As trauma teams push to improve survival, one intervention is gaining renewed attention: whole blood.

The U.S. military started using whole blood in World War I, but it fell out of favor with blood component availability. Military air evacuations revived whole blood use in the early 2000s, and by 2016, most civilian air medical services carried it. Since then, whole blood use has steadily grown, especially in high-volume and Level I trauma centers.

The 2024 ESO Trauma Index offers a detailed analysis of current trends and benchmarks in trauma care, setting a new standard for improvement and allowing healthcare professionals to get a closer look at the data, understand its impact, and explore best practices for enhancing patient outcomes. Pulling data from the world’s largest de-identified trauma registry data program, the Index’s insights reflect over 975,433 trauma patient records that took place between January 1 and December 31, 2023. One of the key metrics covered in the Trauma Index is whole blood usage.

Key Findings

The 2024 ESO Trauma Index, for the first time, looked at all patients who received blood/blood products. Some of the key findings include:

• Among the almost 70,000 trauma patients who received a blood transfusion, 5% received whole blood only, 87% received packed red blood cells (PRBCs), and 8% received both whole blood and PRBCs. 
  
• The median time to whole blood delivery among all patients who received whole blood was 13 minutes. That’s good news.  
• For patients who met the Early Blood Transfusion Needs Score (EBTNS), a score of greater than five and received whole blood, 98% received whole blood within four hours, the goal. 
• The median time to transfusion for trauma patients who received PRBCs was 12 hours. Considering that 87% of transfusion recipients receive PRBCs, 12 hours is concerning.
  
  

Are PRBCs Enough? 

PRBCs remain a mainstay of trauma care. They help stabilize patients and support volume replacement during hemorrhage. But PRBCs alone can lead to over-resuscitation, clotting problems, or metabolic disturbances. The 2024 ESO Trauma Index shows that more than 50% of trauma patients arrive hypocalcemic. 

The increase in EMS agencies and trauma centers administering whole blood is driven by military and civilian research showing that early whole blood transfusion can significantly improve outcomes for patients in hemorrhagic shock.

Key Recommendations from the 2024 ESO Trauma Index 

Hospital trauma centers looking to strengthen transfusion practices should consider these best practices: 

• Track and review all transfusions administered within three hours of injury. 
• Monitor calcium levels during transfusion and provide supplementation. 
• Implement or refine massive transfusion protocols.  
• Administer TXA early, ideally within three hours of injury. 
• Use point-of-care coagulation testing (e.g., TEG, ROTEM) to guide treatment. 
• Develop rapid-access systems for blood products, even in non-critical scenarios. 

Yet, for all its good, whole blood remains expensive and challenging to manage. For trauma centers committed to incorporating whole blood, hospitals and EMS partners should: 

• Set clear protocols for blood handling, transfusion, and storage. 
• Coordinate closely with trauma centers and blood banks to manage supply. 
• Support community blood drives to maintain availability. 
• Provide ongoing training to EMS professionals administering blood products. 
  
  

Whole blood isn’t new, but its return is evidence-backed and outcome-driven. For trauma centers committed to faster intervention and better survival, it may be one of the most powerful tools available.

Want more whole blood benchmarks and guidance? Download the full 2024 ESO Trauma Index for the complete picture. 

The post Why Whole Blood Is Gaining Ground in Trauma Care  appeared first on ESO.

Held from April 22-25, Wave 2025 covered a variety of impressive topics throughout the week. Here are the five themes that were at the forefront of discussions in fire and EMS:

1. Artificial Intelligence   

Front and center on the world stage, AI is an incredible new technology that we’re only skimming the surface of what it can bring to the industry. Despite the fact that we need to proceed cautiously and responsibly, we’re excited to see how its role will continue to evolve in the years to come.  

At Wave, the air was abuzz with talks surrounding AI. Chief Innovation Officer of Cincinnati Children’s Hospital, Todd Ponsky, used his session Global Education Moonshot: Using AI and Media to Transform Medical Knowledge Access to shed light on the new technology’s role in fighting global disparities in patient care.  

Cincinnati Fire Department’s program manager, Robert Hug then shared how his department is transforming their documentation and analyses of their data through the integration of AI into Snowflake in Beyond ChatGPT: Unlocking the Power of AI in Snowflake.  

Finally, we learned how ESO will be tackling AI from ESO Senior VP of Engineering Russell Beggs, Senior VP of Product Reinhard Ekl, and Chief Innovation Officer Brandon Martinez in their session Artificial Intelligence in ESO Products: Efficiency Gains You Can Trust. They discussed the responsible approach ESO is using to harness the new technology to improve the efficiency and accuracy of documentation through our new auto-generated narrative feature. 

2. Mobile Integrated Healthcare 

EMS is on the front lines of providing medical care for their communities, treating the most vulnerable of society, oftentimes on a repeated basis. More than ever before, data and strategic partnerships are being used as tools for empowering first responders to get to the root of patients’ issues through Mobile Integrated Healthcare/Community Paramedicine programs. These programs can be incredibly impactful for both the agencies and the patients they treat.  

