Photograph: A woman collapsed on 7th Street in the East Village when she was with her family. Emergency Medical Technicians arrived and took her to the hospital as her mother and son stand nearby hugging. David Shankbone, photographer. Wikipedia

By Marsha Mercer, Special to Stateline

When bombs exploded in Boston and a monster tornado tore through Oklahoma, paramedics and emergency medical technicians ran toward danger. As first responders, they put their own lives at risk in order to save the lives of others.

Yet EMTs and paramedics are governed by a haphazard patchwork of rules that vary widely by city and state. And their wages differ widely as well (see infographic), from a high of $52,930 a year in Washington, DC, to a low of $25,900 a year in Kansas. The national average wage was $34,370 in 2012, according to the Bureau of Labor Statistics. In smaller and rural communities, EMTs and paramedics are often volunteers.

Accidents and violence-related injuries are the leading cause of death for Americans under age 44, but there is no federal agency responsible for coordinating or guiding emergency services that respond to these incidents. What federal funding is available drips from faucets in several different departments.

In tough economic times, emergency services often are on the chopping block.

A survey of Emergency Medical Services leaders in the 200 largest cities found 44 percent had cut services last year, according to the Journal of Emergency Medical Services. It found 28 percent of big-city EMS agencies had a hiring freeze or were not filling vacancies, some for the third consecutive year. Fifteen percent reported layoffs. Twenty-one percent had no cost-of-living or pay-for-performance increases, some for the fourth year, the journal said.

“Several states have made catastrophic cuts to state EMS offices over the last few years, causing reductions in staff,” said Dia Gainor, executive director of the National Association of State EMS Officials (NASEMSO). She singled out Alabama, New York and Iowa.

A recent investigation by the Des Moines Register found Iowa’s EMS system “broken.” Staff in Iowa’s EMS bureau has been cut 40 percent and its budget reduced by more than one-third since 2009, resulting in delayed inspections of EMS providers and less oversight, the paper reported.

Detroit’s EMS system has been “decimated” by layoffs, and other cities have had furloughs, layoffs and “rolling brownouts” in which a response office shuts down for a day, said Don Lundy, president of the National Association of Emergency Medical Technicians, a federal advocacy group.

Unlike public health, fire and police departments, emergency services are the new kids on the block. In the 1960s, a town’s mortician might respond to a car crash in a hearse. The federal government took a leadership role in the 1970s, developing the nationwide 911 phone system and establishing EMTs as a profession. But funding dropped dramatically in the early 1980s.

“Since then, the push to develop more organized systems of EMS delivery has diminished, and EMS systems have been left to develop haphazardly across the United States,” the Institute of Medicine reported in 2006. The report, “Emergency Medical Services: At the Crossroads,” described the nation’s EMS system as one of “severe fragmentation, an absence of systemwide coordination and planning, and a lack of accountability.”

Bureaucratic Confusion

Even the number of EMTs and paramedics is uncertain.

The Bureau of Labor Statistics said there were 232,860 paid EMTs and paramedics in 2012, based on its survey of employers.

In a 2011 report, the National Highway Traffic Safety Administration (NHTSA) said there were 826,111 certified EMTs and paramedics, based on a survey of state EMS officials. This number includes part-time, unpaid volunteers and those who receive stipends, as well as full-time paid staff. They work in a wide range of settings, including hospitals, clinics, law enforcement agencies, fire stations, oil rigs, Indian reservations, ambulances and air transport.  NHTSA also said the BLS doesn’t distinguish between EMTs and paramedics and doesn’t identify EMS cross-trained as firefighters.

Pages: 1 · 2

More Articles

• Monetary Policy Report Prepared at the Federal Reserve Bank of Richmond, Expectations for Future Growth Were Mostly Unchanged
• A Yale Medicine Doctor Explains How Naloxone, a Medication That Reverses an Opioid Overdose, Works
• National Institutes of Health Launches Home Test to Treat, a Pilot COVID-19 Telehealth Program; Berks County, PA, Is First Community to Join Partnership With Local Public Health Departments.
• Kaiser Health News Research Roundup: Pan-Coronavirus Vaccine; Long Covid; Supplemental Vitamin D; Cell Movement
• How They Did It: Tampa Bay Times Reporters Expose High Airborne Lead Levels at Florida Recycling Factory
• From The Desk of Secretary Antony J. Blinken, US Department of State
• KFF, Kaiser Family Foundation: Vaccinating Children Ages 5-11; Policy Considerations for COVID-19 Vaccine Rollout
• A Scout Report Selection: Science-Based Medicine
• Journalist's Resource: Religious Exemptions and Required Vaccines; Examining the Research
• Government of Canada Renews Investment in Largest Canadian Study on Aging