This study was able to estimate the prevalence of depression, anxiety, and stress among a large cohort of nationally certified EMS professionals and identified statistically significant demographic and work-life characteristics that predicted depression, anxiety, and stress. Future research should attempt to follow EMS professionals prospectively to determine specific characteristics associated with occupational traumatic exposure and the development of depression, anxiety, and stress.

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OBJECTIVE The objective of this study was to characterize repeat Emergency Medical Services (EMS) transports among older adults across a large and socioeconomically diverse region. METHODS Using the North Carolina Prehospital Medical Information System (PreMIS), we analyzed the frequency of repeat EMS transports within 30 days of an index EMS transport among adults aged 65 years and older from 2010–2015. We used multivariable logistic regressions to determine characteristics associated with repeat EMS transport. RESULTS Over the 6-year period, EMS performed 1,711,669 transports for 689,664 unique older adults in North Carolina. Of these, 303,099 (17.7%) transports were followed by another transport of the same patient within 30 days. The key characteristics associated with an increased adjusted odds ratio of repeat transport within 30 days include: transport from an institutionalized setting (OR 1.42, 95% Confidence Interval (CI) 1.38–1.47), Blacks compared to Whites (OR 1.29, 95% CI 1.24–1.33), a dispatch complaint of psychiatric problems (OR 1.38, 95% CI 1.25–1.52), back pain (OR 1.35, 95% CI 1.26–1.45), breathing problems (OR 1.21, 95% CI 1.15–1.30), and diabetic problems (OR 1.14, 95% CI 1.06–1.22). Falls accounted for 15.6% of all transports and had a modest association with repeat transports (OR 1.07, 95% CI 1.00–1.14). CONCLUSIONS More than 1 in 6 EMS transports of older adults in North Carolina are followed by a repeat transport of the same patient within 30 days. Patient characteristics and chief complaints may identify increased risk for repeat transport and suggest the potential for targeted interventions to improve outcomes and manage EMS utilization.