Kicking off the discussion, Associate Chief Medical Officer of Global Medical Response, Gerad Troutman, explored the power of these alternate care models in redirecting non-life-threatening cases away from the ER while providing proactive care for repeat callers in his talk From Sirens to Solutions: How EMS Data is Driving Smarter Healthcare, 

Then, in Unifying Community Paramedicine (CP) and Mobile Integrated Health (MIH) Data: A NEMSIS Initiative, NEMSIS Technical Assistance Center Program Director Kevin Nicholes discussed how impactful data unification can be for MIH/CP programs in improving everything from patient outcomes to billing practices.  

Continuing to drill down into the importance of partnerships to MIH/CP programs, we learned how agencies across the city of Tulsa combined forces to leverage their different strengths and skills in order to get to the root of their patients’ problems thanks to Aligning Community Data for the Common Good by Tulsa Fire Department Chief of EMS, Justin Lemery.  

Finally, even though MIH/CP is an impactful tool for providing care for your community, you need the right funding to make it happen. Asbel Montes from Solutions Group Services gave us the rundown on what not to do when seeking a bigger budget in his talk, The Top 5 Costly Mistakes to Avoid When Seeking Additional Funding for MIH/CP. Then EMS/MIH Consultant Matt Zavadsky of PWW Advisory Group dove into the importance of using data to prove the value of the services you provide in From Data to Impact: Demonstrating Your Agency’s Value to the Community.  

3. Data-driven innovations 

Every day, organizations use ESO data to do incredible things, but without the framework to define, measure, and reduce errors in data, you can’t pull quality insights from the information gleaned. This was emphasized in Reducing Errors, What Percentage of Plane Crashes Would Be Okay?, where Cox Health EMS Medical Director Matthew Brandt shared strategies for using data to improve care, foster accountability, and ensure adaptation, along with in Be Curious not Furious: A Data-Driven Approach to Change by TowerDIRECT Paramedic Jason Drinkwater, where we learned how to measure what matters.  

Then, in Conducting Qualitative Research with Your Team: A Crash Course of Meaningful Outcomes, Fire Chief Dr. Brett Ellis from the City of Webster Grove took it a step further, teaching us it’s not just data quality that needs to be considered but who’s benefiting from the data that it pays to use qualitative research that reflects the personalities and passions of your team.  

We also learned that although data and technological advancements are doing incredible things for first response, organizations need to decide what’s best for them. In Assessing Your Technology Needs: A Practical Roadmap for Smarter Solutions, a session by Principle of Acceleration Strategies, Robert Edson, gave insights into how to determine which innovative tools are necessary for your organization without overspending or underutilizing resources. 

We also drilled down into what we should be measuring as an industry. Recently, data has shown that response times aren’t a reliable indicator for measuring outcomes, as they rarely reflect the quality of care provided. Chief Medical Officer of the Forth Worth Office of the Medical Director, Jeffrey Jarvis, is well versed on the topic and used his talk, Improving Clinical Care Using National EMS Quality Alliance (NEMSQA) Benchmarks, to share what your organization should be measuring instead. 

Using EMS Data to Drive Safety: Resources, Lights, and Sirens by UNC Department of Emergency Medicine’s EMS Chief Medical Officer Joseph Grover and Beyond Response Time Standards, the Evolution of Contract Compliance by Global Medical Response Clinical Quality Managers Brad Cramer and Jake Shores, both also dove into response but focused more on best practices for minimizing lights and sirens usage without sacrificing standard of care.  

We also learned how data is helping us build a better offense in our efforts to keep our communities safe. In Why Risk Reduction Planning Zones are Essential, AP Triton Senior Associate Frank Blackley discussed how the right insights can help agencies more effectively visualize and reduce risks. In the FSRI Fire Dynamics Research Update, UL-FSRI Director of Research Craig Weinschenk gave us the latest learnings related to WUI fires, electrical fires, and search and rescue. 

Cary Fire Department’s Fire and Emergency Services Analyst Blake Boyd raised another good point regarding measuring outcomes in Outliers: An Inclusive Conversation. He led a discussion on how traditional data analysis methods hinder fire departments’ ability to identify and manage outliers and what best practices could be taken instead.  

There are many uses for data. It doesn’t just push us towards better patient outcomes or help us get paid, as discussed by Systems Design West Education Direction Alissa Christenbury in Data-driven insights: improving ambulance billing through documentation analysis, but it is also a tool for keeping our teams safe. In The Power of Reporting: Using Data to Foster Trust and Prevent Violence, Commander Mandy Johnston of Peel Regional Paramedic Services spoke to the violence paramedics face on the job, along with the role data reporting can play in supporting prevention efforts. Then, in PPE Exposure to Energy Storage Fires, Texas A&M Division Director Chris Angerer discussed the data-driven best practices for protecting your department from the devastating impacts of exposure.  

SCEMSA Executive Director Henry Lewis really hit home the importance of data and how, when we work together in a unified front to utilize our collective insights and talents, we can do incredible things. His talk Leveraging Data for EMS Funding: the SCEMSA Story shared how the South Carolina EMS Association has overcome both a hiring and funding deficit by doing just that. 

