Key Takeaways

• The 2026 EMS Insights Report reveals significant shifts in prehospital care, emphasizing increased complexities and operational challenges.
• Key trends include rising prehospital blood administration and behavioral health demand, along with an uptick in trauma incidents.
• Data continuity issues persist, as only 3% of EMS records include post-hospital outcomes, indicating a gap in understanding patient impacts.

Changing Landscape of Prehospital Care

The 2026 EMS Insights Report by ImageTrend offers an extensive analysis of national EMS data from 2023 to 2025, illustrating the evolving landscape of prehospital care across the United States. Utilizing a dataset that includes over 18 million EMS activations in 2025 alone, the report highlights critical trends in patient demand, clinical care, and workforce dynamics.

Joe Graw, Chief Growth Officer at ImageTrend, asserts that the most notable change is not merely the volume of EMS activations but the transformation in care delivery methods. “From the expansion of prehospital blood administration to sustained behavioral health demand, EMS is confronting a new level of clinical and operational complexity,” Graw stated. These changes underline the need for accelerated investments and systemic adjustments to better support EMS operations.

Key Trends in EMS

The report identifies several major shifts impacting the EMS field:

• Expansion of Prehospital Blood Administration: The percentage of ground-based blood transfusions doubled from 5% in 2023 to 10% in 2025, but air units remain dominant in this practice, performing 87% of all blood administrations.

• Rise in Behavioral Health Responses: Incidents related to behavioral health increased from 9.8% in 2023 to 11.7% in 2025, signaling a significant and growing demand on EMS systems.

• Increase in Trauma Incidents: The number of injury-related responses grew from 17.9% in 2023 to 18.6% in 2025, adding to the overall clinical complexity and workload, with a total of 2,317,428 incidents recorded.

Despite the comprehensive data collected, gaps in patient care continuity persist, as evidenced by the low percentage of EMS records—just over 3%—that contain hospital outcome information. This lack of data hinders the ability to fully grasp the impacts of prehospital care.

From Historical to Forward-Looking Analysis

This edition of the EMS Insights Report diverges from previous reports that focused on establishing baseline data. Instead, it provides a longitudinal analysis to identify meaningful changes in care delivery. By transitioning from retrospective to proactive analysis, the report offers agencies insights necessary for strategic planning and resource allocation.

Morgan Anderson, Director of Research at ImageTrend, emphasized the importance of this multi-year perspective: “These trends help illustrate not just what is happening in EMS, but how and why it’s changing—giving agencies and policymakers the insight they need to plan ahead.”

Utilizing Comprehensive Data

The report hinges on a robust database, ImageTrend Collaborate™, which reflects national EMS patterns across all 50 states and includes over 157 million EMS activations since 2018. This dataset is closely aligned with the federally funded National EMS Information System (NEMSIS), making it a reliable source for large-scale EMS analysis.

The complete report is now available at ImageTrend’s official site, providing valuable insights for EMS leaders and stakeholders seeking to adapt to the evolving demands of the field.

ImageTrend has been transforming incident data into actionable intelligence since 1998, aiding over 3,100 customers and 21,000 agencies in enhancing operational efficiency and improving emergency response outcomes.

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