Emergency Medical Services (EMS)

Emergency Medical Services (EMS) is not a single centralized organization but a community-level system that provides emergency medical care activated by calls for help involving serious illness or injury. Its focus is the care of patients before and during transport to a hospital, with each local community designing its own EMS system using local resources. The organizational structure, financing, and delivery of services vary significantly from community to community.

EMS has federal roots in the Highway Safety Act of 1966, which gave the Department of Transportation a coordinating role. Today, NHTSA's Office of EMS (OEMS) provides leadership and coordination to the EMS community, supported by bodies such as the Federal Interagency Committee on EMS (FICEMS) and the National EMS Advisory Council (NEMSAC). Historical antecedents include the first civilian hospital-based ambulance service in Cincinnati in 1865 and the first municipally based EMS in New York City in 1869.

EMS is delivered through public (government-run), private for-profit, private nonprofit, and hospital-based organizational models. As of 2020, there were approximately 1,030,760 licensed EMS clinicians in the U.S. In 2024, EMTs held about 181,000 paid jobs (median wage $41,340/year) and paramedics held about 101,900 paid jobs (median wage $58,410/year), with overall employment projected to grow 5% from 2024 to 2034.

Innovations in emergency medical care, pre-hospital technology, dispatch systems, and workforce tools are directly relevant to EMS given its scale, decentralized structure, and the persistent pressure to improve patient outcomes and operational efficiency across thousands of local systems.