Each EMS agency should measure their percentage of L&S use of total 911 call volume and aim to reduce the percentage to the minimum effective rate. The goal for each EMS agency, after comparing national statistics and trends, should be less than 50 percent L&S use during response and less than 5 percent during transports.² Following these benchmarks would likely improve patient, provider, and public safety without increasing detrimental patient outcomes in most EMS agencies. Providing sound leadership, the ACEP EMS Committee has recommended that EMS medical directors should limit L&S use as much as possible. The role of L&S should be only to “request the right of way,” instead of continuous L&S use.

Opportunity for Improvement

Currently only 17 percent of EMS agencies use L&S for less than 50 percent of all calls; most EMS agencies use L&S for 80 percent of 911 calls.² Creating EMS and ambulance response guidelines for appropriate use of L&S, with a transport goal of less than 5 percent of 911 calls, should be a priority for EMS agencies and medical directors. L&S should only be utilized when the level of care needed is greater than what EMS providers can offer. As part of their quality improvement measures, EMS agencies should routinely monitor their percentage of L&S use and evaluate their protocols to try to minimize L&S use. Increased training on the hazards and standardized protocols regarding L&S use should be considered as mechanisms to improve EMS safety for providers, their patients, and the public.

References

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