2nd Annual National EMS Systems Survey

EMS Magazine offers the results of its second comprehensive survey of EMS systems in the United States.
Future issues of EMS will feature expert commentary on the findings of this survey. The questionnaire for the 3rd Annual National EMS Systems Survey will be featured in the July 2005 issue of EMS Magazine and online at www.emsmagazine.com.

1. What is the population served by your organization according to the 2000 U.S. Census?
Up to 1,000 2.44%
1,000 to 10,000 26.83%
10,000 to 50,000 47.56%
50,000 to 100,000 8.54%
100,000 to 250,000 7.32%
250,000 to 500,000 1.22%
Over 500,000 6.10%

2. What is the size of the area covered by your organization in square miles?
Up to 10 square miles 11.25%
10 to 50 square miles 28.75%
50 to 100 square miles 8.75%
100 to 500 square miles 21.25%
500 to 1,000 square miles 11.25%
Over 1,000 square miles 18.75%

3. How many calls did your organization respond to in 2003?
Up to 100 calls 4.71%
100 to 500 calls 15.29%
500 to 1,000 calls 12.94%
1,000 to 10,000 calls 52.94%
10,000 to 50,000 calls 10.59%
50,000 to 100,000 calls 1.18%
Over 100,000 calls 2.35%

4. How are calls calculated in your system?
Two or more units responding to the same call are counted as two or more calls: 37.50%
Two or more units responding to the same call are counted as the same call: 62.50%

5. How many patients did you transport in 2003?
Up to 100 patients 4.41%
100 to 500 patients 13.24%
500 to 1,000 patients 14.71%
1,000 to 10,000 patients 36.76%
10,000 to 50,000 patients 7.35%
50,000 to 100,000 patients 1.47%
Over 100,000 patients 2.94%
These figures are not available 19.12%

5. What type of system do you operate?
Fire department with cross-trained EMS personnel 24.72%
Fire department with separate EMS personnel 3.37%
Government or third-service 20.22%
Hospital-based 5.62%
Police department with separate EMS personnel 6.74%
Private company 12.36%
Public utility model 7.87%
Other 19.10%

7. What type of calls does your organization usually respond to?
Emergency only 49.44%
Combination of emergency and interfacility 50.56%

8. How is your organization staffed?
Career personnel 42.70%
Volunteer personnel 25.84%
Both career and volunteer personnel 31.46%

9. Please list the services provided by your organization
ALS ambulance transport 73.03%
BLS ambulance transport 64.04%
ALS first response 28.09%
BLS first response 35.96%
Air-medical transport 4.49%

10. In your system, first-response services are provided at the following levels:
ALS 65.52%
BLS 62.07%
AED 24.42%
None 8.14%

11. In your system, first-response services are provided by:
EMS department 50.57%
Fire department 64.37%
Police department 34.48%
Other department 8.05%

12. Do you operate a tiered-response system?
All ALS transport 29.07%
ALS and BLS transport 47.67%
BLS transport with non-ALS transport 6.98%
BLS transport only 9.30%
Other 6.98%

13. How many frontline EMS providers are there in your organization?
First Responder 12.59
EMT-Basic 21.35
EMT-Intermediate 11.10
EMT-Paramedic 19.77
Registered Nurse 3.70

14. How many personnel in your
organization are assigned to full-time
non-response jobs?
Education and/or quality improvement 9.18
Field supervision 3.93
Management/administration 3.55
Office personnel (non-uniformed or civilian) 17.82
Support/logistics/other 11.67

15. For the following job titles, what is the entry-level, midpoint and maximum annual salary available in your organization?
Entry annual salary
First Responder $14,468.00
EMT-Basic $25,030.06
EMT-Intermediate $26,089.25
EMT-Paramedic $32,101.63
Registered Nurse $30,000.00
Education and/or QI $39,120.14
Field Supervision $44,320.61
Management/administration $47,440.14
Office personnel (non-uniformed/civilian) $24,630.40
Support/logistics $31,600.00