This leads us to create the right culture around your data – from using insights to transform your leadership, as discussed by Dare County EMS Deputy Chief Terence Sheehy in Transformative Leadership: Don’t Give Up the Ships, to the importance of promoting the creation and use of data at your own organization as touted by the President/CEO of International Public Safety Data Institute, John Oates, in his talk What is Your Data Culture?, we were taught a lot about making your agency a hub for fostering excellence and growth.  

4. Prehospital and hospital interoperability  

Day in and day out, EMS providers make critical decisions with lives weighing in the balance. Today, data and technology are instrumental in closing the feedback loop and ensuring they have the necessary information to make the right call the moment they need it.  

In ESO Health Data Exchange (HDE): The Bridge to Better Patient Outcomes, VHC Health EMS Liaison Justin Nelson discussed how his team used ESO HDE to better facilitate communication with their partners, increasing feedback loop closures from 11% to 94% and increasing overall EMS transports by 7%, which ultimately transformed both the quality and quantity of the care they were able to provide.  

In Precision Under Pressure: How Technology Is Transforming Prehospital Dosing and Clinical Support, Hinkley Medical CEO Tristen Hazlett and Physician Abraham Campos gave us a run down on how powerful data-driven decision-making can be in shaping the future of prehospital care while Gaining “Insight” into Patient Acuity: Enhancing Response Plans by Linking Emergency Medical Dispatch (EMD) Codes to Patient Care Interventions by Wake County EMS Deputy Medical Director Jefferson Williams explained how insights can improve patient-based response planning and prioritization today. 

As the role of fire and EMS continues to rapidly change beyond first response, data is helping them to become a bigger part of the patient care continuum than ever before. In The Evolving Role of Fire and EMS in Healthcare, Axene Continuing Education CEO & Founder Eric Axene, MD, FACEP, discussed how data-driven partnerships are transforming the relationship between prehospital and hospital care.  

The more we understand the entire continuum of care, the clearer we can see EMS’s full range of capabilities for treating patients and the impact they make. In To Transfuse or Not to Transfuse: Using ESO Data to Evaluate the Utility of Implementing a Prehospital Blood Product Program, Medical Director of Cincinnati Fire Department, Dustin Calhoun, dove into the current state of prehospital 911 blood product administration and our learnings thus far.  

5. NERIS 

The nervous excitement around NERIS was palpable at Wave, and crowds were out the door for sessions surrounding the new system. UL-FSRI Director of Research Craig Weinschenk led a session called National Emergency Response Information System (NERIS): Changing the Future of Fire Departments, where he gave a highly anticipated update on what’s currently happening with the project and how NERIS is set to transform the industry.  

In NERIS is Near Us, ESO product experts Jennifer Billingsley and Katie Heins gave a demo on the brand new NERIS-compliant Fire Incidents and answered a wide range of questions regarding the new response system. If you missed it, have no fear. You can check out our NERIS FAQs here, and if you don’t find an answer to your questions, submit them here, and we’ll be happy to assist you.  

Stay ahead of what’s trending in the industry. 

Our data experts at ESO compiled a few resources to help you keep up with a shifting industry while using aggregated data to ensure your organization stays at the top of its game. Check out the 2025 ESO EMS and Fire Services Indices to see where your organization stands against national benchmarks in important metrics. Pulling from the ESO Data Collective, the Indices help your team see where you’re on top of your game and areas that are ripe for improvement, along with sharing best practices that promote growth. 

Read the 2025 ESO Fire Service Index

Read the 2025 ESO EMS Index

It’s not too early to start thinking about Wave 2026! 

Mark your calendars for April 7-10, 2026, to join us in Austin, TX, for four days of thought leadership, networking, and learning. If you’re interested in being the first to get the inside scoop on what data-driven advancements and technologies are trending industry-wide, mark your calendars and stay tuned to register.  

The post Wave 2025 Recap: Top 5 Topics in EMS and Fire   appeared first on ESO.

Critical connections during emergencies 

ESO Health Data Exchange (HDE) is the critical connection between the field and the hospital, giving emergency department (ED) clinicians near real-time access to prehospital care information during time-sensitive emergencies.  

Just as your hospital evaluates and improves over time, ESO evolves its solutions to meet your changing needs. Read on to find the latest ESO HDE enhancements that provide hospitals with actionable insights into EMS activity and collaboration.  

What’s new: Enterprise Master Patient Index (EMPI)

Benefit: Automated patient match rates of over 90% in under two minutes 

Accurately matching patients with their prearrival care information is critical to patient safety, community health, and hospital business success. Poor patient-matching capabilities are both inefficient and costly. Repeated medical care because of duplicate records costs over $1,700 per ED visit, while denied claims from patient misidentification cost the average hospital $2.5 million.  

ESO HDE now includes automated matching of hospital records to EMS encounters, thanks to Enterprise Master Patient Index (EMPI). This technology: 

• Eliminates the need for paper runsheets 

• Eliminates the need for wristband scans 

• Greatly reduces time spent on manual searches 

• Reduces care wait times while reconciling missing EMS records  

Hundreds of hospitals now enjoy match rates of over 90%, which automatically occur in less than 120 seconds. 

What’s new: EMPI matching for all responding units

Benefit: Shared patient outcomes and improved billing 

In addition to patient identification, ESO HDE EMPI matching allows all units and agencies responding to an incident to qualify for an EMPI match.  Without this enhancement, only the transporting EMS unit links to the patient, risking the loss of other agencies’ critical contributions because of unmatched records.  

