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Finding the Blind Spots: Using Geospatial Analysis to Optimize EMS Coverage Before Trauma Patients Die
Heather X Rhodes-Lyons1, Rachel Gabor1, Kristin Braun2
1Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA.
The American Surgeon
|July 28, 2026
Summary
Geospatial analysis revealed critical gaps in emergency medical services (EMS) coverage for traumatic injury deaths in rural areas. Strategically placing one additional EMS resource per region could significantly improve response times and access to care.
Area of Science:
- Public Health
- Emergency Medicine
- Geographic Information Systems (GIS)
Background:
- Traumatic injury is a leading cause of death, with rural populations facing disproportionately higher mortality rates.
- Existing trauma system coverage gaps, particularly for on-scene mortality, are not well understood.
- This study addresses the need to characterize these coverage deficiencies across regional trauma systems.
Purpose of the Study:
- To identify geographic "blind spots" in emergency medical services (EMS) coverage for on-scene trauma deaths.
- To pinpoint time-critical, spatially advantageous locations for potential new EMS resources.
- To analyze coverage gaps within a 10-minute drive-time standard across seven North Central state trauma regions.
Main Methods:
- Retrospective analysis of geocoded death certificate records (2019-2023) linked to ZIP Code Tabulation Areas.
- Modeling of 10-minute EMS drive-time service areas using Geographic Information Systems (GIS) software.
- Identification of candidate EMS resource placement sites by maximizing coverage of uncovered death locations, considering EMS agency staffing models.
Main Results:
- Overall EMS coverage within a 10-minute drive time varied significantly by region, from 53.5% to 87.0%.
- A substantial portion of trauma deaths (29.7%) occurred outside the modeled 10-minute service areas.
- Placing one additional EMS resource per region could extend modeled coverage to hundreds of additional death locations, particularly in volunteer-dominant EMS regions with reported scheduling gaps.
Conclusions:
- Geospatial analysis effectively identified actionable EMS coverage gaps in trauma systems.
- Targeted placement of EMS resources can improve modeled response coverage in underserved areas.
- Further evaluation is needed to confirm actual mortality reductions, especially considering staffing reliability in volunteer EMS systems.
