National Characteristics of Emergency Medical Services Responses in the United States

Abstract Objective. Despite its long history and current prominence in U.S. communities, only limited data describe the national characteristics of emergency medical services (EMS) care in the United States. We sought to characterize out-of-hospital EMS care in the United States. Methods. We conducted an analysis of the 2010 National Emergency Medical Services Information System (NEMSIS) research data set, encompassing EMS emergency response data from 29 states. From these data, we estimated the national number and incidence of EMS responses. We also characterized EMS responses and the patients receiving care. Results. There were 7,563,843 submitted EMS responses, corresponding to an estimated national incidence of 17.4 million EMS emergency responses per year (56 per 1,000 person-years). The EMS response incidence varied by U.S. Census region (South 137.4 per 1,000 population per year, Northeast 85.2, West 39.7, and Midwest 33.3). The use of lights and sirens varied across Census regions (Northeast 90.3%, South 76.7%, West 68.8%, and Midwest 67.5%). The percentage of responses resulting in patient contact varied across Census regions (range 78.4% to 95.7%). The EMS time intervals were similar between Census regions; response median 5 minutes (interquartile range [IQR] 3–9), scene 14 minutes (10–20), and transport 11 minutes (7–19). Underserved populations (the elderly, minorities, rural residents, and the uninsured) were large users of EMS resources. Conclusion. These data highlight the breadth and diversity of EMS demand and care in the United States.

[1]  C. Bladin,et al.  Paramedic Diagnosis of Stroke: Examining Long-Term Use of the Melbourne Ambulance Stroke Screen (MASS) in the Field , 2010, Stroke.

[2]  T. Rea,et al.  The relationship between time to arrival of emergency medical services (EMS) and survival from out-of-hospital ventricular fibrillation cardiac arrest. , 2010, Resuscitation.

[3]  D. Davis,et al.  Emergency medical services intervals and survival in trauma: assessment of the "golden hour" in a North American prospective cohort. , 2010, Annals of emergency medicine.

[4]  K. Anstrom,et al.  Implementation of a statewide system for coronary reperfusion for ST-segment elevation myocardial infarction. , 2007, JAMA.

[5]  Craig D Newgard,et al.  Advanced Statistics: Missing Data in Clinical Research—Part 2: Multiple Imputation , 2007, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[6]  C. Camargo,et al.  National Study of Ambulance Transports to United States Emergency Departments: Importance of Mental Health Problems , 2006, Prehospital and Disaster Medicine.

[7]  Drew E. Dawson,et al.  National Emergency Medical Services Information System (NEMSIS) , 2006, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[8]  M. Eisenberg The C. J. Shanaberger Lecture: The Evolution of Prehospital Cardiac Care: 1966–2006 andBeyond , 2006, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[9]  Richard Zane,et al.  International EMS systems: The United States: past, present, and future. , 2004, Resuscitation.

[10]  E. Lerner,et al.  Research in Prehospital Care , 2002 .

[11]  David R. Miller,et al.  Emergency Medical Services Outcomes Project (EMSOP) II: developing the foundation and conceptual models for out-of-hospital outcomes research. , 2001, Annals of emergency medicine.

[12]  L. Brown,et al.  Do warning lights and sirens reduce ambulance response times , 1999 .

[13]  G. Howard,et al.  Why do we have a stroke belt in the southeastern United States? A review of unlikely and uninvestigated potential causes. , 1999, The American journal of the medical sciences.

[14]  M. Morrisey,et al.  Rural emergency medical services: patients, destinations, times, and services. , 1995, Journal of Rural Health.

[15]  J S Geddes,et al.  A mobile intensive-care unit in the management of myocardial infarction. , 1967, Lancet.

[16]  Deborah K Niedbala,et al.  Analysis of ambulance transports and diversions among US emergency departments. , 2008, Journal of trauma nursing : the official journal of the Society of Trauma Nurses.

[17]  Kenneth W. Williams,et al.  National EMS Research Agenda. , 2002, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.