With the ESO HDE EMPI match: 

• All responding agencies receive patient outcome information.  

• All responding units can learn, update training if needed, and ultimately improve patient care.  

• All services provided can be documented and billed, reducing missed revenue. 

• All responding units automatically process through the ESO EMPI system, which is particularly crucial for high-utilization regions. 

• Hospitals save time by no longer having to manually share outcomes with multiple responding agencies.
   

EMPI matching for responding agencies closes a critical gap in EMS data systems – ensuring every touchpoint during a response is captured, linked, and actionable.    

What’s new: Integrated with ESO Insights  

Benefit: Operational and clinical information in easy-to-understand reports 

ESO HDE now includes ESO Insights, an integrated reporting platform that offers clear, easy-to-understand reports and visuals. Hospital leaders can embrace their data while using it to identify areas for performance improvement. ESO Insights is built with users in mind, offering point-and-click functions.  

With all the data integrated into a single data platform, pre-built dashboards for both operational and clinical views are available. For example, operational dashboards include: 

• EMS transport summary – View EMS transport data in different ways – including the top transporting agencies, reason for transport, and why patients are choosing your facility, etc. 

• Ambulance Patient Offload Time (APOT) by facility and EMS agency – Previously accessible only through research, this data is now available at your fingertips. 

Existing clinical dashboards include specific measures for stroke and STEMI. This offers a deep dive into understanding progress toward meeting standards

What’s new: ESO Suite enhancements 

Benefit: Improved experience
 

You asked, and we answered! Three fresh enhancements to the ESO Suite include

1. A federated single sign-on (SSO) – Enjoy a single password for all ESO applications. Plus, your designated IT administrators can create and disable users centrally and easily. 

1. Submit direct product feedback – When you share feedback in the suite, the product team triages it and keeps you informed about progress.    

1. Data Exporter tool – The ESO Data Exporter tool allows users to manage and export large amounts of data, simplifying data management. You can build, schedule, download, and email data exports directly.  

Request a demo to see how ESO HDE can help your hospital enhance patient outcomes, streamline operations, and support performance initiatives throughout the emergency services journey.
 

The post Close the Gaps: Smarter EMS Information for Hospitals appeared first on ESO.

“A culture of excellence for us is ensuring that our data is as high-quality as it can be and using it in our reporting metrics.” 

– Matt Jacoby, Assistant Fire Chief at Cary Fire Department, North Carolina

Cary Fire Department in Cary, North Carolina, knows that good data can mean the difference between guessing and making informed decisions that keep firefighters safe. Over the years, the department has built a culture focused on collecting high-quality, consistent data and turning it into action.

In this video, Matt Jacoby, Assistant Fire Chief at Cary Fire Department, shares how data has become part of their daily operations and how that mindset helps drive continuous improvement across the department. Between setting higher benchmarks to pioneering new processes, Cary Fire is using data to protect firefighters, improve patient care, and shape the future of fire service operations.

Video Transcript

How Cary Fire Department Uses Quality Data

to Make Informed Decisions 

Matt Jacoby

Assistant Fire Chief at Town of Cary Fire Department

Cary, North Carolina

We collect an awful lot of data through reports and other metrics that we all are required to complete, and there’s a real opportunity to use that data in a way that drives our profession forward.

The culture of excellence for us is really ensuring that our data is as high-quality as it can be and then using that in our reporting metrics. This culture has been ingrained in us for much of my career, and year by year, we incrementally try to raise the bar, set that standard, and continue that journey of continuous improvement.

Now, the fire service is traditionally resistant to change, so it does impede progress sometimes. I just want to challenge folks, the fire service leaders who are there, to rethink what they do and think outside of where they currently are in different ways [and how] they can use that data to stretch.

If you can’t compare your data to itself with a benchmark, then it becomes useless. So you have to have that established standard and then continue to raise that bar so you can challenge yourself.

That’s what it’s all about for us. That’s the culture of continuous improvement and excellence.

We’ve been tracking fire decontamination, products of combustion, and exposures for about a year. I think we’ve just implemented that as a mandatory field now. So that’s going live just this week. Very excited to see the outcome of that and the impact on our folks because that’s a huge focus, as you know, making sure our people stay safe and get them into retirement for a long life.

Becoming the first fire department in our county to implement the HDE and electronic patient transfer is groundbreaking for us.

We embarked on a long journey, really working with our county partners to get to a point where everybody was comfortable turning this function on. Since that time, we’ve been live with that for about two years or so. We really paved the way for other departments to come on board and simplify their process.

We like things very simple, and with the iOS app coming online, that simplifies and streamlines things even more. The ability to dictate what a medication that you’re administering is, automatically ingesting that, and putting it in the proper spot – that is remarkable.

The advice I would give anyone who’s looking to start this would be to embrace it fully – but don’t force it upon anyone. When we build our teams, many of them are voluntary. We solicit input, and whoever wants to contribute can contribute.

That’s the heart of a successful team. They want to be there. They want to be a part of that change.

We like to lead the way. Cary Fire Department enjoys being first in anything that we can.

I get to be a small part of that, and that’s the true joy for me.

