Emergency medical service (EMS) systems are not consistently providing optimal care based on new national standards of quality to patients who call 911, according to a new study from the Icahn School of Medicine of Mount Sinai.
The study demonstrates that EMS performance on key clinical and patient safety measures varies widely across urban and rural communities. The findings, published in the February 13 issue of Prehospital Emergency Care, identify opportunities that could lead to improved care during 911 responses and improved outcomes for patients across the United States.
This is one of the first studies to use specific safety and clinical quality measures to assess patient care across the entire 911 system in the United States. The research team reviewed all 911 responses in the United States for the year 2019, more than 26 million responses from 9,679 EMS agencies. They assessed specific quality measures in each call outlined by the National EMS Quality Alliance – a nonprofit organization that was formed to develop and endorse evidence-based quality measures for EMS and healthcare partners that improve the experience and outcomes of patients and care providers. This includes the treatment of low blood sugar, seizures, stroke, pain, and trauma, as well as medication safety and transport safety. Some of the notable findings were:
- Pain for trauma patients improved in only 16 percent of cases after treatment by EMS.
- 39 percent of children with wheezing or asthma attacks did not receive breathing treatments during their EMS call, even though earlier treatment can lead to earlier relief of distressing symptoms.
- Nearly one-third of patients with suspected stroke did not have a stroke assessment documented, potentially delaying or missing time-sensitive treatment.
The researchers also analyzed performance of all EMS agencies, looking at agency size and location—urban, suburban, and rural. They discovered substantial differences in agencies that primarily responded in rural communities compared to urban and suburban areas. Agencies with responses in mostly rural areas were less likely to treat low blood sugar or improve pain for trauma patients, and more likely to use lights and sirens unnecessarily when compared to EMS systems in urban and suburban communities.