Midpoint annual salary
First Responder $15,000.00
EMT-Basic $25,799.21
EMT-Intermediate $30,534.00
EMT-Paramedic $36,831.24
Registered Nurse $45,760.00
Education and/or QI $53,622.00
Field Supervision $42,689.83
Management/administration $55,944.44
Office personnel (non-uniformed/civilian) $27,070.50
Support/logistics $43,500.00

Maximum annual salary
First Responder $14,468.00
EMT-Basic $32,774.30
EMT-Intermediate $33,485.74
EMT-Paramedic $43,865.49
Registered Nurse $44,000.00
Education and/or QI $54,027.40
Field Supervision $53,993.88
Management/administration $60,664.40
Office personnel (non-uniformed/civilian) $31,615.67
Support/logistics $40,000.00

Entry hourly
EMT-Basic $8.50
EMT-Intermediate $10.60
EMT-Paramedic $12.80
Registered Nurse $21.92
Education and/or QI $29.00
Field Supervision $18.00
Management/administration $22.45
Office personnel (non-uniformed/civilian) $13.08

Midpoint hourly
EMT-Basic $10.21
EMT-Intermediate $15.63
EMT-Paramedic $15.11
Registered Nurse $26.40
Education and/or QI $31.00
Management/administration $33.17
Office personnel (non-uniformed/civilian) $15.00

Maximum hourly
EMT-Basic $12.28
EMT-Intermediate $15.92
EMT-Paramedic $18.02
Registered Nurse $30.88
Education and/or QI $33.00
Field Supervision $25.00
Management/administration $35.75
Office personnel (non-uniformed/civilian) $17.25

16. How many hours per week do field providers work on average?
Under 20 15.28%
20 to 40 16.67%
40 to 50 33.33%
Over 50 34.72%

17. Are field providers subject to an FLSA 40-hour work week?
Yes 46.25% No 53.75%

18. What is the total number of transport ambulances operated by your organization?
One or two 29.27%
Three to five 36.59%
Five to 10 21.95%
10 to 25 8.54%
More than 25 3.66%

19. What is the minimum number of ambulances staffed 24/7 in your system?
One or two 64.47%
Three to five 17.11%
Five to 10 13.16%
10 to 25 1.32%
More than 25 3.95%

20. What is the peak number of ambulances staffed in your system?
One or two 42.50%
Three to five 28.75%
Five to 10 17.50%
10 to 25 5.00%
More than 25 5.00%

21. How many ambulances are typically kept as reserve units?
None 24.10%
One or two 60.24%
Three to five 7.23%
Five to 10 6.02%
More than 25 2.41%

22. Are your reserve ambulances kept fully stocked and ready to roll?
Yes 88.57%
No 11.43%

23. How many ambulances are ALS-capable?
None 22.22%
One or two 23.46%
Three to five 24.69%
Five to 10 18.52%
10 to 25 7.41%
More than 25 3.70%

24. How many ambulances are only BLS-capable?
None 40.54%
One or two 33.78%
Three to five 14.86%
Five to 10 6.76%
10 to 25 1.35%
More than 25 2.70%

25. How many other response vehicles are operated by your organization (including supervisory units, MCI units, rescue units, etc.)?
None 27.38%
One or two 38.10%
Three to five 17.86%
Five to 10 8.33%
10 to 25 5.95%
More than 25 2.38%

26. How many administrative and support vehicles are operated by your organization (including unmarked units and those not typically used for emergency responses)?
None 57.50%
One or two 28.75%
Three to five 12.50%
Five to 10 1.25%

27. Your system stocks ambulances with consumable medical supplies from:
Your organization 55.95%
Local hospitals 2.38%
Both 41.67%

28. Your system stocks ambulances with medications from:
Your organization 47.37%
Local hospitals 28.95%
Both 23.68%

29. If your organization operates an air-medical service, how many rotary-wing aircraft do you currently operate?
Two 50%
More than three 50%

30. Is your jurisdiction covered by 9-1-1 as a universal emergency number?
Yes 100.00%

31. Is the 9-1-1 system enhanced (landline 9-1-1 automatically provides the caller’s location and number)?
Yes 95.12%
No 4.88%

