Oregon EMS & Trauma Systems Program, Public Health Division, Oregon Health Authority
Last Updated: 2023-12-08
The Oregon EMS & Trauma Systems Program develops and regulates systems for quality emergency medical care in Oregon, ensuring that EMS Providers are fully trained, that emergency medical vehicles are properly equipped, and emergency medical systems are functioning efficiently and effectively. EMS includes dispatch centers (the initial 911 call point of contact), emergency medical response, field triage, treatment and stabilization, and transport by ground or air ambulance to a hospital. EMS provides inter-hospital transfers, by ground ambulance, helicopter or fixed-wing aircraft between hospitals. Inter-hospital transport (IHT) can span hundreds of miles and is an integral aspect of the continuum of care, moving complex patients to higher levels of care.
Senate Bill 52 (2017) required Oregon licensed EMS Agencies report patient encounter data to the Oregon EMS Information System (OR-EMSIS) in the form of a standardized electronic Patient Care Report (ePCR). These data are used for purposes of EMS care quality improvement, disaster and mass casualty event planning and response, trauma research, public health prevention, tracking patient outcomes, and ensuring high-quality emergency medical care throughout the state. This dashboard presents data related to EMS care in Oregon for 2021.
All data used in the preparation of this dashboard is drawn from OR-EMSIS or the Oregon EMS License Management System (LMS) except where otherwise noted. Direct any questions regarding Oregon EMS & Trauma to EMS.Trauma@odhsoha.oregon.gov.
This chart draws on data about EMS agencies reporting NEMSIS 3.X data to the OR-EMSIS system in 2021. Transporting agencies in Oregon are reporting to the system by an overwhelming margin (93.3%). Of the remaining agencies, half are currently in process to onboard to the system. These numbers also reflect a small degree of churn in EMS agencies. Year 2021 saw 2 entities drop their licenses, and one new one applied for a license.
Note that under statute non-transporting agencies are not currently required to report to OR-EMSIS. Only 14.7% of non-transporting agencies currently report to OR-EMSIS. Another 11.1% are scheduled to onboard to the system.
This chart draws on license data for EMS personnel over the last 5 years. These data indicate that the workforce has increased after 2020. The increase in licensed EMT and Paramedics is in part reflective of the Emergency Initial Provisional License (EIPL) process whereby an applicant who is licensed or certified as an EMS provider in another state or has been issued a provisional certification from the National Registry of Emergency Medical Technicians (NREMT) may receive a short-term provisional license during a declared emergency or public health emergency. This process was initiated in response to the COVID-19 pandemic.
Licensing data are always a snapshot. The annual numbers here were captured as the number of valid licenses on August 31st of each year in order to capture licenses following the renewal season for each license level. License numbers are reported for each level only in years when that level goes through renewal.
This plot draws on data for all ambulances licensed to active transporting agencies with documented certification level = “Ground.” The box plot represents the distribution of ambulance age in years. The box in the center represents the middle half of ambulance units, with the line in the center representing the median, or middle value. Individual data points are superimposed over the box plot to show frequency/density, and allow drill down to the level of the individual ambulance.
This figure indicates that the median age of ambulances serving Frontier areas is considerably greater than that of urban or rural areas. The age range of ambulances serving rural and frontier areas is wider than that of ambulances in urban areas, with the distribution skewed toward older units. Nearly a quarter of ambulances in service in frontier areas are older than the oldest ambulance currently in use in urban areas statewide.
This analysis does not take into account wear and tear on the vehicle, or mileage due to lack of data.
This chart draws on EMS response data on the service of level (ALS, BLS, Special Critical Care) of ambulances responding to frontier, rural and urban areas. The chart represents the percentage of calls at each service level to allow comparison between regions with very different populations. Designations were able to be attributed for most calls in the state, however there were 319 records that could not be classified as urban rural or frontier based on geographic data provided.
Frontier areas of the state rely more heavily on Basic Life Support (BLS) ambulances (19.4%). Rural and Urban areas are served predominantly by Advanced Life support (ALS) ambulances (91.1% and 88.8% respectively).
Limitations of this analysis are the presence of missing values for zip code, and, to a lesser extent, service level. Designation is based on record geographic identifiers, and there are records with missing zip codes, zip codes that contain an error, or zip codes that do not correspond to a geographic area. An attempt has been made to classify zip codes that correspond to P.O.boxes, based on the location of the post office. These zip code errors may be disproportionately in Frontier and rural areas. Where possible city and county information has been used to supplement zip codes to accurately classify calls as urban, rural or frontier.
This chart is based on all ePCRs submitted to OR-EMSIS in 2021 (n = 608,034). The graph shows all calls and those in which a patient encounter occurred (n = 472,448).
