systems survey

4th Annual National

EMS Systems Survey
Below, EMS Magazine offers the results 50,000 to 100,000 patients 2.56% 12. Do you operate a tiered-response
of its fourth comprehensive survey of Over 100,000 patients 1.71% system?
EMS systems in the United States. The Figures not available 24.79% All-ALS transport 39.37%
questionnaire for the 5th Annual National ALS and BLS transport 39.37%
EMS Systems Survey will be featured in 6. What type of system do you BLS transport with
the July 2007 issue of EMS Magazine operate? non-ALS transport 6.30%
and online at www.emsresponder.com. Fire department with cross-trained EMS BLS transport only 4.72%
personnel 38.35% Other 10.24%
QUESTION# QUESTION % Fire department with separate EMS
1. What is the population served by personnel 3.76% 13. How many front-line EMS provid-
your organization according to the Government or third-service 23.31% ers are there in your organization?
2000 U.S. census? Police department with cross-trained First responder 10.90
Up to 1,000 5.34% EMS personnel 0.75% EMT-Basic 53.24
1,000 to 10,000 26.72% Police department with separate EMS EMT-Intermediate 8.90
10,000 to 50,000 42.75% personnel 0.75% EMT-Paramedic 40.81
50,000 to 100,000 6.87% Private company 12.78% Registered nurse 7.67
100,000 to 250,000 9.16% Public utility model 1.50%
250,000 to 500,000 4.58% Hospital-based 6.77% 14. How many personnel in your
Over 500,000 4.58% Other 12.03% organization are assigned to
full-time non-response jobs?
7. What type of calls does your Education and/or quality
2. What is the size of the area covered
organization usually respond to? improvement 4.21
by your organization in square miles?
Emergency only 64.39% Field supervision 7.77
Up to 10 square miles 7.69%
Interfacility transport only 0.76% Management/administration 4.84
10 to 50 square miles 34.62%
Combination of emergency and Office personnel (non-uniformed
50 to 100 square miles 10.77%
interfacility 34.85% or civilian) 7.72
100 to 500 square miles 26.92%
Support/logistics/other 11.07
500 to 1,000 square miles 13.08%
8. How is your organization staffed?
Over 1,000 square miles 6.92%
Career personnel 37.88% 15. For the following job titles, what
Volunteer personnel 21.97% are the entry-level, midpoint and
3. How many calls did your maximum annual and hourly salaries
Both career and volunteer
organization respond to in 2005? available in your organization?
personnel 40.15%
Up to 100 calls 6.06% Entry-level annual
100 to 500 calls 25.76% First responder $27,101.20
9. Please list the services provided by
500 to 1,000 calls 9.09% your organization: EMT-Basic $27,138.81
1,000 to 10,000 calls 40.15% ALS ambulance transport 76.69% EMT-Intermediate $28,073.13
10,000 to 50,000 calls 12.12% BLS ambulance transport 57.89% EMT-Paramedic $33,666.67
50,000 to 100,000 calls 5.30% ALS first response 41.35% Registered nurse $37,389.00
Over 100,000 calls 1.52% BLS first response 42.86% Education and/or QI $38,006.46
Air-medical transport 1.50% Field supervision $44,287.97
4. How are calls calculated in your Management/admin. $51,791.79
system? 10. In your system, first-response Office personnel (non-
Two or more units responding to services are provided at the following uniformed/civilian) $24,759.85
the same call are counted as two levels: Support/logistics $24,599.15
or more calls 34.35% BLS 83.33% Midpoint annual
Two or more units responding to ALS 61.36% First responder $32,704.00
the same call are counted as the AED only 20.45% EMT-Basic $32,378.23
same call 65.65% None 6.06% EMT-Intermediate $33,333.94
EMT-Paramedic $39,068.44
5. How many patients did you 11. In your system, first-response Registered nurse $47,726.75
transport in 2005? services are provided by: Education and/or QI $50,917.89
Up to 100 patients 5.98% EMS department 34.62% Field supervision $52,701.67
100 to 500 patients 19.66% Fire department 78.46% Management/admin. $61,235.36
500 to 1,000 patients 2.56% Police department 20.00% Office personnel (non-
1,000 to 10,000 patients 31.62% Other department 3.85% uniformed/civilian) $30,408.44
10,000 to 50,000 patients 11.11% Support/logistics $31,577.40