To learn more about the incredible work Cary Fire Department is doing, visit carync.gov/services-publications/fire. 

Interested in more stories like this?

Join us at Wave 2025  featuring ESO Training Academy from April 22–25, 2025 in Austin, Texas, to hear from leaders like Matt. 

The post Using Data to Protect Firefighters and Drive Improvement appeared first on ESO.

The findings may surprise you.  

The Leading Causes of Trauma – And Who Is Most at Risk 

Data from the ESO Data Collaborative, which includes nearly 1 million anonymized patient records, show that the top three causes of trauma injuries are consistent across all age groups: 

1. Falls 
2. Motor Vehicle Crashes (MVCs) 
3. Struck by/against  

The number one reason a person receives trauma care is from a fall, accounting for 52% of all injuries.  However, following the top three leading causes of injury, age-related differences emerge: 

• As a cause of trauma injury, firearms ranked fifth for pediatric patients (ages 1-18), fourth for adults (19-64 years), and tenth for older adults (65 and older)
• Interpersonal violence was 115 times more likely to be reported in pediatric patients compared to older adults, with 3% of children under 18 reporting interpersonal violence, compared to less than 1% of adults or older adults

These findings reinforce what many trauma professionals already know: Violence disproportionately affects children, and firearm-related injuries continue as a major public health crisis.  

Firearm Injuries: A Rising Concern in Trauma Centers 

According to the CDC, firearms are the leading cause of death for youth ages 1-17 years for the third year in a row. Between 2019 and 2020, firearm homicides and nonfatal firearm-related trauma increased by approximately 35–37%, marking one of the most significant spikes in recent history.  

Even more people suffer nonfatal firearm-related injuries than die, with effects reverberating across families, neighborhoods, and communities. The impact is staggering: 

• More than 40,000 people experience traumatic firearm-related injuries each year
• Youth exposed to gun violence are at higher risk of becoming victims themselves
• Firearm-related injuries and fatalities cost an estimated $410 billion annually in medical care, lost work, and quality of life losses

Firearm Injury Prevention: Recommendations for Trauma Centers 

• Hospital systems and trauma centers looking to reduce firearm-related injuries can follow these best practices: 
• Screen early – Identify risk factors for firearm-related injuries in trauma patients 
• Provide mental health support for firearm -injury victims and their families 
• Participate in the CDC’s National Syndromic Surveillance Program to track trends in gun violence by geographic area 
• Promote firearm safety – Offer free gun locks and safety resources, especially for families with children 
• Improve access to firearm injury prevention programs, particularly in under-resourced communities 
• Ensure your trauma centers follow updated trauma-informed prevention and intervention protocols to address violence effectively 

Interpersonal Violence: A Critical but Overlooked Factor in Trauma Care 

For the first time, the 2024 ESO Trauma Index also examined interpersonal violence as a mechanism of injury. Interpersonal violence – including physical, sexual, and psychological aggression – has long-term effects on victims. Interpersonal violence was 115 times more likely to be reported in pediatric patients compared to older adults, with 3% of children under 18 reporting interpersonal violence, compared to less than 1% of adults or older adults.  

It increases risks for: 

• Chronic health issues 
• Mental health disorders 
• Repeat injuries and hospital visits 

Thanks to leadership from The American College of Surgeons (ACS), all Level I trauma centers now screen for interpersonal violence, abuse, and mental health disorders. This ensures that patients receive comprehensive care beyond their physical injuries. 

Interpersonal Violence: Recommendations for Trauma Centers

• Use standardized screening protocols for all patients
• Train staff in how to recognize and document signs of abuse
• Ensure privacy and support for patients disclosing abuse
• Provide referrals to social services while using non-triggering language (e.g., labeling resources as “women’s health” or “social services” rather than “domestic violence”)

Data Drives Action 

Understanding the mechanisms of injury in U.S. populations is more than an exercise in data analysis; it’s about turning data insights into action that improves patient care and community safety. With falls, MVCs, firearms, and violence shaping trauma cases nationwide, hospitals and EMS providers must adapt protocols to better identify, treat, and prevent these injuries. 

Want to see how your trauma center compares? 

Download the 2024 ESO Trauma Index today to find trends, benchmarks, and best practices for improving trauma care in your community. 

The post A Closer Look at Trauma: What Mechanism of Injury Reveals appeared first on ESO.

Delays from communication breakdowns, logistical issues, or procedural bottlenecks can make the difference between life and death. Specifically, traumatic brain injury, complex orthopedic injuries, and hemodynamic instability issues like hemorrhage all require rapid, specialized surgical intervention at higher-level trauma centers.

Key Findings: How Fast Are Trauma Patients Moving? 

In this first exploration of time to transfer data, ESO considered time to transfer for emergency department patients, time to transfer for inpatient patients, and if trauma center level mattered. Data from the ESO Data Collaborative, which includes nearly 1 million anonymized patient records, show: 

Emergency Department Transfers 

• The median time to transfer was 78 minutes (Range: 63–84 minutes) 
• Time to transfer varied by trauma center level but not significantly  

Inpatient Transfers 

• The median time to transfer was 141 minutes, nearly 2.5 hours (Range: 132–152 minutes)  
• There was no clear trend between trauma center levels and inpatient transfer time  

These findings challenge the assumption that higher trauma center levels always transfer patients more quickly. They also show that the proverbial ‘golden hour’ is rarely met, especially with inpatient transfers. There is room for improvement. 