This tiled heatmap is based on all EMS incidents in Oregon in 2021 (n = 608,034). The graph shows all calls broken out by day of the week and time of day. The color of the cells in the graph represent the percentage of total calls that occur at that time on that day of the week. The graph also shows how EMS incidents tend to be clustered between 10 AM and 6 PM, and on week days.
This graph is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). The graph indicates that the number of EMS incidents increase as we move from younger to older age groups.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). Data for this chart are drawn from the ePatient.13 data element, Patient Gender, but align with EMS personnel’s assessment of patient biological sex. The unknown category is a combination of missing data, “Unknown” and “Not Documented” values.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448).
Note that Race and Ethnicity are represented in NEMSIS 3.4 in a single list. All percentages are calculated as the percentage of all EMS patients for whom a particular race or ethnic category was selected. Multiple values may be selected, resulting in percentages that will sum to greater than 100%.
The graph indicates that the race and ethnicity field is not documented in all records. There are implicit challenges is documenting information related to identity during an EMS encounter. The Oregon EMS & Trauma Systems Program will be collaborating with the Office of Equity and Inclusion to link OR-EMSIS data to data from the REALD & SOGI Repository for purposes of reporting on equity performance measures.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). The graph shows the distribution of EMS incidents across Area Trauma Advisory Board (ATAB) regions. ATABs are regional boards that develop and support implementation of local trauma system plans, advise the State Trauma Advisory Board (STAB) and Public Health Division on rules, policies and procedures, and act as liaison between providers and the public in their region. A map of the ATAB regions may be found here. The ATAB is on the x axis with bar height representing the number of EMS patient encounters. Unsurprisingly patient encounters are more prevalent in densely populated urban ATAB regions. The number of encounters tracks with regional population.
This map is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448) County color coding is based on the rate at which county residents were transported in 2021, calculated as the number of transports divided by the population of the county multiplied by a base of 1,000. Rates are standardized based on population estimates from the Portland State University’s Population Resource Center. These rates may be interpreted as the number of EMS transports per 1,000 people in one year.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). The graph shows the distribution of EMS incidents across frontier, rural and urban zip codes. Rural designation is on the x axis with bar height representing the rate of EMS patient encounters per 1000 population. Frontier, rural and urban areas of the state are assigned to incidents based on the zip code in which the incident occurred using definitions from the Office of Rural Health. Rates are standardized based on population estimates from the Portland State University’s Population Resource Center. While there are considerably more calls in urban areas, rural and frontier areas lead the state in the number of calls per person. This may reflect differences in underlying comorbidities, differences in transportation options, or demographic differences between urban and rural areas, with residents of rural areas tending to be older on average.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). For the year considered there were 6 records ( 0.0%) that had a missing or undocumented value for dispatch complaint. Percentages were calculated as the number of incidents in which a dispatch complaint was reported divided by the total number of incidents for each year. Please note that because only the top 15 complaints are reported in the graph, the sum of all percentages will be less than 100%.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). Of these 57,836 had an ICD-10 code for their primary impression or symptom indicating an injury or poisoning. Of these patients there were 44078 records for which a cause of injury was documented (76.2%).
Percentages were calculated as the number of incidents in which the cause of injury code was reported divided by the total number of incidents for each year. Please note that because only the top 15 causes of injury are reported in the graph, the sum of all percentages will be less than 100%.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). For the year considered there were 135,524 records (28.7%) that had a missing or undocumented value for primary symptom. Percentages were calculated as the number of incidents in which a primary symptom was reported divided by the total number of incidents for each year. Please note that because only the top 15 primary symptoms are reported in the graph, the sum of all percentages will be less than 100%.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). For the year considered there were 0 records ( 0.0%) with no documented procedures performed. Percentages were calculated as the number of incidents in which a procedure was performed divided by the total number of incidents for each year. Please note that because more than one procedure may be performed during each EMS incident, the sum of all procedures will be greater than 100%.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 472,448). For the year considered there were 18,323 records ( 3.9%) that had a missing or undocumented value for primary impression. Percentages were calculated as the number of incidents in which a primary impression was reported divided by the total number of incidents for each year. Please note that because only the top 15 primary impressions are reported in the graph, the sum of all percentages will be less than 100%.
This chart is based on all EMS incidents in Oregon in which there was a patient during 2021 (n = 472,448). For the year considered there were 6,464 records ( 1.4%) that had a missing or undocumented value for scene type. Percentages were calculated as the number of incidents in which a scene type was reported divided by the total number of incidents for each year.
This chart is based on all EMS incidents in Oregon in which there was a patient during 2021 (n = 472,448). For the year considered there were 0 records ( 0.0%) that had a missing or undocumented value for disposition. Percentages were calculated as the number of incidents in which a disposition was reported divided by the total number of incidents for each year.
