Insights, actions and the future of EMS: The 2025 ESO EMS Index

In this special data-driven edition of the EMS One-Stop podcast, host Rob Lawrence is joined by Dr. Brent Myers, chief medical officer, ESO, and Dr. Remle Crowe, ESO’s director of clinical and operational research, to unpack the newly released 2025 ESO EMS Index.

This annual report provides a powerful, real-world snapshot of national EMS trends — drawing on more than 14 million anonymized records to surface opportunities for clinical and operational improvement.

The conversation dives into key metrics that move beyond response times and into areas like pain management, opioid overdoses, airway confirmation, obstetric emergencies, whole blood use, pediatric behavioral health and high-utilization patient populations.

Throughout the episode, Drs. Myers and Crowe share the motivation behind each metric, explain how the data was gathered and analyzed, and reflect on how EMS agencies can use these insights to guide better care delivery and system design. From confronting equity in pain management, to pushing forward innovations like buprenorphine administration and whole blood programs, this is a compelling call to turn data into meaningful change.

Timeline

01:08 – Overview of the ESO EMS Index and its intent

02:59 – Origins of the report and data methodology

05:46 – Database scale: 14M+ records, 3,000+ agencies

07:14 – Metric 1: Pain management for long bone fractures

10:53 – Documentation, AI in EMS, and future documentation tools

14:30 – Metric 2: Suspected opioid overdose and buprenorphine use

18:51 – Best practices, COWS scoring, and naloxone delivery strategy

21:31 – Metric 3: Invasive airway confirmation using waveform capnography

28:06 – Metric 4: Obstetric emergencies (postpartum hemorrhage & hypertension)

34:34 – Metric 5: Prehospital whole blood surveillance

40:22 – Metric 6: Pediatric behavioral health and substance use disorder cases

44:54 – Metric 7: High utilization patient group (HUG)

52:48 – Final thoughts, calls to action, and Rob’s reflections

55:47 – Episode wrap-up and subscription reminder