How Does Your EMS Agency Compare to the National Average?
If you’re like me, you have no idea who the ancient Greek philosopher Heraclitus is. But you are very familiar with his words of wisdom: The only thing that is constant is change.
EMS agencies – and, by extension, EMS providers – are experiencing subtle and not-so-subtle changes. There’s greater scrutiny around where and how dollars are spent, what results are being measured, how to best serve rural areas, how to deal with the increasing opioid crisis, and what the latest information about stroke will do to the way providers both asses stroke and transport patients suffering from stroke.
In this world of constant questioning and seeking to understand, data – and the smart use of data in particular – are playing a key role in helping agencies answer critical questions when it comes to ensuring success and improving patient outcomes.
To that end, we’ve launched our inaugural EMS Index – the 2018 ESO EMS Index – to look at five key metrics that affect EMS agencies across the country. We looked at more than 5 million patient encounters from January 1, 2017 – December 31, 2017. What we discovered was at times surprising, but definitely interesting, insightful, and helpful.
The five metrics we measured for this first-ever Index are: 1) Stroke assessment performance; 2) percent of patients suffering from overdose; 3) ETCO2 after advanced airway procedure; 4) 12-lead performance in adult chest pain; and 5) aspirin administration in adult chest pain.
Here are the results:
Stroke Assessment Performance
For the stroke assessment performance metric, we looked at how many people with a primary impression of stroke received a formal stroke assessment that was appropriately documented. The results were a bit surprising, with only 50% of patients either getting a stroke assessment (or a stroke assessment being documented). As treatment for stroke continues to evolve, it is becoming increasingly important to not only identify a stroke but to determine the severity of the stroke using a validated, formal stroke assessment.
Percent of Patients Suffering from Overdose
The opioid epidemic is a serious problem in this country. We found that approximately 1.65% of all the 5M+ calls were related to overdose. That’s not a small number, and the problem is only getting worse. Men accounted for 28% more overdose encounters than women. This is consistent with what we hear from our customers, with overdose calls accounting for approximately 11.5% more than stroke as primary impression calls.
ETCO2 After Advanced Airway Procedure
The measurement of exhaled carbon dioxide, referred to as end-tidal CO2 (ETCO2) following advanced airway placement, is an industry best practice and should be measured in every agency. The use of ETCO2 monitoring confirms proper placement, can alert the provider of accidental dislodgement, and the second-by-second wave form provides definitive proof that the tube remained in place during the encounter. The good news is that in 94.5% of advanced airway cases, EMS providers are following this ETCO2 best practice.
12-Lead Performance in Adult chest Pain
The EKG is one of the most powerful tools an EMS provider has at their disposal, allowing EMS providers to screen for cardiac ischemia, and especially for acute ST-elevation myocardial infarction. Measureable and reproducible reductions in mortality are associated with appropriate acquisition and interpretation of EMS EKGs. With that in mind, it’s surprising that in only 76% of cases where non-traumatic chest pain was identified as a primary impression in individuals over the age of 35 was a 12-lead EKG used.
Aspirin Administration in Adult Chest Pain
The aspirin administration for chest pain metric looked at the number of patients over the age of 35 with a primary impression of non-traumatic chest pain that received aspirin or had a documented aspirin allergy. With aspirin playing such an important role in helping reduce deaths from acute coronary syndrome, it’s was an eye opener to see that in only 55% of cases was aspirin protocol followed.
Is your agency performing above or below the national average? Download the full 2018 ESO EMS Index today and see where you stand.