A Successful Reduction in Time to Transfer

The Oregon Health and Science University conducted a three-year quality improvement project on patient transfers. Measurable improvements include:  

• Decreased the number of transfers that arrived with incomplete (or missing) medical records from more than 17% to just over 1%  
• Decreased arrival-to-procedure time for patients being transferred for a procedure from 51 hours to 35 hours  
• Decreased unnecessary transfers from 15% to 3%  
• Increased case mix index by one-third, corresponding to about a 60% jump in reimbursement 
  

How Can Trauma Centers Reduce Transfer Delays? 

Trauma leaders, including the American College of Surgeons (ACS), emphasize the importance of rapid – and accurate – injury identification, established transfer protocols, and seamless communication between referring and receiving facilities. 

Best practices for improving time to transfer include: 

• Quickly identify trauma patients requiring transfer – ideally within 30 minutes of arrival 
• Establish clear criteria for transfer, prioritizing patients needing specialized surgical care 
• Create predefined agreements with higher-level trauma centers to streamline transfers 
• Facilitate direct physician-to-physician communication for quicker acceptance 
• Appoint a dedicated transfer coordinator to reduce logistical delays
• Focus on stabilization without unnecessary imaging or procedures that slow down the process 
• Set and track a decision to transfer time as part of your trauma performance improvement program
• Regularly review transfer times with staff and provide feedback on identified delays 
• Ensure compliance with state and regional trauma guidelines, some of which mandate specific transfer timeframes  

The Bottom Line: Faster is Better 

The data is clear: time to transfer can be improved, and hospital systems and trauma centers that optimize transfer times can improve patient survival and recovery. 

Want to see how your facility compares to national benchmarks?

Download the full 2024 ESO Trauma Index to learn how your trauma center could improve patient outcomes and community health. 

The post The Clock Is Ticking on Trauma Center Time to Transfer  appeared first on ESO.

It is with great pride that we’ve watched these organizations redefine what’s possible in first response throughout the year. From protecting the mental health and safety of first responders to providing care in underserved areas to empowering the next generation of nurses, the stories below highlight the incredible impact made by our community in 2024.

How Ute Pass’ MIH Program Centers Care Around the Patient 

Serving over 500 square miles in rural Colorado, Ute Pass Regional Health Service is using community paramedicine programs to improve healthcare access for underserved populations. By focusing on preventive care and data-driven insights, the agency is lowering costs and improving outcomes.

Read the blog or watch the video to get the full story. 

Addressing Violence in EMS 

Despite being driven by a desire to provide a service to their community, first responders are met with an increasing amount of violence in their day to day — a lot of which goes unreported due to its normalization in the field. Elizabeth Donnelly, PhD, MSW, MPH, NREMT, Associate Professor at the University of Windsor and Co-Principal Investigator of the Violence in Paramedicine Research Group, shares insights from years of research and frontline experiences, advocating for strategies like incorporating reporting tools and promoting a safer work environment for paramedics

For more information on the work Dr. Donnelly and the Violence in Paramedicine Research Group are doing and to learn how we can create safer working environments for EMS professionals, visit www.protectparamedics.com. 

Medavie’s Mobile Integrated Healthcare solution  

Based in Canada, Medavie Health Services uses Mobile Integrated Healthcare (MIH) programs to deliver primary care and mental health support directly to patients, especially in rural areas. By using data to identify where care is needed most, they tailor their programs to address the unique needs of their communities.

Transforming Community Safety 

Trevor Wilson, Division Chief of Planning at the Indianapolis Fire Department understands that when it comes to community safety, a good offense is the best defense. In the past six months, he’s used his organizational insights to reduce emergency incidents in his at-risk neighborhood by an incredible 75%. 

Shaping the Future of Nursing 

Shawntay Harris, President and CEO of Eminent Healthcare Resources Consultants and the President of the Texas Emergency Nurses Association is passionate about shaping leaders in the field of nursing. Learn how she’s working with organizations to not only retain nurses but help them thrive in their careers.   

Why Cook Children’s Medical Center Chose ESO Patient Registry 

When it comes to providing the best trauma care, Cook Children’s Medical Center knows that having timely, reliable data is vital. ESO Patient Registry streamlined their collection process while reducing errors, improving the patient experience along the way.  

Children’s Hospital Colorado: Improving Care While Saving $40k

The Children’s Hospital Colorado team needed a faster way to exchange patient data, as their manual process often took two to three days. They implemented ESO Health Data Exchange (HDE), reducing that process to just a few minutes. By using ESO HDE, the hospital strengthened relationships with EMS partners, improved patient care, and saved $40,000 annually.

Download the full case study

Looking Ahead 

Thank you for taking the time to reflect on 2024 with us. We are so incredibly proud of the accomplishments our ESO community has made in the last year and look forward to seeing how their work shapes the future of health and safety in the years to come.  

There’s a lot of other achievements and big ideas that happened at ESO in 2024. To read more on the product innovations and research that made us most proud, check out the blog posts below. 