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systems survey

Maximum annual 10 to 25 12.61% 26. How many administrative and sup-

First responder $37,104.17 More than 25 3.60% port vehicles are operated by your
EMT-Basic $39,591.47 organization (including unmarked units
EMT-Intermediate $40,300.90 19. What is the minimum number of and those not typically used for emer-
EMT-Paramedic $48,599.92 ambulances staffed 24/7 in your gency responses)?
Registered nurse $61,449.20 system? None 43.70%
Education and/or QI $61,770.33 One or two 67.89% One or two 24.37%
Field supervision $58,730.33 Three to five 13.76% Three to five 20.17%
Management/admin. $74,992.79 Five to 10 7.34% Five to 10 5.04%
Office personnel (non- 10 to 25 10.09% 10 to 25 3.36%
uniformed/civilian) $39,333.60 More than 25 0.92% More than 25 3.36%
Support/logistics $39,767.33
Entry-level hourly 20. What is the peak number of 27. How many of your ambulances
First responder $13.00 ambulances staffed in your system? are:
EMT-Basic $9.92 One or two 49.07% Up to 1 year old? 2.96
EMT-Intermediate $10.59 Three to five 25.93% 1+ to 3 years old? 4.03
EMT-Paramedic $13.93 Five to 10 12.96% 3+ to 5 years old? 2.53
Registered nurse $16.00 10 to 25 9.26% 5+ to 7 years old? 2.11
Education and/or QI $18.00 More than 25 2.78% 7+ years or older? 4.48
Field supervision $13.50
Management/admin. $17.23 21. How many ambulances are 28. From what source(s) does your
Office personnel (non- typically kept as reserve units? system stock ambulances with
uniformed/civilian) $12.90 None 40.16% consumable medical supplies?
Midpoint hourly One or two 38.52% Your organization 53.72%
First responder $14.50 Three to five 13.11% Local hospitals 2.48%
EMT-Basic $10.49 Five to 10 5.74% Both 43.80%
EMT-Intermediate $10.25 10 to 25 1.64%
More than 25 0.82% 29. From what source(s) does your
EMT-Paramedic $14.04
system stock ambulances with
Registered nurse $19.00
22. Are your reserve ambulances kept medications?
Education and/or QI $18.00
fully stocked and ready to roll? Your organization 44.25%
Field supervision $15.00
Yes 81.91% Local hospitals 29.20%
Management/admin. $20.54
No 18.09% Both 26.55%
Office personnel (non-
uniformed/civilian) $13.00
23. How many ambulances are ALS- 30. If your organization operates an
Maximum hourly
capable? air-medical service, how many rotary-
EMT-Basic $13.08
None 16.67% wing aircraft do you currently
EMT-Intermediate $11.08
One or two 29.17% operate?
EMT-Paramedic $17.55
Three to five 25.83% More than three 100.00%
Registered nurse $22.00
Five to 10 12.50%
Field supervision $16.50
10 to 25 12.50% 31. How many aircraft are front-line
Management/admin. $26.22 aircraft?
More than 25 3.33%
Office personnel (non- Three 50.00%
uniformed/civilian) $16.13 More than three 50.00%
24. How many ambulances are only
BLS-capable?
16. How many hours per week do 32. Is your jurisdiction covered by 9-1-
None 61.68%
field providers work on average? 1 as a universal emergency number?
One or two 25.23%
Under 20 13.89% Yes 98.44%
Three to five 10.28%
20 to 40 18.52% No 1.56%
Five to 10 0.93%
41 to 50 26.85%
10 to 25 1.87%
Over 50 40.74% 33. Is the 9-1-1 system enhanced (i.e.,
25. How many other response vehicles landline 9-1-1 automatically provides
17. Are field providers subject to a the caller’s location and number)?
are operated by your organization
FLSA 40-hour workweek? Yes 96.06%
(including supervisory units, MCI units,
Yes 45.00% No 3.94%
rescue units, etc.)?
No 55.00%
None 19.05%
One or two 34.92% 34. What was your aggregate
18. What is the total number of response time for 2005?
Three to five 23.81%
transport ambulances operated by Minutes 6.03
Five to 10 13.49%
your organization? Seconds 30.22
10 to 25 5.56%
One or two 36.04% Information not available 35.54%
More than 25 3.17%
Three to five 31.53%
Five to 10 16.22%

