Facts & Data
Specific problems of the industry
Tracking & Organizing personal certifications.
Time-consuming and confusing to research the industry.
Reliance Word of mouth information.
Varied city, state, & company requirements.
Difficultly in determining steps to achieve career goals.
Geographic barriers for individuals lacking access to essential industry networks and resources.
Large scale issues
Growing need for first responders amid an inadequate workforce.
Increased call volume, coupled with a shortage of first responders, has resulted in inadequate rest.
This has led to longer response times, health issues for first responders, and an increase in emergency vehicle crashes.
Lack of EMS workers
According to a 2022 report by the National Association of Emergency Medical Technicians (NAEMT), 39% of EMS agencies face a shortage of EMTs, while 55% report a shortage of paramedics.
A 2021 report by the American Ambulance Association (AAA) highlights a deficit in the EMS workforce, with turnover rates as high as 20-30% annually in some areas.
According to the Bureau of Labor Statistics (BLS), the demand for EMTs and paramedics is projected to grow by 7% from 2021 to 2031, outpacing the average growth rate for all occupations.
Regional examples of EMS shortages:
Minnesota: A 2021 survey by the Minnesota Ambulance Association found that 90% of ambulance services reported staffing shortages, significantly impacting rural areas and causing delays in emergency response times.
North Carolina: A 2022 report from WFMY News stated that over 20 counties in North Carolina had EMS vacancies exceeding 20%, leading to significant delays in response times and overburdening of current staff
New York City: From 2010 to 2019, the FDNY saw a 22% increase in EMS calls, with opioid overdoses and mental health crises contributing to this growth.
In California, the Los Angeles Fire Department (LAFD) saw a 16% increase in EMS calls from 2013 to 2018, largely attributed to the growing elderly population and chronic health issues.
New York City experienced a 22% increase in EMS calls between 2010 and 2019, with mental health crises and opioid overdoses driving much of the demand.
Rural Areas: Rural EMS services have also seen increases, largely due to aging populations and increased travel distances to healthcare facilities. Rural EMS providers reported increases of 5-10% annually over the past decade.
Why there is an increase in call volume for EMS workers:
Overall Increase: According to the National Emergency Medical Services Information System (NEMSIS), EMS call volume in the U.S. has steadily increased by about 4-6% annually over the past decade.
For example, NEMSIS data shows that EMS responded to over 37.7 million calls in 2019, compared to 32.5 million in 2014.
Opioid Epidemic: In the U.S., EMS responses related to opioid overdoses increased sharply, particularly from 2015 to 2017, with some states reporting increases as high as 200-300% during peak years of the opioid crisis. These call volumes have since plateaued but remain higher than pre-crisis levels.
Aging Population: The growing elderly population has been a major contributor, with EMS responses to people aged 65+ increasing by around 6-8% annually in many areas. Seniors account for a disproportionate number of EMS calls, particularly related to falls, cardiac events, and respiratory issues.
COVID-19 Pandemic: In 2020, EMS call volume was significantly impacted by the pandemic, with an initial decrease in non-emergency medical calls as people avoided hospitals. However, there was a notable increase in COVID-related and critical care transport calls, particularly in regions heavily affected by the virus.
According to the Centers for Disease Control and Prevention (CDC), approximately 6 in 10 adults in the U.S. have a chronic disease, and 4 in 10 have two or more chronic conditions. These health issues often result in emergency medical calls, particularly for life-threatening events like heart attacks and strokes.
Calls related to mental health crises and substance abuse are on the rise, putting additional pressure on EMS systems. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported a 24% increase in the number of Americans experiencing mental health crises between 2017 and 2021.
According to the CDC, the prevalence of obesity among U.S. adults has risen from 30.5% in 1999-2000 to 42.4% in 2017-2018. This increase has led to a higher incidence of obesity-related emergencies, including cardiovascular disease and respiratory distress.
EMS systems have reported a 5-8% annual increase in calls related to diabetes complications, particularly in communities with high rates of obesity.
Longer response times
Staffing Shortages:
Many EMS agencies have been facing staffing shortages in recent years, exacerbated by burnout, retirements, and difficulties in recruiting new EMTs and paramedics.
The American Ambulance Association (AAA) reported that 39% of EMS providers were experiencing staffing shortages in 2021, leading to longer response times in both urban and rural areas.
Call Volume Increases:
According to the National Association of Emergency Medical Technicians (NAEMT), some EMS agencies reported response time increases of up to 20% in certain areas over the past few years.
Hospital Overcrowding and Offload Delays:
Hospital overcrowding and extended offload times (the time it takes to transfer a patient from the ambulance to the emergency department) have been growing problems.
A 2021 survey from the National EMS Advisory Council (NEMSAC) found that ambulance offload delays in emergency departments contributed to 16-22% longer EMS turnaround times, as ambulances were held up waiting for hospital space to become available.
Urban vs. Rural Divide:
Urban areas have seen moderate increases in response times due to traffic congestion and call volume increases. In contrast, rural areas have experienced even more significant delays due to the growing demand and longer travel distances.
