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Our Darkest Hour (Again)

     If your child brought home a report card that looked like this, they would probably be grounded. According to the National Report Card on the State of Emergency Medicine, America gets a C- for the emergency healthcare it provides its citizens.

     The report was compiled by the American College of Emergency Physicians and paints a picture of our emergency care system as a "ticking time bomb" with increasing costs leading to ED closures at a time of rising demand for these services. This news is not new for the EMS industry, as we regularly struggle to deal with ED diversions and overcrowding, as well as the trickle-down effect of caring for a growing patient base with nowhere to turn for healthcare services.

     The report analyzed five areas: access to emergency care, patient safety environment, medical liability environment, public health and injury prevention, and disaster preparedness, offering recommendations on both the national and state level that it is hoped will be incorporated into any healthcare reform implemented by President-elect Obama.

     In regard to public health and injury prevention, the data is damning. Our infant mortality rate of 6.9 deaths per 1,000 live births is twice the rate of six other countries, and the average rate of seat-belt use by front seat occupants is 83%, with some states below 65%. As we discuss in EMS Magazine, one way to decrease your 9-1-1 call volume is to improve public health and injury activities in your community if the appropriate funds to support such programs are in place.

     In the area of disaster preparedness, a lack of federal funds meant that even with investments in infrastructures and systems for disaster response the overall grade in this category is a C+. The states that ranked the highest have written all-hazards medical response or ESF-8 plans, have high bed surge capacity, and have held disaster drills and trainings.

     To see where your state ranks, visit, and check out for further coverage on the report in the January issue of EMS on the Hill, where we detail how you can utilize the report's findings to make a case for increased funding and support for your EMS system.

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