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Emergency Medical Services, more commonly known as EMS, is a system that provides emergency medical care. It is activated by a call for help, after an incident of serious illness or injury. The focus of EMS is the emergency medical care of the patient(s). EMS is most easily recognized when emergency vehicles or helicopters are seen responding to emergency incidents.

But EMS is much more than a ride to the hospital. It is a system of coordinated response and emergency medical care, involving multiple people and agencies. A comprehensive EMS system is ready every day for every kind of emergency.

EMS is an intricate system, with each component playing an essential role as part of a coordinated and seamless system of emergency medical care. EMS includes all of the following components:

  •  Agencies and organizations (both private and public)

  •  Communications and transportation networks

  •  Trauma systems, hospitals, trauma centers and specialty care centers

  •  Rehabilitation facilities

  •  Highly trained professionals

    • Volunteer and career prehospital personnel

    • Physicians, nurses, and therapists

    • Administrators and government officials

  • An informed public that knows what to do in a medical emergency

The delivery of emergency medical care is a local function and is organized in a variety of ways. Local communities design their own EMS systems, using local resources to address local needs. The organizational structure of EMS, as well as who provides and finances the services, varies significantly from community to community. Prehospital services can be based in a fire department, a hospital, an independent government agency (i.e., public health agency), non-profit corporation (e.g., Rescue Squad), or provided by commercial for-profit companies.

The National Highway Traffic Safety Administration (NHTSA) and its predecessor agency have supported comprehensive national emergency medical services system development for 50 years. NHTSA has been a consistent Federal advocate in promoting A Safe System Approach to the development of emergency medical services. 

In collaboration with its Federal partners, NHTSA’s Office of EMS has successfully implemented many programs to support and enhance EMS systems. Such programs include national standard curricula for EMS clinicians the National EMS Agenda for the Future, the National Emergency Medical Services Information System (NEMSIS) for EMS data, and planning for the implementation of Next Generation 911.

Consensus-building, collaboration and leveraging of limited resources for significant projects are the hallmarks of NHTSA's role in EMS system development. An efficient EMS system is integral to reducing traffic morbidity and mortality, essential to traffic mobility, and key to ensuring prompt emergency response to any type of incident. The Nation's best preparation for any incident is a comprehensive EMS system, ready every day for every emergency.

The Office of EMS is housed within the U.S. Department of Transportation, National Highway Traffic Safety Administration. To find out more about the Office of EMS and its programs and products, explore EMS.gov, visit the Office of EMS page, register to participate in free Federal webinars, receive email updates, or sign up for the EMS Update newsletter from the Office of EMS.

Each State and territory has a lead EMS agency. These agencies are often within the State health department, but in some states they are part of the public safety department or are independent State agencies. State EMS agencies are responsible for the overall planning, coordination and regulation of the State EMS system as well as licensing or certifying EMS clinicians and ambulances.

The following functions are typically, but not universally, performed by State EMS agencies:

  • Operating or coordinating a statewide communications system that connects EMS clinicians in the field with hospitals as well as trauma and specialty centers

  • Promoting statewide medical protocols for EMS clinicians, or otherwise establishing the scope of EMS practice within the State

  • Operating or coordinating a statewide communications system that connects EMS clinicians in the field with hospitals as well as trauma and specialty centers

  • Coordinating the distribution of grants for EMS or administering grant programs

  • Planning for and coordinating the medical response to disasters and mass casualty incidents and, since 9/11, homeland security medical initiatives

  • Serving as the lead agency for statewide trauma systems or other specialty care systems 

  • Collecting data from local EMS agencies, hospitals, and trauma centers, monitoring system performance and outcome

  • Administering or coordinating regional EMS programs

More information about State agencies is available from the National Association of State EMS Officials (NASEMSO), a non-profit organization of State EMS Directors, State EMS Medical Directors, Training Coordinators, Data Managers and Trauma Coordinators. For more information about NASEMSO and State EMS agencies, visit the NASEMSO website and its list of State EMS agencies.

Since its inception, the purpose of EMS has been to render emergency medical care to sick or injured people in emergency situations. But during the past 50 years, its role has continuously evolved. Modern EMS developed out of simultaneous advances in the science of cardiac resuscitation as well as the recognition of accidental death and disability as a neglected epidemic. It was created to meet the immediate needs of the acutely ill and injured as well as to provide emergency care and transportation.

Over the past five decades, EMS has expanded to provide emergency medical care for all types of emergencies. In many areas of the country, EMS serves as a healthcare "safety net," especially for the uninsured and underinsured. Public health authorities have also turned to EMS to assist in prevention activities, to promote health and wellness programs, and to assist in the identification of new or significant outbreaks of illness or injury.