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 systems survey

35. Your aggregate response time is 43. Does your communications system 49. Is continuous National Registry
calculated by what method? use mobile data terminals? certification mandated in your system?
Average—50% 32.76% Yes 34.92% Yes 21.09%
Fractile—90% 19.83% No 65.08% No 78.91%
Other 9.48%
Information not available 37.93% 44. Does your communications system 50. If so, who mandates it?
use a system of call screening and Organization 21.21%
36. When does the response time prioritization? Regional regulatory agency 3.03%
clock start? APCO 9.38% State regulatory agency 75.76%
When the 9-1-1 line rings 3.20% Medical Priority Dispatch 34.38%
When the 9-1-1 call is answered 13.60% Other 7.03% 51. How is initial EMS training
When information is available to None 32.03% provided in your system?
dispatch the assignment 28.00% Information not available 17.19% Providers receive training prior to
When the assignment is hiring
dispatched 47.20% 45. What is your primary radio Yes 79.53%
When the first unit is rolling 4.80% communication frequency? No 20.47%
Information not available 3.20% VHF low band 15.87% Providers receive training after they
VHF high band 45.24% are hired
37. When does the response time UHF 7.94% Yes 54.69%
clock stop? 800 MHz 30.95% No 45.31%
When the first unit arrives at
the address 45.60% 46. What is your secondary radio 52. Are you looking to replace or
When the first ambulance arrives communication system? supplement any of your traditional
at the address 41.60% VHF low band 14.29% classroom-based training with learning
When a responder arrives at VHF high band 28.57% products?
the patient 7.20% UHF 13.49% Yes 63.28%
Information not available 5.60% 800 MHz 10.32% No 36.72%
Cellular 65.87%
38. Who provides primary dispatch Nextel 25.40% 53. How are core EMS certifications
services for your organization? Digital or alphanumeric 29.37% provided in your system?
Your organization 18.75% Other 3.97% Certifications are provided by your
Fire department 2.34% organization
Law enforcement 21.88% 47. List any EMS special operations Yes 33.59%
Multijurisdictional comm center 57.03% components that your organization No 66.41%
participates in and how they are Certifications are provided by another
39. Does your organization use any primarily staffed. training organization
radio codes (10-codes or signals)? Hazardous materials Yes 87.50%
Yes 34.38% You are the primary agency 18.92% No 12.50%
No 65.63% Multi-agency team 81.08%
Technical rescue 54. How are refresher EMS certifica-
40. Is your organization capable of You are the primary agency 24.66% tions provided in your system?
regular and routine radio communica- Multi-agency team 75.34% Certifications are provided by your
tions with any of the following? Collapse rescue organization
Air-medical services 81.60% You are the primary agency 22.95% Yes 62.79%
Fire department 95.20% Multi-agency team 77.05% No 37.21%
Hospitals 90.40% Disaster Medical Assistance Team Certifications are provided by another
Law enforcement 68.80% You are the primary agency 2.70% training organization
Mutual-aid EMS agencies 89.60% Multi-agency team 97.30% Yes 72.87%
Other EMS agencies 62.40% Water rescue No 27.13%
You are the primary agency 38.89%
41. Does your communications system Multi-agency team 61.11% 55. How are other EMS training
use automatic vehicle locators? Tactical EMS programs offered in your system?
Yes 17.97% EMS providers are armed Certifications are provided by your
No 82.03% team members 9.84% organization
EMS providers are not armed 90.16% Yes 80.62%
42. Does your communications system Other No 19.38%
use a CAD system? Yes 13.83% Certifications are provided by another
Yes 76.56% No 86.17% training organization
No 23.44% Yes 64.34%
48. Does your organization routinely No 35.66%
use the incident command system?
Yes 96.83% No 3.17%

