ESO Releases 2020 ESO EMS Index: COVID-19 Special Edition to Examine Nationwide Impact of COVID-19 on EMS Agencies and Personnel

Report focuses on 911 call volume, personal protective equipment usage, vital sign documentation and hospital outcomes related to COVID-19

August 27, 2020 – AUSTIN, TexasESO, the leading data and software company serving emergency medical services (EMS), fire departments and hospitals, today announced the findings of its 2020 ESO EMS Index: COVID-19 Special Edition. The Index is based on data from more than 2,000 EMS agencies nationwide that are part of the ESO Data Collaborative. The report looks at a number of measures, including 911 call volume; personal protective equipment (PPE) use and reuse; vital sign documentation, including temperature and pulse oximetry; and hospital diagnoses. Data used for the Index are from 4.1 million 911 calls from January 1, 2020 to July 31, 2020.

“COVID-19 continues to affect our nation and has a significant impact on our healthcare system and people,” said Dr. Brent Myers, Chief Medical Officer for ESO. “With the information from the ESO Data Collaborative, we are able to identify specific COVID-19 trends affecting frontline health and public safety responders and providers – especially around 911 calls and whether patients are refusing transport, how and when providers are using PPE, if we are closing the data loop with hospitals, and how we are documenting vital information.”

Key Findings Include: 

  • Total 911 Calls Dropped…for a Bit: Overall, we noticed a decrease in total 911 call volume since early January 2020 by as much as 18 percent through the end of April. Motor Vehicle Crash calls, in particular, experienced a significant drop, down by 40 percent. However, this trend began reversing in May and we continue to see an upward trajectory.
  • Cardiac Arrest Spikes: Substantial increases in the number of out-of-hospital cardiac arrests have been observed, particularly in regions with increased COVID-19 cases. In April 2020, EMS responses for cardiac arrests spiked by 36 percent compared to the prior year.
  • Penetrating Injuries are Up: While warmer months are often associated with a rise in penetrating trauma (such as stabbings and gunshot wounds), the rate of increase appears higher in 2020 compared to the previous year.
  • Questions remain about PPE usage: In up to 20 percent of patients with documented COVID-19 disease at the receiving hospital, there is no documentation of appropriate PPE usage in the EMS patient care record.
  • Opioid Overdose Calls are Up: Between January 1, 2020 and July 31, 2020, opioid overdose responses jumped 30 percent. The numbers increased particularly in May and June by approximately 41 percent and 53 percent respectively.
  • Linked Hospital Outcomes Provide Valuable Information: The COVID-19 Specific Diagnosis Code was officially implemented April 1 and provides a HIPAA-compliant, automated mechanism for EMS providers to determine which of their patients have a confirmed diagnosis. This also allows population-level monitoring of trends and helps communities plan for next steps.

“We are not through the pandemic as of yet, and timely analysis of data will be critical in the months to come,” added Myers. “We will continue monitoring the COVID-19 situation, helping to translate data into actionable information. Improved documentation of PPE usage, pulse oximetry, and patient temperatures are simple steps to better inform us all. Additionally, continued community education regarding the safety of medical evaluation for time-critical conditions is necessary.”

The 2020 ESO EMS Index: COVID-19 Special Edition can be downloaded here.

About the Index

The dataset for the ESO EMS Index is from the ESO Data Collaborative. It is real-world, de-identified data, compiled and aggregated from more than 2,000 agencies across the United States that use ESO’s products and services and agreed to have their data used for research purposes. These data are based on 4.1 million anonymized 911 calls between January 1, 2020 and July 31, 2020.

About ESO

ESO (ESO Solutions, Inc.) is dedicated to improving community health and safety through the power of data. Since its founding in 2004, the company continues to pioneer innovative, user-friendly software to meet the changing needs of today’s EMS agencies, fire departments, hospitals and state EMS offices. ESO currently serves thousands of customers throughout North America with a broad software portfolio, including the industry-leading ESO Electronic Health Record (EHR), the next generation ePCR; ESO Health Data Exchange (HDE), the first-of-its-kind healthcare interoperability platform; ESO Fire RMS, the modern fire Record Management System software platform; trauma, burn and stroke registry software; and ESO State Repository. ESO is headquartered in Austin, Texas. For more information, visit

Media Contact:

Andy Prince

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