For many of us, the image we have of first responders comes mostly from television and movies.
We picture ambulances with sirens wailing and lights flashing en route to the scene of an emergency. We imagine emergency medical service (EMS) clinicians tending to seriously ill and injured patients, administering emergency medical care, and whisking them away to a hospital.
EMS clinicians are first responders, emergency medical technicians, paramedics, and others whose titles may not always suggest their EMS duties. For example, firefighters and nurses may provide pre-hospital emergency medical care as part of their routine job duties. They are all vital to emergency response.
There are several coordinated efforts underway by federal agencies to help create resilient, stable, and capable EMS systems. They include initiatives to share EMS data, develop the workforce, and enhance public health readiness.
Public Health & EMS Collaboration
EMS systems provide an essential service in response to emergencies. The last few years have reminded us how important EMS clinicians are to our healthcare, public health, emergency management, and public safety systems, especially in times of crisis.
During the COVID-19 pandemic, EMS clinicians helped keep people out of the hospital by evaluating them in their homes and nursing facilities. They administered vaccines and treatments for COVID-19. They staffed emergency operations centers, hospitals, and other medical facilities around the country. All the while putting themselves at risk for injuries and illnesses, including mental harm caused by the inherent stressors of the job.
The National Highway Traffic Safety Administration (NHTSA) has partnered with the National Institute for Occupational Safety and Health (NIOSH). Together they are developing risk mitigation strategies and interventions to protect and improve the health and resilience of our EMS workforce.
It’s important that local, regional, and state EMS leaders work closely with public health, 911 emergency communications systems, and emergency management to prepare for future public health emergencies.
NHTSA’s Office of EMS (OEMS) is part of a national focus on integrating EMS into planning and preparedness initiatives. It is co-funding a project to research and publish best practices for engagement and collaboration between EMS, 911, public health, and emergency management. It will serve as a valuable tool that can help reduce morbidity and mortality during public health emergencies and promote population health and illness/injury prevention.
During the COVID-19 response, the FEMA/HHS Healthcare Resilience Working Group’s Prehospital EMS/911 team was led by the OEMS. It brought together 27 SMEs from the EMS and 911 industries, generating over 36 cleared documents to help EMS and 911 function throughout the pandemic by collaborating with federal, state, and local partners. Additionally, the use of information exchange between the community and OEMS allowed for shared learning and best practices on how to best manage triage and transport throughout the pandemic.
The Value of Data
NHTSA’s OEMS supports efforts to improve EMS and 911 systems, using evidence based on data, to improve the response to and treatment of patients suffering from traffic crashes, severe injuries, acute illness, or other medical emergencies.
Every encounter between an EMS clinician and a patient is documented following the National EMS Information System (NEMSIS) data standard. Portions of the collected patient care data are submitted to the National EMS Database.
EMS data has proven valuable to researchers, policymakers, and public health officials on topics ranging from COVID-19, drug overdose, stroke care, and traffic crashes. It is used at the local, state, and national levels to improve care and develop evidence-based guidelines.
NEMSIS data were used to develop Prehospital Evidence Based Guidelines on naloxone administration and pain management. It’s also used by the National EMS Quality Alliance to develop performance measures for the National Guideline for the Field Triage of Injured Patients.
NEMSIS is providing the CDC with data on EMS activations that it use to conduct syndromic surveillance, monitor health-related trends, and inform and assess public health interventions. In coordination with state and local partners, federal agencies are exploring ways to link NEMSIS data with other data to monitor and improve outcomes, while protecting patient confidentiality.
Many EMS systems across the country face challenges to providing essential services. They include funding, recruitment, and retention.
With an understanding of the unique challenges faced by rural and tribal communities, the OEMS is working with them to improve communications and access to available resources. The OEMS collaborates with national partners to enhance interstate recognition and reciprocity of EMS personnel.
The theme of this year’s National EMS Week is “Rising to the Challenge.” Meeting current and future challenges requires the people of the EMS system to work together to meet the emergency medical needs of people in every kind of emergency.