Rural EMS response times have increased by 8-10 minutes in some regions, as reported by the Rural Health Information Hub, particularly in states with large geographical coverage areas like Montana and Wyoming.
Data from Major Cities:
Los Angeles, CA: In 2021, the Los Angeles Fire Department (LAFD) reported that EMS response times had increased by over 30% compared to 2019, with wait times for non-life-threatening calls averaging more than 15-20 minutes.
New York City, NY: The FDNY saw EMS response times increase to 9.5 minutes on average for life-threatening emergencies in 2021, up from 7 minutes in 2019.
Dallas, TX: Dallas-Fort Worth saw a similar trend, with response times increasing from an average of 8.7 minutes in 2019 to 11.3 minutes in 2021, particularly due to staffing shortages and higher call volumes.
EMS Wait Time Standards:
According to the National Fire Protection Association (NFPA), the standard goal for EMS response times in urban areas is 8 minutes or less for 90% of calls. However, many cities are struggling to meet this standard due to the issues mentioned above
EMS workers getting inadequate rest
Longer Working Hours:
EMS Worker Shifts: Many EMS workers, particularly paramedics and EMTs, often work 12 to 24-hour shifts, with some working 48-hour shifts in certain regions. These extended hours are a long-standing practice in EMS due to the unpredictable nature of emergency calls, but they have been associated with high levels of fatigue.
Overtime and Staffing Shortages: A 2021 survey by the American Ambulance Association (AAA) reported that 39% of EMS agencies were experiencing significant staffing shortages, leading to mandatory overtime and longer workweeks for many EMS professionals. In some cases, EMS workers were logging more than 60-80 hours per week due to the shortage of personnel.
Sleep Deprivation and Fatigue:
A study published in Prehospital Emergency Care in 2020 found that 69% of EMS workers reported severe sleep deprivation, citing their irregular shifts, long hours, and frequent nighttime emergency calls. Many EMS workers also reported chronic fatigue due to limited recovery time between shifts.
A 2018 survey by the National Association of Emergency Medical Technicians (NAEMT) found that 62% of paramedics and EMTs experienced excessive fatigue during their shifts, with the majority citing that they were not getting enough sleep. Sleep deprivation was most common among workers who regularly worked 24-hour shifts.
Firefighters and Sleep Issues:
Firefighters, who often work 24-hour shifts, experience similar sleep challenges. According to a study conducted by Harvard Medical School and Brigham and Women’s Hospital in 2016, nearly 37% of firefighters screened positive for sleep disorders, including sleep apnea, insomnia, and shift-work disorder. These issues were linked to the demanding nature of their shifts, which involve frequent nighttime emergency calls.
Another study found that 49% of firefighters reported having been awakened multiple times during their sleep period while on duty. Interrupted sleep is common in fire stations, where alarms can disrupt sleep at any hour.
Impact on Health
Mental Health Impact:
The lack of sleep also takes a toll on mental health. A survey from the National EMS Management Association (NEMSMA) found that EMS professionals who work extended shifts and suffer from sleep deprivation are at higher risk for depression, anxiety, and PTSD. The study highlighted that 38% of EMS workers reported significant mental health challenges related to the long hours and lack of sleep.
Increased Risk of Cardiovascular Disease (CVD):
The International Association of Fire Chiefs (IAFC) reports that sleep deprivation contributes to elevated risks of hypertension, heart disease, and stroke among firefighters and EMS responders.
Increase in injuries:
Firefighters working long shifts with sleep deprivation have a 60% higher chance of workplace injury due to reduced reaction times and alertness.
Higher risk of other medical issues:
Firefighters experiencing chronic sleep loss are 35% more likely to develop obesity, metabolic syndrome, and related conditions such as diabetes
Impact on safety and performance
EMS Vehicle Crashes:
According to the U.S. National Highway Traffic Safety Administration (NHTSA), approximately 4,500 ambulance crashes occur in the U.S. each year, resulting in an average of 1,500 injuries and 33 deaths annually.
According to the NFPA, there are approximately 15,000 to 20,000 fire department vehicle crashes annually in the U.S.
Impaired Cognitive Function:
The National Institute for Occupational Safety and Health (NIOSH) reports that being awake for 17 hours impairs performance similarly to a blood alcohol concentration of 0.05%, affecting decision-making and reaction times. Firefighters with chronic sleep deprivation exhibit a 20-30% decrease in cognitive processing speed and decision-making ability during emergencies. The Centers for Disease Control and Prevention (CDC) note that sleep deprivation impairs cognitive performance, affecting decision-making and reaction times.
Increased Risk of Errors:
Sleep deprivation and long hours are linked to higher rates of errors and injuries among EMS workers. A 2019 study published by the JAMA Network Open showed that EMTs and paramedics who reported higher levels of fatigue were more likely to make clinical errors, such as medication mistakes or incorrect assessments.
Sources:
nemsis.org
bls.gov
ambulance.org
usfa.fema.gov
naemt.org
pmc.ncbi.nlm.nih.gov
cdc.gov
samhsa.gov
iafc.org/
OSHA.gov
hsph.harvard.edu