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As is the case in many states, the collection and analysis of
EMS data is still very much a work in progress. Much of what is known is
obtained through a variety of sources including directly from individual EMS
organizations themselves. Still, the data that is available serves to provide an
accurate snapshot of how Wisconsin EMS is set up and functions. It also provides
us with a look at some of the data that is currently available.
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How many ambulance
services are there in Wisconsin?
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How many ambulance
calls occur in Wisconsin each year?
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Does the local
fire department usually provide ambulance service to the community?
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Who owns and
operates Wisconsin's ambulance services?
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Who responds to
the most calls or provides the largest amount of EMS service in the state?
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What percentage of
EMS is provided by volunteers?
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At what point do
communities typically consider hiring full-time EMTs and Paramedics?
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How many levels of
ambulance service are there and how many operate at each level?
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What are the
reasons that people call for an ambulance?
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How old are the
people that require ambulance care and transport?
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What percentage
of calls are life threatening? What percentage require advanced levels of care?
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How many EMTs and
ambulance services in Wisconsin start IVs and administer medication?
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How often is an
EMT-Paramedic or EMT-Intermediate available to provide advanced level care?
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Are volunteers
sometimes paid, and if so, how much?
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How often is an
ambulance involved in a motor vehicle crash in Wisconsin?
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There are approximately 375 ambulance providers who respond
to emergency (911) calls in Wisconsin. There are another 75 services that
provide training, interfacility transfers, intercepts, or are satellite stations
of other ambulance providers. This brings the Wisconsin ambulance service total
to approximately 450 EMS organizations or services.
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While a definitive number is not currently available, it is
estimated between 475,000 and 525,000 ambulance transports are completed in
Wisconsin each year.
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While it is a common belief that the local fire department
also provides ambulance services, in Wisconsin, 40% of 911 responding ambulance services
come from the fire department while 60% are separate and apart from the fire
department. Fire department ambulance vehicles transport approximately 45% of
patients each year while 55% are transported by non-fire-based ambulance
providers. When taking into account all ambulance services including
interfacility, special event and intercept services, 68% are non-fire-based and
32% are provided by the fire department.
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Approximately two-thirds of Wisconsin ambulance providers
(64%) are owned and operated by a local municipality. Twenty-six percent (26%) are owned by a
private, non-profit organization. The remaining 10% are for-profit ambulance
services in the business of providing ambulance transport. Regardless of
ownership, slightly over half of Wisconsin's ambulance providers are
stand alone or "third service" organizations not affiliated with a
fire department or hospital. Volunteer fire departments
represent 19% followed by full-time, paid fire departments at 13%. Hospitals
provide ambulance service in 9.5% of cases. County-run ambulance services
represent the remaining 5.5% of Wisconsin providers.
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Wisconsin's largest services also represent the largest
amount of activity. Approximately 40% of all the calls that take place each year in
Wisconsin are responded to by only 10 EMS services: Milwaukee Fire Department,
Bell Ambulance, Paratech Ambulance, MedaCare Ambulance, Madison Fire Department,
Curtis Ambulance, Gold Cross Ambulance of the Fox Valley, Tri-State Ambulance,
Kenosha Fire Department and Racine Fire Department. Four out of five (80%) of
Wisconsin’s ambulance services respond to less than 1,000 calls each year. More
than half of Wisconsin’s ambulance services respond to under 400 calls each
year. Nearly 40% see 200 or less runs a year.
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Volunteer EMS providers are responsible for staffing nearly 75% of Wisconsin’s ambulance
services. However, they are responsible for responding to only 25% of Wisconsin’s EMS calls.
The majority of ambulance transports are provided by full-time, paid ambulance
services and fire departments.
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It is rare to find full-time, paid, fire departments or
ambulance services with an annual call volume below 750. Typically when annual
run volumes meet or exceed 1,000 is when communities begin to consider hiring
full time EMTs and Paramedics.
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Of the four different levels of ambulance services
provided in Wisconsin (EMT-Basic, EMT-Intermediate Technician, EMT-Intermediate,
EMT-Paramedic), 180 (41%) are licensed at the EMT-Basic level. A total of 130 (29%)
are licensed at the Intermediate Technician level. There are 110 (25%) at the
Paramedic level, and 20 (5%) At the EMT-Intermediate level.
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Citizens call 911 to request an
ambulance for a large number of reasons. Statistically, the most common reason
is for trauma. The trauma can be a result of an automobile crash, a fall, an
industrial accident, a sports injury, a physical assault, or many other reasons.
Chest pain ranks second followed by respiratory distress. The list, in order of
most common, continues with abdominal pain, altered level of consciousness,
stroke, fainting, seizures, diabetic problems, cardiac arrest, and others.
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As with other types of health care,
the elderly often require an ambulance more often than younger adults or
children. In a previous state survey of run data, 45% of patients were found to
be 65 years old or older. Age groups of 19 to 34, 35 to 49, and 50 to 64 each
represented approximately 14% of patients. Only 5% of calls were for children
age 12 and under, including newborns.
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While an emergency is often defined
as a traumatic event or medical condition that the patient or others at the
scene deem to be an emergency, not all ambulance calls are life threatening.
Most ambulance services report that approximately 50% or more of their calls
involve non-life-threatening conditions requiring only Basic Life Support (BLS)
care. The remaining 50% require some form of advanced care, although the
additional care may only include starting an IV on the patient. Approximately
20% of calls require the administration of one or more medications to the
patient. Most ambulance services report that only 10% of their calls are a true
life and death situations. Remember, a patient with a broken leg who cannot walk
requires an ambulance just as much as the patient that is unconscious or not
breathing. However, a broken leg is rarely a life-threatening event.
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Currently 60% of Wisconsin ambulance
services are trained and authorized to start IVs and administer eight or more
medications to patients. Fifteen years ago only 29% had this training and
authorization.
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It is estimated that approximately
85% of ambulance calls have Advanced Cardiac Life Support (ACLS) medications,
narcotic medications and multiple advanced procedures available to the patient
or have agreements in place to call another ambulance service for an intercept
to provide this advanced care to the patient when needed. These services are
provided by the 30% of Wisconsin's ambulance services operating at the EMT-Intermediate
or EMT-Paramedic level.
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Multiple, repeat surveys from the
Wisconsin EMS Association has shown that EMTs who are paid when they go on a
call earn between $12.59 and $14.10 an hour, on average. Most ambulance services
(approximately 70%) do not pay anything to their volunteers while they are "on
call" waiting for a call to come in. The remaining 30% who do pay their EMTs to
be "on call" pay an overall average of $1.30/hour. The majority of EMTs who
receive some amount of pay claim they earn $1,500 or less each year from EMS. It
is rare for volunteer/paid-on-call EMS providers to earn more than $2,500 in any
given year.
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Vehicle crashes involving an
ambulance are a rare occurrence in Wisconsin. According to the Wisconsin
Department of Transportation (DOT) there are an average of 15 crashes each year
involving an ambulance. That figure represents 0.01% of all motor vehicle
crashes in the state. An average of five ambulance crashes each year involve
injuries. During the ten year period 1997-2006 there were a total of four fatal
crashes involving an ambulance in Wisconsin.
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