The natural and man-made disasters of recent years have further changed the role of EMS. There is an increased need for the capabilities to respond to a growing list of hazards and care for large numbers of patients. Advances in medicine and technology continue to generate changes in operations and the protocols for emergency care provided by EMS. Learn more about the development of modern EMS.

NHTSA’s Office of EMS envisions an accessible and effective community-based emergency health system that produces optimal outcomes from motor vehicle crashes and other health emergencies based on the most current available data. The Office of EMS has and will continue to support a variety of programs and projects that encourage and support EMS systems nationwide as they collect and make meaningful use of all relevant data to ensure the best possible patient outcomes.

One of the most recognizable and successful Office of EMS managed EMS Data initiatives is the National Emergency Medical Services Information System (NEMSIS).

NEMSIS empowers EMS professionals to turn that data into meaningful information, enabling data-driven, evidence-based care to patients and communities. NEMSIS provides the framework for standardized data collection, hosting the National EMS Database and providing tools and resources for EMS data use with the goal of improving patient care.

Since the 1970s, the need for EMS information systems and databases was recognized and many statewide data systems were created to address that need. These EMS systems varied in their ability to collect patient and systems data to allow collective analysis at a local, State and Federal level. For this reason, NEMSIS was developed to support the sharing of standardized data elements by states and agencies to improve systems of care.

For more information about the Office of EMS’ activities to support the nationwide collection and use of EMS data, visit the Using EMS Data page at EMS.gov.


The Federal Interagency Committee on Emergency Medical Services (FICEMS) was established by Congress in 2005 to ensure coordination among Federal agencies supporting local, regional, State, tribal, and territorial EMS and 911 systems. FICEMS also exists to improve the delivery of emergency medical services throughout the Nation. Learn more about FICEMS.

NHTSA has long been involved in advocating for a universal number the public can call to access emergency help. The NHTSA National 911 Program, housed within the Office of EMS, provides Federal leadership to support and promote optimal 911 services. It was created by Congress to provide information to improve the 911 system as well as to coordinate information-sharing and activities among Federal agencies and the 911 community. The program fulfills its mission by developing and distributing a variety of tools and resources for the nation’s 911 stakeholders.

For more information on NHTSA’s 911 initiatives, visit www.911.gov.

Recognizing the need for a symbol that would represent this critical public service and be easily recognized by all, NHTSA created the "Star of Life" and holds priority rights to the use of this registered certification mark. Adapted from the personal medical identification symbol of the American Medical Association, each bar on the Star of Life represents one of six EMS functions.

The Star of Life has become synonymous with emergency medical care around the globe. It is visible as a means of identification on all of the following:

  • Ambulances and emergency medical equipment

  • Patches or apparel worn by EMS clinicians

  • Materials such as books, pamphlets, manuals, reports, and publications that either have a direct application to EMS or were generated by an EMS organization

  • Road maps and highway signs indicating the location of or access to qualified emergency medical care

Download "Star of Life" Emergency Medical Care Symbol: Background, Specifications & Criteria (PDF)

The National EMS Advisory Council (NEMSAC) consists of 25 members of the EMS community appointed by the Secretary of the Department of Transportation (DOT) to represent different aspects of the industry. The council provides a forum for the development, consideration and communication of information. NEMSAC activities align with the guiding principles of EMS Agenda 2050, with activities based around six committees:

  • Adaptability & Innovation

  • Equitable Patient Care

  • Integration & Technology

  • Preparedness & Education

  • Profession Safety

  • Sustainability & Efficiency

An independent organization without regulatory or management oversight, NEMSAC provides advice and recommendations about EMS to members of the Federal Interagency Committee on EMS (FICEMS) and to NHTSA at the DOT. For more information about the council’s work and a schedule of past and upcoming meetings, visit the NEMSAC page on EMS.gov.

The EMS and 911 systems throughout the country are a key element in preventing death and disability on our roadways. The delivery of quality post-crash care by robust and resilient 911 and EMS systems is one of the final opportunities to address transportation safety goals of reducing fatalities from crashes.  EMS data collected and shared at a local and national level is a valuable tool for transportation officials.

In January 2022, the Department of Transportation (DOT) released the National Roadway Safety Strategy (NRSS). It outlines a specific approach to reducing injuries and deaths on highways, roads and streets in the U.S., including a role for EMS in post-crash care. The NRSS calls for relevant stakeholders and agencies to adopt a Safe System Approach as they work together toward a long-term goal of zero roadway fatalities. Learn more about the NRSS to understand how the approach it outlines will impact the future of post-crash care and EMS. Learn more about the NRSS.

Last Updated: 05/17/2023