32. What was your aggregate average response time for 2002?
Six minutes and 40 seconds

33. Your aggregate response time is calculated by which method?
Average - 50% 28.00%
Fractile - 90% 18.67%
Other 6.67%
This information is not available 46.67%

34. When does the response time clock START?
When the 9-1-1 line rings 9.41%
When the 9-1-1 call is answered 14.12%
When information is available to dispatch the assignment 23.53%
When the assignment is dispatched 44.71%
When the first unit is wheels-rolling 2.35%
This information is not available 5.88%

35. When does the response time clock STOP?
When the first unit arrives at the address 31.33%
When the first ambulance arrives at the address 54.22%
When a responder arrives at the patient 9.64%
This information is not available 4.82%

36. Who provides primary dispatch services for your organization?
Your organization 16.28%
Fire department 2.33%
Law enforcement 34.88%
Multijurisdictional communications center 46.51%

37. Does your organization use ANY radio codes (10-codes or signals)?
Yes 51.19%
No 48.81%

38. Is your organization capable of regular and routine radio communications with any of the following?
Air-medical services 46.51%
Fire department 56.47%
Hospitals 58.82%
Law enforcement 47.06%
Mutual aid EMS agencies 56.98%
Other EMS agencies 48.84%

39. Does your communications system use automatic vehicle locators?
Yes 8.33%
No 91.67%

40. Does your communications system use a computer-aided dispatch system?
Yes 59.76%
No 40.24%

41. Does your communications system use mobile data terminals?
Yes 12.20%
No 87.80%

42. Does your communications system use a system of call screening and prioritization?
APCO 12.82%
Medical Priority Dispatch System (MPDS) 29.49%
Other 3.85%
None 39.74%
This information is not available 14.10%

43. What is your primary radio communication frequency?
VHF low band 10.13%
VHF high band 51.90%
UHF 16.46%
800 MHz 16.46%
Other 5.06%
44. What is your secondary radio communication system?
VHF low band 17.28%
VHF high band 31.25%
UHF 22.22%
800 MHz 15.00%
Cellular 58.02%
Nextel 19.75%
Digital or alphanumeric pagers 24.69%
Other 2.47%

45. List any EMS special operations components that your organization
participates in and how they are primarily staffed:
Hazardous Materials
You are the primary agency 18.75%
Multi-agency team 81.25%
Technical Rescue
You are the primary agency 29.79%
Multi-agency team 70.21%
Collapse Rescue
You are the primary agency 25.58%
Multi-agency team 74.42%
DMAT
You are the primary agency 16.13%
Multi-agency team 83.87%
Water Rescue
You are the primary agency 34.88%
Multi-agency team 65.12%
Tactical EMS
EMS providers are armed team members 17.50%
EMS providers are not armed 82.50%

46. Does your organization routinely use the Incident Command System?
Yes 79.52%
No 20.48%

47. Is continuous National Registry certification mandated in your system?
Yes 19.75%
No 80.25%

48. If so, who mandates this?
Organization 27.27%
Regional regulatory agency 9.09%
State regulatory agency 63.64%

49. How is initial EMS training provided in your system?
Providers receive training prior to hiring Yes 79.27%
No 20.73%
Providers receive training after they are hired
Yes 47.50%
No 52.50%

50. Are you looking to replace or supplement any of your traditional classroom-based training with e-learning products?
Yes 45.78%
No 54.22%

51. How are core EMS certifications (EMT, paramedic, etc.) provided in your system?
Certifications are provided by your organization
Yes 28.57%
No 71.43%
Certifications are provided by another training organization
Yes 91.57%
No 8.43%

52. How are refresher EMS certifications (EMT, paramedic, etc.) provided in your system?
Certifications are provided by your organization
Yes 58.54%
No 41.46%
Certifications are provided by another training organization
Yes 81.71%
No 18.29%

53. How are other EMS training programs (CPR, ACLS, etc.) offered in your system?
Certifications are provided by your organization
Yes 75.90%
No 24.10%
Certifications are provided by another training organization
Yes 69.88%
No 30.12%

