Quality of EMS Care Varies Widely Across the U.S.


The level of care patients receive in a medical emergency varies widely based on where 911 is being dialed.

Why it matters: A first-of-its-kind study of emergency medical service systems’ performance across the country points to opportunities to improve patient care when the pressure is on.

What they did: Researchers at the Icahn School of Medicine at Mount Sinai reviewed more than 26 million responses from nearly 9,700 EMS agencies in 2019.

  • They assessed how those agencies performed on safety and clinical quality measures that had been outlined by a nonprofit industry organization that year.
  • The researchers said it’s a shift from looking primarily at response times to determine EMS performance, which they say is an imprecise metric for most calls.

What they found: Agencies largely responding in rural areas were less likely to treat low blood sugar or improve trauma patients’ pain, researchers found.

  • They were also more likely to use lights and sirens unnecessarily, which other studies have found raises the risk of crashes.
  • Delivery of time-sensitive treatment also varied during EMS calls. For instance, 4 in 10 kids with wheezing or asthma attacks didn’t get breathing treatment, and about 1 in 3 suspected stroke patients didn’t have a stroke assessment documented.

What they’re saying: “We have to move away from solely looking at response times and start looking at performance that directly impacts the people we are meant to treat,” said lead author Michael Redlener, an associate professor of emergency medicine.