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.
The following questions and their answers will help you develop an accurate picture of EMS operations, data and statistics throughout Wisconsin.
1. How many ambulance services and EMTs are there in Wisconsin?
There are approximately 365 ambulance services 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. In addition, there are currently 10 air medical providers (helicopters) in Wisconsin and 328 certified First Responder groups. This brings the total to approximately 771 licensed or certified EMS organizations or services in Wisconsin. There are approximately 18,500 licensed EMS personnel; 3,400 certified First Responders, 8,100 EMT-Basics, 2,900 Intermediate Technicians, 160 Intermediates, and 4,000 Paramedics.
2. How many ambulance calls occur in Wisconsin each year?
For the year 2011, there were 598,416 calls for EMS in Wisconsin, which is almost 15% higher than the EMS calls in 2010.
3. Does the local fire department also usually provide ambulance service to the community?
While it is a common belief that the local fire department also provides ambulance services, in Wisconsin, 37% of 911 responding ambulance services are provided by the fire department while 63% 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, 71% are non-fire-based and 29% are provided by the fire department.
4. Who owns and operates Wisconsin’s ambulance services?
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.
5. Who responds to the most ambulance emergency calls or provides the largest amount of EMS service in the state?
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.
6. What percentage of EMS is provided by volunteers?
Defining a volunteer as someone who earns less than $2,500 a year for their EMS involvement (often less than $1,500 each year), volunteer and paid-on-call or paid-per-call 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. While definitive data is difficult to obtain, true volunteers where the EMS provider receives “nothing of financial value” for their EMS involvement is believed to be around 60%.
7. At what point do communities typically consider hiring full-time EMTs and Paramedics?
It is rare to find full-time, paid, fire departments or ambulance services with an annual call volume below 750, although since about 1998 the number of such agencies has increased. Typically when annual run volumes meet or exceed 1,000 911 calls is when communities begin to consider and find it necessary to hire full time EMTs and Paramedics.
8. How many levels of ambulance service are there and how many operate at each level?
Of the four different levels of ambulance services provided in Wisconsin (EMT-Basic, EMT-Intermediate Technician, EMT-Intermediate, EMT-Paramedic), 139 (32%) are licensed at the EMT-Basic level. A total of 146 (34%) are licensed at the Intermediate Technician level. There are 136 (32%) at the Paramedic level, and 12 (3%) at the EMT-Intermediate level. In addition, there are 328 groups certified at the Medical First Responder level. First Responder groups do not transport patients but are a vital component of the EMS System and can provide early intervention, including CPR, first aid and stabilization.
9. What are the reasons that people call for an ambulance?
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. A chief complaint of respiratory distress ranks second followed by complaints of 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.
10. How old are the people that require ambulance care and transport?
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.
11. What percentage of calls are life threatening? What percentage require advanced levels of care?
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 (ALS), 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 less than 10% of their calls are a true life and death situations. Even so, a patient with a broken leg who cannot walk requires transport in an ambulance just as much as the patient who is unconscious or not breathing. However, a broken leg is rarely considered to be a life-threatening event.
12. How many EMTs and ambulance services in Wisconsin start IVs and administer medication?
The number of Wisconsin ambulance services able to establish an IV and administer medications has more than doubled in the 20 year period from 1992 through 2012. Currently 68% of Wisconsin ambulance services (294) are trained and authorized to start IVs and administer eight or more medications. In 1992 only 29% of Wisconsin ambulance providers had this training and authorization while in 2002 46% provided these services.
13. How often is an EMT-Paramedic or EMT-Intermediate available to provide advanced level care?
It is estimated that nearly 85% of ambulance calls in Wisconsin 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 35% of Wisconsin’s ambulance services operating at the EMT-Intermediate or EMT-Paramedic level.
14. Are volunteers sometimes paid, and if so, how much?
Multiple, repeat surveys from the Wisconsin EMS Association and others 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 request for service 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 “volunteer EMTs” who receive some amount of pay claim they earn $1,500 or less each year from their EMS involvement. It is rare for volunteer/paid-on-call EMS providers to earn more than $2,500 in any given year.
15. How often is an ambulance involved in a motor vehicle crash in Wisconsin?
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.