ESO Releases 2022 EMS Index 

PRESS RELEASE

ESO, a leading data and software company serving emergency medical services (EMS), fire departments, hospitals, state and federal agencies, has announced the findings of its 2022 ESO EMS Index. The Index tracks data for more than 2000 EMS agencies nationwide across both performance and surveillance measures: stroke assessment documentation, 12-lead electrocardiogram (EKG) acquisition for hospital-confirmed heart attack (STEMI/NSTEMI), ketamine administration with patient weight recorded and end-tidal carbon dioxide (EtCO₂) documented, lights and siren use, nontransport of patients by EMS following a 9-1-1 call, encounters involving death notifications, and percent of patients with suspected overdose.

In addition to measures across EMS, this year’s Index takes a deeper look at a handful of measures across patient race/ethnicity and gender to identify disparities in response and treatment. 

“This is the fifth year of our annual EMS Index, and we continue to see how agencies and departments are using data to make meaningful and deliberate decisions that have a positive impact,” said Dr. Brent Myers, chief medical officer for ESO. “Additionally, we take a hard look at how, as EMS, we respond to our diverse patient population to identify where we have gaps and disparities when it comes to assessment and care for all members of a community.”

Key findings include: 

• Stroke assessment performance—The data show a slight increase in the number of stroke assessments performed at 73%, up from 72% in 2020. However, when we break down stroke screening by patient race and ethnicity, we find variation in the rates of completed assessments.
• 12-lead EKG with ED-diagnosed STEMI/NSTEMI—Approximately 70% of EMS patients who were diagnosed with a STEMI or NSTEMI in the emergency department had a documented 12-lead EKG. This indicates there is room for improvement in prehospital STEMI/NSTEMI identification.
• Ketamine administration with patient weight recorded—In 83% of cases, patients administered ketamine had their weight documented in the EMS record. 
• Lights and siren use—EMS use of lights and siren must be judicious as studies show that use of these emergency signals increase risk of ambulance crashes. Overall, most patients were transported without lights and siren (83%).   
• Nontransport dispositions—Overall nontransport dispositions represented 16% of all 9-1-1 encounters, down from 22% in 2020.  
• Death notifications—A substantial increase in on-scene deaths during COVID means EMS clinicians delivered up to 47% more death notifications than pre-COVID. This includes patients for whom resuscitation was not attempted or resuscitation efforts were terminated on-scene.
• Percent of encounters for suspected overdose—Encounters involving patients who experienced suspected overdose accounted for 2.6% of 9-1-1 calls, which is slightly lower than the 2.7% observed in 2020. However, on-scene death rates jumped 67% from pre-COVID.  

“While it’s fantastic to see improvements across many of the metrics, we know there are still some areas that warrant further attention across the entire EMS landscape,” added Myers. “We are excited to continue partnerships with our customers and the industry to share data-driven knowledge that helps improve the health and safety of all our communities.”

Download the full 2022 ESO EMS Index here.

The dataset from the ESO Data Collaborative used for the ESO EMS Index is real-world, de-identified data, compiled and aggregated from more than 2000 agencies across the United States that use ESO’s products and services and agreed to share their data for research purposes. This report is based on 9.9 million anonymized 9-1-1 encounters between January 1, 2021 and December 31, 2021, representing a full calendar year.