How Many Medics Does It Take...

Understanding ideal crew configuration is vital to maintain EMS systems. There’s a lack of evidence demonstrating the need for a second ALS provider on a general ALS response. Implications of overstaffing may result in more patient care errors and draining of financial resources which could be spent on additional state-of-the-art medical equipment or number of units resulting in better system performance and patient care.

A study conducted with the Mississippi Department of Health evaluated the volume-outcome relationship of paramedics.¹⁴ This 14-year study estimated the relationship between experience accumulation and performance of paramedics who responded to approximately 175,000 general trauma calls. A greater volume of paramedic experience was significantly related to reduced total prehospital time and time on scene. The authors concluded that retention of skills is accomplished by increased volume.

A 2010 study of 10,298 out-of-hospital cardiac arrests evaluated whether more paramedics (three or more vs. two paramedics) resulted in improved outcomes. No difference was found in survival to discharge, and return of spontaneous circulation wasn’t associated with a greater number of paramedics.¹⁵

A similar paper evaluated two paramedic vs. single paramedic crews in simulated cardiac arrest scenarios. They found that additional paramedics on the crews resulted in more errors than with single paramedic crews.¹⁶