Year in Review: ESO Research and Data That Shaped 2024 

Year in Review: Product Innovation and Progress from 2024

The post Year in Review: The Impact of the ESO Community in 2024 appeared first on ESO.

Earlier in the year, we released the 2024 ESO EMS, Fire Service, and Hospital Trend Reports, which forecasted the trends ESO experts believed would shape each industry. The 2024 ESO Trends Reports explored topics such as the growing demands on first responders and healthcare workers, improving first responder safety, and addressing gaps in care delivery. These priorities shaped many of the insights and research released throughout the year.

While much was accomplished in 2024, here are some of the highlights, white papers, and research that defined our journey:

Pioneering Research for Emergency Services

Aggregate data is an incredibly powerful tool for transforming first responders’ ability to serve their communities. With contributions from over 2,700 EMS agencies, fire departments, and hospitals across the U.S., the ESO Data Collaborative  provides one of the largest datasets for public safety and healthcare research, including studies on topics like airway management, cardiac care, and firefighter safety.

These findings help agencies improve health outcomes and make informed decisions about responder safety. ESO’s research also produces practical resources, such as white papers and guides, that agencies can use to implement these insights in the field.

Using the Power of Data to Drive Change

Released on April 2, 2024

The ESO Data Collaborative fuels research and helps agencies measure and improve operational performance. With aggregate insights from this extensive dataset, the annual ESO EMS, Fire Service, and Trauma Indices provide a detailed view of performance metrics compared to organizations across the U.S. These indices also share best practices to help agencies identify and address areas for improvement.

Read the 2024 ESO EMS Index

Read the 2024 ESO Fire Service Index

Post-Resuscitation Epinephrine Vs. Norepinephrine in Cardiac Arrest

Released in May 2024

Epinephrine and norepinephrine are both commonly used as prehospital vasopressors in the United States. However, previous research has suggested that epinephrine post-ROSC may be associated with increased chances of rearrest and mortality in comparison to norepinephrine.

Using target trial emulation methodology made possible by ESO data, this study aimed to review both methodologies to see if epinephrine did in fact increase changes of negative outcomes in order to help guide industry decision making. To better inform your own post-resuscitation practices, check out the full study below.

READ THE RESEARCH

The Threat That Burns On: Protecting Firefighters from Carcinogenic Exposure

Released on June 28, 2024 

Firefighters face significant risks from exposure to harmful carcinogens during and after responses. This year, we released “The Threat That Burns On: Carcinogenic Exposure and The Importance of Decontamination Procedures for Firefighters,” a white paper that outlines practical steps to reduce contamination on gear and equipment.

ACCESS THE WHITE PAPER

Longitudinal Changes in Emergency Medical Services Advanced Airway Management

Released on August 22, 2024

Playing a crucial role in resuscitating patients from life-threatening conditions, such as cardiac arrest, trauma and respiratory failure, airway management is an incredibly important intervention, yet its practice can shift greatly from agency to agency.

This study used ESO data and aimed to examine longitudinal trends in endotracheal intubation (ETI) and supraglottic airway (SGA) utilization nationally in order to better understand and improve airway management overall.

READ THE RESEARCH

When Do Minutes Matter? Prioritizing 911 Calls When Demand Exceeds Availability

Released on October 17, 2024

Responding to 911 calls is one of the most critical aspects of emergency care – but how do agencies decide which calls need immediate attention? This year, we released “When Do Minutes Matter? Prioritizing 911 Calls When Demand Exceeds Availability,” a white paper exploring a recent study in collaboration with eight EMS Systems and their dispatch centers examining 911 prioritization systems that shows only 10% of 911 calls require a lights-and-sirens response.

The report provides practical strategies for identifying high-priority calls and aligning resources to improve response times without compromising patient care.

ACCESS THE WHITE PAPER

The Effectiveness of Numerical Cincinnati Stroke Scale as a Stroke Severity Screening Tool

Released on November 19, 2024

The numerical Cincinnati Prehospital Stroke Scale (CPSS) was developed to broadly screen for strokes and is one of the simpler scales available to do so. Previous research has shown that CPSS performs similarly to other screening tools designed to detect stroke severity.

This study used ESO research to add to the body of work surrounding those findings. It found that this simpler, numerical scale had comparable results to more complex screening tools including C-STAT, FAST-ED, and BE-FAST and could be a good alternative option for maintaining accuracy.

READ THE RESEARCH

Another Successful Wave 2024 Filled with Data-Driven Insights

Once a year, the brightest minds in first response reunite for four days of networking, collaboration, and thought-provoking sessions. Held in Austin, Texas, from April 2–5, Wave 2024 brought together 1,275 attendees, 74 sessions, and countless opportunities to explore how data can empower teams and improve outcomes.

This year’s conference highlighted topics such as responder safety, operational efficiency, and improving patient outcomes. Attendees left with actionable insights and strategies to bring back to their organizations.

Missed Wave 2024 or want to revisit the highlights? Check out our recap blogs for the top insights from the conference:

Get the top fire and EMS insights from Wave 2024 

Get the top hospital insights from Wave 2024 

Want to know what makes Wave a must-attend event? Watch the video to hear directly from attendees.