54. Are providers paid (overtime, compensatory time, etc.) for training once they are hired?
Yes 51.90%
No 48.10%

55. Are providers given time off for training?
Yes 65.33%
No 34.67%

56. Does your organization provide tuition reimbursement for college education?
Yes 45.24%
No 54.76%

57. Does your organization provide all required uniforms or provide a regular uniform allowance?
Yes 81.93%
No 18.07%
58. Does your organization provide health benefits?
Yes 65.85%
No 34.15%

59. Does your organization provide incentive pay for:
Additional training level/certificates?
Yes 42.50%
No 57.50%
Call volume?
Yes 10.26%
No 89.74%
Specialty team membership?
Yes 13.92%
No 86.08%

60. Who sets your medical treatment
protocols?
Your organization
Yes 45.12%
No 54.88%
Local or regional protocols
Yes 56.25%
No 43.75%
State protocols
Yes 50.00%
No 50.00%

61. Is your organizaton capable of obtaining the following?
12-lead ECG
Yes 58.54%
No 41.46%
Regularly transmitting 12-lead ECG to base or receiving hospitals
Yes 37.04%
No 62.96%
Providing CPAP treatment
Yes 21.25%
No 78.75%
Pharmacologic-assisted
intubation (RSI)
Standing orders 13.58%
Medical control only 9.88%
Not allowed 76.54%
Surgical airway
Standing orders 28.05%
Medical control only 19.51%
Not allowed 52.44%
Other invasive airway
Standing orders 46.25%
Medical control only 20.00%
Not allowed 33.75%
Adult intraosseous infusion
Standing orders 28.05%
Medical control only 14.63%
Not allowed 57.32%
Needle thoracentesis
Standing orders 32.93%
Medical control only 20.73%
Not allowed 46.34%
Administering narcotics for seizures
Standing orders 60.98%
Medical control only 9.76%
Not allowed 29.27%
Administering narcotics for analgesia
Standing orders 51.22%
Medical control only 18.29%
Not allowed 30.49%
Field termination of cardiac arrest
resuscitation
Standing orders 38.55%
Medical control only 42.17%
Not allowed 19.28%

62. Do you routinely respond to all emergencies with lights and sirens?
Yes 65.06%
No 34.94%

63. Do you routinely transport all patients to hospital with lights and sirens?
Yes 8.75%
No 91.25%

64. Who is responsible for making the decision about lights and sirens?
EMS crew discretion 79.76%
Online medical control 1.19%
Protocol-driven 14.29%
Not applicable 4.76%

65. How much of your 2003 total operating budget was allocated to the following?
Capital vehicle costs 14.79%
Educational costs 5.95%
Medical supplies and consumables 11.17%
Personnel costs (salaries, benefits, etc.) 59.67%
Other capital costs 9.92%
Other costs 11.24%
Other operational costs 11.37%

66. Does your organization have a
physician medical director?
Yes 92.94%
No 7.06%

67. Is your medical director compensated?
Yes, by the organization 24.68%
Yes, by another organization 32.47%
Yes, costs shared 5.19%
No 37.66%

68. Who is your medical director’s primary employer?
EMS organization 3.75%
Local hospital 76.25%
Other 20.00%

69. Are your organization’s frontline providers organized in a labor union?
Yes 14.46%
No 85.54%

70. Is your organization accredited by an independent body such as CAAS or CAMTS?
Yes 6.02%
No 93.98%

71. What type of patient documentation do you use?
Paper 61.18%
PC-based 31.76%
Palm/Pocket PC 4.71%
Web-based 2.35%

72. Does your organization bill for services?
Yes 84.52%
No 15.48%

73. If yes, who provides your billing?
Your department 40.00%
Another in-house branch 17.14%
Outsourced to private company 42.86%

74. What type of billing system do you use?
Billing service 37.14%
Commercial software 37.14%
Custom-made software 12.86%
Paper 12.86%

75. What resources do you use for information on EMS products and services?
Conferences and trade shows
Yes 87.80%
No 12.20%
Manufacturer-distributed information
Yes 83.75%
No 16.25%
Trade publications
Yes 87.80%
No 12.20%
Websites
Yes 80.49%
No 19.51%