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NHTSA implemented a statewide EMS technical assessment program in 1988.
In 1989, the Office of Technology Assessment released a report detailing the challenges faced by rural EMS (United States Congress, Office of Technology Assessment, 1989) (see the discussion of rural EMS below).
In 1995, through the urging of then NHTSA Administrator Ricardo Martinez, NHTSA and HRSA commissioned a strategic plan for the future EMS system.
Recognizing the need for a cohesive approach between EMS and the remaining healthcare world, the 1996 EMS Agenda for the Future was drafted to detail how EMS can integrate into the other medical and care fields as well as advance its own practice.
NHTSA (National Highway Traffic Safety Administration). 1996.
Gausche M, Seidel JS. 1999.
Gausche M, Lewis RJ, Stratton SJ, Haynes BE, Gunter CS, Goodrich SM, Poore PD, McCollough MD, Henderson DP, Pratt FD, Seidel JS. 2000.
The report also noted that most of the available information is localized and anecdotal (GAO, 2001b).
EMTALA was intended to protect access to emergency care by preventing private hospitals from turning away needy emergency patients who are uninsured or underinsured or precipitously transferring these patients to the closest public hospital, a practice known as “dumping” (GAO, 2001a).
Air ambulance operations have served thousands of critically ill or injured persons over the past several decades (Blumen and UCAN Safety Committee, 2002). However, there has been growing concern about the safety of these operations.
2003 Survey and Analysis of EMS Scope of Practice and Practice Settings Impacting EMS Services in Rural America: Executive Brief and Recommendations.
In 2004, 9-1-1 call centers fielded approximately 200 million emergency calls, including medical, police, fire, and other calls.
As is evident from the Mears (2004) survey, a strong plurality of EMS systems nationwide is fire department–based.
As a result of these and other challenges, recently surveyed EMS agencies and administrators ranked recruitment and retention as the number one issue they face (EMS Insider, 2005).
TABLE 2-2 EMS-Related Fiscal Year 2005 Federal Funding
Davis and colleagues (2005) found that patients with moderate to severe traumatic brain injury who received care through air ambulance had improved outcomes.
Federal Interagency Committee on Emergency Medical Services (FICEMS). [Online]. Available: http://www.usfa.fema.gov/subjects/ems/ficems.shtm [accessed January 5, 2006].
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| Company name | Founded date | Revenue | Employee size | Job openings |
|---|---|---|---|---|
| AmeriCare Ambulance | - | $9.9M | 130 | - |
| Care Ambulance Services | 1969 | $2.3M | 35 | 6 |
| Elite Ambulance | 2012 | $380,000 | 750 | 19 |
| LifeCare Medical Center | 1995 | $50.0M | 350 | 57 |
| Superior Air-Ground Ambulance Service | 1959 | $250.0M | 3,000 | 41 |
| American Ambulance | 1975 | $61.0M | 500 | 6 |
| Gold Cross Ambulance | - | $42.2M | 329 | 8 |
| Emergency Ambulance Service | 1977 | $4.6M | 100 | 12 |
| Acadian Ambulance | 1971 | $55.0M | 900 | 130 |
| American Medical Response | 1992 | $860.0M | 29,000 | - |
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