Forgoing the usual metrics for emergency medical services, researchers evaluated more than 9,000 EMS companies through 11 measures. They found large discrepancies in patient care.
EMS are typically compared to response times and out-of-hospital cardiac arrest survival rates, but researchers from New York City's Icahn School of Medicine at Mount Sinai said these performance metrics don't cover it.
In a study published Feb. 12 in Prehospital Emergency Care Journal, the researchers analyzed 9,679 EMS companies, which collectively answered more than 26 million 911 calls in 2019. Each response was tested among 11 categories, including successes in airway procedures, pediatric care and pain assessments.
The research is the first to test quality performance across EMS agencies on a national scale. Overall, most companies performed well with pediatric care — such as offering weight-based medication doses — but safety and trauma scores varied widely, especially among rural areas.
"Although benchmarks for acceptable practice have not been developed at the national level, at least half of agencies demonstrated documented performance below 35% for 5 out of the 10 national measures evaluated," the researchers said.
The study also found lights and sirens were used unnecessarily, and 1 in 3 suspected stroke patients failed to receive a stroke assessment.
The researchers said the findings highlight potential national and regional recommendations, such as decreasing light and siren use across the U.S. and bolstering trauma care in urban areas.