Want to join fellow data enthusiasts from across the country and bring home actionable insights for improving your organization’s process? It’s time to grab your ticket for Wave 2025 happening in Austin, Texas from April 22-25, 2025.

Register for Wave 2025

Looking Ahead

As we close out 2024, we’re turning our attention to what lies ahead. The coming year will bring exciting new research projects, innovative tools, and continued collaboration with our customers to tackle emerging challenges in the public health and safety industries.

The post Year in Review: ESO Research and Data That Shaped 2024 appeared first on ESO.

Tracking your department’s data year after year helps you see where you’re doing well and where there’s room to improve. Understanding the types of incidents you handle most often, the areas that need prevention efforts, and ways to protect your firefighters are all steps toward improving your response.

Understanding incident types and trends

Knowing the types of incidents your department responds to most often is a good place to start. The 2024 ESO Fire Service Index shows that:

• 67% of all calls are EMS-related, while 3% are fire-related.
• Among fire-related calls, the top three incident types are:
  
  1. Structure fires (36%)
  2. Natural vegetation fires (21%)
  3. Outside rubbish fires (21%)
     
     

For departments serving wildland-urban interface (WUI) areas, the rise in natural vegetation fires highlights the importance of being ready for these incidents. Community education programs focused on fire-wise practices, such as clearing debris and managing controlled burns, can help reduce risks and prevent fires from starting in the first place.

Safety is more than a priority – it’s essential

Firefighter safety extends beyond the fireground and has long-lasting effects on their health. Research from ESO, based on data from more than 31,000 personnel across 581 agencies, shows that:

• Only 8% of firefighters documented fire-related exposure, but 82% of those performed at least one on-scene decontamination procedure.
• Fewer than 4% documented all recommended best practices, such as using soapy water to clean PPE, wiping exposed areas, and sealing contaminated gear.
  
  

These practices are critical in reducing exposure to harmful carcinogens. Studies, including those conducted by the National Institute for Occupational Safety and Health (NIOSH), show that firefighters are at a 9% higher risk of cancer diagnoses and a 14% higher risk of cancer-related deaths compared to the general U.S. population. The longer a firefighter spends on the fireground, the greater their risk.

Learn more about these risks and actionable solutions in the ESO white paper, The Threat That Burns On: Carcinogenic Exposure and the Importance of Decontamination Procedures for Firefighters.

So, what can your department do to improve your response?  

Track and improve response times

Your response time is a good place to begin. The 2024 ESO Fire Service Index shows that the median turnout time for fire calls was 1 minute, 12 seconds, which is better than the NFPA benchmark of 1 minute, 20 seconds. The median travel time for fire calls was 4 minutes, meeting the NFPA standard.

To improve further, incorporating a timer with a notification system into your processes can help track turnout times and identify delays. Immediately completing reports once all units are cleared also allows your department to more accurately track data and provide actionable feedback to your crew about performance.

Be prepared for wildland fires

Wildland fire incidents are on the rise, with over 42,000 calls recorded in 2023, according to the 2024 ESO Fire Service Index. Early detection plays an important role in reducing delays, especially in wildland-urban interface (WUI) areas where the combination of vegetation and structures increases fire risks. Collaborating with landowners to install detection systems and investing in foundational training programs like S-130/190 can help crews respond effectively and safely.

WUI environments present unique challenges, requiring careful preparation. Strategies such as creating evacuation plans, identifying staging areas, and conducting controlled burns are essential for limiting the spread of fires. These proactive measures, paired with prevention efforts tailored to WUI-specific risks, can significantly improve outcomes during fire responses.

Focus on firefighter health

Firefighter health is a key priority as departments work to reduce the risks associated with carcinogenic exposure. The ESO Research Roundtable: The Importance of Firefighter Decontamination Procedures is a resource created to help departments start meaningful conversations about improving decontamination practices. Building on insights from ESO’s white paper, The Threat That Burns On, the ESO Research Roundtable offers practical talking points and strategies to address gaps in safety protocols. Departments can use this guide to review current practices, identify areas for improvement, and encourage consistent habits, such as cleaning PPE thoroughly, documenting exposures, and isolating contaminated gear. These steps, supported by structured discussions, can lead to safer outcomes for crews both on and off the fireground.

Better decisions start with better data

Big changes are happening in the fire service industry, and data is at the forefront.  On the industry level, the upcoming transition from NFIRS to NERIS as the new emergency reporting standard in the U.S. introduces changes in how data is collected and reported, making it important for departments to have reliable systems in place. On the organizational level, accurate data helps fire departments track performance, improve safety, and adjust to the evolving reporting standards. ESO Fire RMS meets state and national compliance requirements – including NERIS – and supports these efforts by helping departments manage incident reporting, inspections, hydrants, and other operational needs.

Good data is more than numbers – it’s a resource for making informed decisions that improve outcomes for firefighters and the communities they serve. Compiled from 2,269 departments and representing over 6.5 million incidents from January 1 through December 31, 2023, the 2024 ESO Fire Service Index is designed to be used as a baseline to see how your organization aligns nationally across key performance metrics, such as the documentation of decontamination procedures, call response times, most common response types and more. Interested in seeing how your department compares? Read the full 2024 ESO Fire Service Index.

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