Paramedic PapersHome Operations & systems How US states organise EMS and trauma systems
Operations & systems
How US states organise EMS and trauma systems
From sirens to systems: Characterizing EMS and trauma care across America
Journal of Trauma and Acute Care Surgery · 2026-11-11 · Added 12 November 2026
A survey of EMS and trauma system leaders in all 50 US states plus DC found broad protocol and registry coverage — 84% statewide trauma triage protocols, 88% mandatory registry participation — but weak operational coordination, with only 6% a single point of contact for helicopter dispatch and 55% rating their system as needing at least moderate improvement.
- Study type
- Cross-sectional
- Design
- Cross-sectional survey of state EMS and trauma system leaders (56-item instrument)
- Participants
- 51 US jurisdictions (all 50 states plus DC)
- Main finding
- 84% had a state EMS medical director and statewide trauma triage protocols; 88% mandatory trauma registry participation; only 29% a centralised trauma communications centre and 6% a single HEMS dispatch contact; over half rated EMS funding in the two lowest adequacy categories and 55% wanted at least moderate system improvement
- Caveat
- Self-reported leader perceptions describing a US state-based structure that differs from Australian arrangements
- Bottom line
- Context only
Why it matters in Australia (Medium relevance). A US state-patchwork survey — Australian state systems are more centralised, but the coordination, funding and rural-gap themes read familiar from this side of the Pacific.
Learning goal
Understand how system-level structures like trauma triage protocols and registry participation shape Australian prehospital trauma care.
More
- Topic: Operations & systems
- Daily scan: 12 November 2026
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