EMS1 Staff

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).

The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Pit Long Pit Long Tuesday, January 03, 2012 6:20:08 PM Not good news. 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. Will this lead to 30 dollar an hour jobs or are we going to be paying 40k to make 10.00 and hour. We need Internships with on the job training. We are headed in the wrong direction. Insurance is not going to pay Pre Hospital 30 an hour and people are no going to go in debt for 30k to make 30k a year this is joke.
Bryan Fass Bryan Fass Wednesday, January 04, 2012 6:01:36 AM Physical abilities and professional education are two of the most important keys to advancing the profession of EMS. Without a fitness and musculoskeletal injury prevention program/policy and without advanced degree education on top of certification EMS may continue to wallow. Pay and career advancement are often tied to physical fitness, mental wellness/education and strong national policy. It appalls me that so many medics are physically unable to do the job and with injury rates so high agencies do not have the money to fund and run a successful wellness and injury prevention program. Stop injuries and improve wellness, this often allows departments to 'find' the money to advance education from within.
Alexander Kuehl Alexander Kuehl Wednesday, January 04, 2012 8:33:07 AM You are right. The problem is the definition of PARAMEDIC. Advanced treatment , medically sophisticate paramedics need and deserve a degree..however CFRs , basic EMTs and even intermediate EMTs can operate with straightforward protocols. It would be nice to raise EMS salaries..but insyead I am guessing that the benifit packages for fire and police are going to stagnate or even drop.
Alexander Kuehl Alexander Kuehl Wednesday, January 04, 2012 8:38:14 AM There are alot of good suggestions..but most(all?)are 25 years old. However the ideas of extensive federal and state mandates are simply wrong..all EMS is local.
Leroy Murphy Leroy Murphy Wednesday, January 04, 2012 8:53:49 AM In Short we SUCK and all need to set goals for improvements, and our management needs to lead, set 5 year plans, and really support us. The National Registry needs to get a game and really improve skills/talents instead of spending time/money/effort on titles!
J.t. Cantrell J.t. Cantrell Wednesday, January 04, 2012 11:10:18 AM I may be remiss here but the same problems existed in the mid 1960's. We had no benefits to speak of and we were considered a more or less disposable labor force. The management level personnel whether they are private, third service, fire based or whatever know full well that if one EMT or medic is lost, the schools are churning out more to fill the void. I believe that most of us are guilty (?) of working at multiple services to make ends meet. We cannot make it on one income even if it is a career or municipal service. There is no career ladder to speak of and I must confess that I see no change coming other than as a previous contributor stated that police and fire salary and benefit packages may drop. Add to this that to get "qualified" appllicants some cities are dropping entry level scores to dangerous levels. They do not know nor will they accept the fact that you cannot dumb it down to fill the trucks. Perhaps when the outcry against poor service is finally heard there may be some changes but they may also be too little, too late.
Bob McNally Bob McNally Wednesday, January 04, 2012 2:02:27 PM Bryan, keep up the good work. Fitness and Injury prevention ought to mandatory in EMS and its shocking and embarrassing that it is not.
Steve Jacobi Steve Jacobi Wednesday, January 04, 2012 4:04:28 PM Many are willing to go into debt with $2000 for an EMT-B cert and another $15,000 for a Paramedic cert if it can be done in 6 months but are not willing to pay a $5000 or less for a 2 year community college degree. People are also willing to work for free to put emergency lights on their POV. Guess how much some are willing to pay to trick out their POV with lights. Many will also pay $1500 - $5000 for another cert like Community Paramedic or CCEMTP which can be as little as 2 weeks in length. I doubt if it is the money but rather how fast one can go from Zero to Hero. If more time was spent in college to where there was an actual understanding of what you were doing, the job might lose its glamor and hero appeal and only the serious would stick around. There are also many in EMS who still don't understand how their own credentialing and certification system works so there is little chance of moving forward until more take an interest in their own chosen line of work or hobby. The NREMT is a testing organization contracted by a state to administer an exam. It does not tell a state what requirements it should set for EMS providers. If the state does not agree with the NREMT, the titles tested for or the accreditation of Paramedic programs, the state just provides its own test. It also took 15 years for the new national curriculum and titles to come out. It offers nothing higher than a certificate so it is highly unlikely advancement to a degree will be seen in the next 15 years. Why should there be? More states are coming up with a new batch of certs like the Community Paramedic. As long as certs and new patches can easily be given out there is no need to advance education as a whole. Patchwork and piece mill medic factories seem to be what the majority want and has become the accepted expectation. Almost all the other health care professions started with diplomas and certificates for entry but many advanced within 20 years to an Associates or Bachelors. Many are now Masters and Doctorates. EMS doesn't even require a mere Associates for its instructors.
John Oscar John Oscar Saturday, January 07, 2012 3:03:38 AM I agree. My state/community is way ahead of the curve as far as our level of practice. I'd hate to have to back up ten years because the Feds mandate us to.
Bobby Wisenberger Bobby Wisenberger Sunday, January 08, 2012 11:39:54 AM I'll get an "EMS" degree the moment I make more than 7.80$/HR.

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