MediCab…EMS today, tomorrow
Editor’s Note: This is the second of a six-part series on the future of Emergency Medical Services.
A sampling of EMS/911 usage across South Carolina suggests that most calls are not actual emergencies.
The following is an estimate of emergency and non-emergency requests for EMS via 911 for the year 2012.
(The estimates: emergency and non-emergency: are ours, based on the total calls from the various counties that classified emergency calls according to the category of call. For example, cardiac, respiratory distress, abdominal pain, general sickness, etc. Keep in mind that almost all EMS organizations respond to all calls as emergencies, and treat the calls and patients equally, transporting to hospital emergency rooms.)
12,455: total calls
6,756: emergency calls, 54 percent
5,699: non-emergency calls, 56 percent
6,153: total calls
2,196: emergency calls, 35 percent
3,957: non-emergency calls, 65 percent
15,002: total calls
4,350: emergency calls,28 percent
10,652: non-emergency calls, 72 percent
4,333: total calls
1,072: emergency calls,24 percent
3,261: non-emergency calls, 76 percent
6,430: total calls
2,806: emergency calls,43 percent
3,622: non-emergency, 57 percent
56,252: total calls
12,468: emergency calls, 22 percent
43,784: non-emergency calls, 78 percent
1,579: total calls
579: emergency calls, 36 percent
1,568: non-emergency calls, 64 percent
41,315: total calls
14,840: emergency call, 38 percent
26,475: non-emergency calls, 64 percent
62,443: total calls
17,660: emergency calls, 28 percent
44,783: non-emergency calls, 72 percent
43, 625: total calls
(sample) 8,729: total calls
371: emergency calls, 4 percent
8,358: non-emergency calls, 96 percent
17,316: total calls
10,787: emergency calls, 63 percent
6,529: non-emergency calls, 37 percent
Counties throughout the state responded to a Freedom of Information Act request asking them for their total calls for the year 2012, broken down by type of call — cardiac, abdominal pain, headache, general sickness, etc., as well as emergent/non-emergent (emergency/non-emergency).
This caused some confusion as most EMS respond to all calls as emergencies and consider non-emergency calls to be only pre-arranged transports as opposed to unnecessary EMS/911 calls.
Consequently we counted all diabetic, respiratory, stroke, unconscious, chest pain, motor vehicle accident, and so forth as real emergencies. This inflates the numbers considerably.
However, Spartanburg, responded with a breakdown that clearly defined the nature of the call, how it came into dispatch (almost all came in as emergencies) and what it really was. This resulted in 1,505 pages of calls for 2012. We took a sample — 20 percent of the calls and manually counted every call that was ultimately determined by responding EMS to be a real emergency.
The result was shocking. Only 4 percent of the calls they responded to were true emergencies.
The numbers indicate that Spartanburg’s numbers may reflect the reality on a nationwide basis.
Spartanburg EMS Director Jimmy Greene confirms that only about 4 percent of their calls are true emergencies: “People will call and once we are on scene they have either already left by other means or it is not as bad as they thought.”
EMS triage and treat at scene, he said, which can eliminate the need for a trip to the hospital or result in a Code 1 (no siren/high speed) trip.
“We try to stabilize at the scene so we don’t have to use lights and sirens,” he said.
Greene estimates about 15 to 20 percent of their EMS/911 calls are “taxi service” calls, meaning, he says, “they don’t need an ambulance or don’t need to be treated enroute to the hospital.”
In New York City, EMTs (Emergency Medical Technicians) call their service the “emergency taxi service.”
They say that in high use times, especially in the summer, low-need patients and repeat users can tie up ambulances and create delays for patients actually in crisis.
On an average day in New York, according to a 2012 story in the New York Times, an EMT team might respond to 10 to 16 calls of which only two will be high-urgency, five till need medical care but not emergency transport and three will need a basic, primary care physician and remedies as simple as Tylenol.
In New York City in 2011, EMS responded to 1.2 million calls of which 800,000 were non-life threatening. One in four emergency transports in New York City rank in the least-urgent category.
These statistics hold true in most areas. All EMS know their “frequent fliers” — those who call EMS/911 simply for a ride, companionship or a meal.