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56. Are providers paid (overtime, Providing CPAP treatment? Medical supplies and
compensatory time, etc.) for training Yes 33.87% consumables 11.70%
once they are hired? No 66.13% Personnel costs (salaries,
Yes 63.93% Providing pharmacologic-assisted benefits, etc.) 63.30%
No 36.07% intubation (RSI)? Other capital costs 13.60%
Standing orders 22.76% Other costs 9.79%
57. Are providers given time off for Medical control only 11.38% Other operational costs 13.95%
training? Not allowed 65.85%
Yes 66.40% Providing surgical airways? 69. Does your organization have a
No 33.60% Standing orders 26.61% physician medical director?
Medical control only 19.35% Yes 90.00%
58. Does your organization provide Not allowed 54.03% No 10.00%
tuition reimbursement for college? Providing other invasive airways?
Yes 48.06% Standing orders 58.54% 70. Is your medical director
No 51.94% Medical control only 13.82% compensated?
Not allowed 26.83% Yes, by this organization 35.90%
59. Does your organization provide all Providing adult intraosseous infusion? Yes, by another organization 26.50%
required uniforms or a regular uniform Standing orders 47.58% Yes, costs shared 4.27%
allowance? Medical control only 12.90% No 33.33%
Yes 85.38% Not allowed 39.52%
No 14.62% Providing needle thoracentesis? 71. Who is your medical director’s
Standing orders 50.00% primary employer?
60. Does your organization provide Medical control only 16.13% EMS organization 6.72%
health benefits? Local hospital 70.59%
Not allowed 33.87%
Yes 72.09% Other 22.69%
Administering narcotics for seizures?
No 27.91%
Standing orders 62.60%
Medical control only 13.82% 72. Are your organization’s front-line
61. Does your organization provide providers organized in a labor union?
Not allowed 23.58%
incentive pay for: Yes 27.91%
Administering narcotics for analgesia?
Additional training levels/certificates? No 72.09%
Standing orders 55.65%
Yes 48.78%
Medical control only 22.58%
No 51.22% 73. Is your organization accredited by
Not allowed 21.77%
Call volume? an independent body such as CAAS?
Providing field termination of cardiac
Yes 7.69% Yes 4.65%
arrest resuscitation?
No 92.31% No 95.35%
Standing orders 36.80%
Specialty team membership?
Medical control only 53.60%
Yes 23.53% 74. What type of patient
Not allowed 9.60%
No 76.47% documentation do you use?
Other? Paper 47.69%
64. Do you routinely respond to all
Yes 7.26% PC-based 33.08%
emergencies with lights and sirens?
No 92.74% Palm/pocket PC 2.31%
Yes 77.34%
Web-based 16.92%
No 22.66%
62. Who sets your medical treatment
protocols? 75. Does your organization bill for
65. Do you routinely transport all
Your organization services?
patients to hospitals with lights and
Yes 36.92% Yes 80.62%
sirens?
No 63.08% No 19.38%
Yes 9.17%
Local or regional protocols No 90.83%
Yes 63.08% 76. If yes, who provides your billing?
No 36.92% 66. Who is responsible for making the Your department 29.91%
State protocols decision about lights and sirens? Another in-house branch 11.21%
Yes 45.38% EMS crew discretion 82.03% Outsourced to private company 58.88%
No 54.62% Protocol-driven 16.41%
Not applicable 1.56% 77. What type of billing system do
63 Is your organizaton capable of: 67. What was your 2005 total you use?
Obtaining 12-lead ECGs? operating budget? Billing service 50.47%
Yes 67.44% $8,963,408.72 Commercial software 33.64%
No 32.56% Custom-made software 8.41%
Regularly transmitting 12-lead ECGs 68. How much of this budget was Paper 7.48%
to base or receiving hospitals? allocated to the following?
Yes 32.03% Capital vehicle costs 11.42%
No 67.97% Educational costs 5.57%

182 DECEMBER 2006 ■ EMS ■ www.emsresponder.com