This chart is based on all EMS incidents reported in Oregon in which there was a patient during 2021 (n = 399,175). For the year considered there were 31 records ( 0.0%) that had a missing or undocumented value for destination type. Percentages were calculated as the number of incidents in which a destination type was reported divided by the total number of incidents for each year.
NEMSQA Respiratory-01 Respiratory Assessment
Percentage of EMS encounters originating from a 911 call with primary or secondary impression of respiratory distress for whom a respiratory assessment was performed and documented.
Initial Population:
The population for this metric is all EMS encounters in Oregon.
Denominator 1: Total
All EMS responses in the initial population with a primary or secondary impression indicating respiratory distress for 2020 (n = 26,416) and 2021 (n = 30,546). Respiratory distress may include impressions of Asthma, Dyspnea, Unspecified Orthopnea, shortness of breath, diagnosis of a respiratory ailment, and complaint or condition commonly associated with dyspnea.
Numerator:
EMS encounters for patients in the denominator who received both a SpO2 and respiratory rate measurement during the EMS response.
Measure specification:
NEMSQA Asthma-01 Administration of Beta Agonist for Asthma
Percentage of EMS responses originating from a 911 request for patients with a diagnosis of asthma who had an aerosolized beta agonist administered.
Initial Population:
The population for this metric is drawn from EMS encounters in Oregon.
Denominator 1: Total
All EMS responses in the Initial Population with a primary or secondary impression of asthma exacerbation or acute bronchospasm for 2020 (n = 976) and 2021 (n = 1,031).
Numerator:
EMS responses in the denominator who had an aerosolized beta agonist administered by an EMS professional during the EMS response. Beta agonist medications may include Albuterol, Levalbuterol and Metaproterenol.
Measure specification:
NEMSQA Pediatric-03 Documentation of Estimated Weight in Kilograms
Percentage of EMS responses originating from a 911 request for patients less than 18 years of age who received a weight-based medication and had a documented weight in kilograms or length-based weight estimate documented during the EMS response.
Initial Population:
The population for this metric is drawn from EMS incidents in Oregon where the patient was less than 18 years of age.
Denominator:
All EMS responses in the initial population who received a weight-based medication during the EMS response for 2020 (n = 70,966) and 2021 (n = 86,850).
Numerator:
EMS responses originating from a 911 request for patients in which a weight value was documented in kilograms or a length-based weight was documented during the EMS response.
Measure specification:
NEMSQA Safety-01 Use of Lights and Sirens During Response to Scene
Percentage of EMS responses originating from a 911 request in which lights and sirens were not used during response to the scene. Safety-01 and Safety-02 focus on the judicious use of lights and sirens during response to scene (Safety-01) and during patient transport (Safety-02). The intent of these two measures is to determine how often EMS professionals are using lights and sirens during response and transport, and ensure that this balances concerns of patient outcomes and ambulance safety.
Initial Population:
All EMS patient encounters originating with 911 call.
Denominator 1:
All EMS responses in the initial population for 2020 (n = 325,332) and 2021 (n = 379,787).
Numerator:
EMS responses originating from a 911 request in which lights and sirens were not used.
Measure specification:
NEMSQA Safety-02 Use of Lights and Sirens During Transport
Percentage of EMS transports originating from a 911 request in which lights and sirens were not used during transport from the scene. Safety-01 and Safety-02 focus on the judicious use of lights and sirens during response to scene (Safety-01) and during patient transport (Safety-02). The intent of these two measures is to determine how often EMS professionals are using lights and sirens during response and transport, and ensure that this balances concerns of patient outcomes and ambulance safety.
Initial Population:
All EMS transports originating with 911 call.
Denominator 1:
All EMS transports in the initial population for 2020 (n = 209,794) and 2021 (n = 245,199).
Numerator:
EMS transports originating from a 911 request in which lights and sirens were not used.
Measure specification:
Use of Provider Personal Protective Equipment (PPE) for Possible Infectious Disease Patients
Percentage of EMS patient contacts with possible infectious disease where EMS providers used personal protective equipment intended to reduce the transmission of infectious disease. Oregon EMS and Trauma adopted NEMSIS national custom elements related to PPE at the beginning of the COVID-19 pandemic. These elements track PPE type and use by EMS crews during patient care and transport. This measure tracks the documentation and use of PPE in transports with patients displaying symptoms commonly associated with COVID-19.
Initial Population:
This metric is drawn from all EMS episodes of care reported to OR-EMSIS.
Denominator:
All EMS episodes of care in the initial population where patient care is provided and symptoms or impressions indicate possible infectious disease. in 2020 (n = 19,549) and 2021 (n = 20,436).
Numerator:
EMS responses where EMS providers used personal protective equipment (excluding gloves).