In the comprehensive 2009 Report on Emergency Medicine Physician Assistants survey that was commissioned by the Society of Emergency Medicine Physician Assistants (SEMPA) and the American College of Emergency Physicians (ACEP), and conducted by the National Commission on Certification of Physician Assistants (NCCPA), data pertaining to the clinical practice of EMPAs was collected and analyzed. Results are broken down by SEMPA members, non-members and total respondents.
Summary of Procedures Performed by EMPAs | Clinical Skills Practice Frequency |
Years in Clinical PA Practice | Years in Clinical Practice as an EM or Urgent Care PA |
Monthly or Annual Clinical Time | Primary Practice Site | Practice in State of Residence |
Population Size of the Community or Service Area | Number of PAs Providing Locum Work |
Physician Supervision | Method of Logging Procedures |
Method of Tracking Procedures Logged
The table below shows the percentage of EMPAs who report that they perform a number of procedures (irrespective of the frequency with which they perform them).
|
Procedure |
Performed by % of PAs |
|
Multiple layer laceration repair |
73.1% |
|
Reduction of major joint dislocations |
71% |
|
Arthrocentesis |
69.8% |
|
Closed fracture reductions |
68% |
|
Slit lamp exam |
64.7% |
|
Procedural sedation |
54% |
|
Lumbar puncture |
52% |
| Rapid sequence intubation |
43.1% |
| Write admission orders |
39.5% |
| Interosseus line placement |
37.7% |
| Central line placement |
35.9% |
| Chest tube thoracotomy |
34.7% |
| Provide medical direction for EMS |
32.3% |
| Prepare admission histories and physicals |
28.8% |
| Emergency ultrasonography |
28.1% |
| Needle thoracentesis |
26.8% |
| Arterial line placement |
18.2% |
| Venous cutdown |
11.4% |
| Cricothyrotomy |
10.9% |
Using a six-point scale, survey respondents were asked how often they perform specific clinical tasks. The following table provides data results for all respondents.
|
Practice type |
Never |
At least once a week |
At least once a month |
At least once every 6 months |
At least once a year |
Not credentialed |
Total |
|
Rapid Sequence Intubation |
32.21% |
3.01% |
10.58% |
14.51% |
15.42% |
24.27% |
100.00% |
|
Cricothyrotomy |
53.28% |
0.00% |
0.18% |
0.73% |
8.12% |
37.68% |
100.00% |
|
Needle thoracentesis |
45.16% |
0.18% |
1.37% |
6.84% |
15.60% |
30.84% |
100.00% |
|
Chest tube thoracotomy |
39.05% |
0.00% |
2.65% |
10.40% |
17.97% |
29.93% |
100.00% |
|
Central line placement |
35.95% |
3.38% |
8.49% |
11.31% |
13.23% |
27.65% |
100.00% |
|
Interosseus line placement |
45.89% |
0.18% |
2.10% |
11.22% |
20.07% |
20.53% |
100.00% |
|
Venous cutdown |
57.48% |
0.27% |
0.27% |
1.82% |
7.66% |
32.48% |
100.00% |
|
Procedural sedation |
16.88% |
13.59% |
27.74% |
18.07% |
4.84% |
18.89% |
100.00% |
|
Arterial line placement |
48.36% |
1.46% |
2.10% |
5.02% |
8.76% |
34.31% |
100.00% |
|
Reduction of major joint dislocations |
9.12% |
17.88% |
33.67% |
24.36% |
8.76% |
6.20% |
100.00% |
|
Closed fracture reduction |
10.86% |
19.89% |
26.55% |
27.55% |
8.21% |
6.93% |
100.00% |
|
Multiple layer laceration repair |
0.73% |
55.38% |
28.92% |
12.23% |
2.37% |
0.36% |
100.00% |
|
Arthrocentesis |
14.14% |
10.04% |
25.27% |
33.21% |
11.31% |
6.02% |
100.00% |
|
Lumbar puncture |
24.00% |
8.30% |
20.26% |
18.80% |
10.68% |
17.97% |
100.00% |
|
Slit lamp exam |
9.58% |
51.92% |
24.64% |
8.39% |
2.65% |
2.83% |
100.00% |
|
Emergency ultrasonography performance |
31.66% |
13.59% |
9.76% |
7.12% |
3.28% |
34.58% |
100.00% |
|
Write admission orders |
31.84% |
41.70% |
8.49% |
3.92% |
1.64% |
12.41% |
100.00% |
|
Prepare admission histories and physicals |
47.35% |
32.66% |
3.65% |
1.92% |
2.37% |
12.04% |
100.00% |
|
Provide medical direction for EMS |
42.88% |
23.72% |
9.03% |
5.38% |
3.38% |
15.60% |
100.00% |
The following table provides EMPA data results for years in clinical PA practice.
|
Years Interval |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
1-10 |
176 |
53.66% |
383 |
49.87% |
559 |
51.00% |
|
11-20 |
90 |
27.44% |
246 |
32.03% |
336 |
30.66% |
|
21-30 |
46 |
14.02% |
98 |
12.76% |
144 |
13.14% |
|
31-40 |
16 |
4.88% |
41 |
5.34% |
57 |
5.20% |
|
Total |
328 |
100.00% |
768 |
100.00% |
1096 |
100.00% |
The following table provides data results for years in clinical PA practice and emergency medicine or urgent care PA.
|
Years Interval |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
1-10 |
216 |
65.85% |
499 |
64.97% |
715 |
65.24% |
|
11-20 |
81 |
24.70% |
217 |
28.26% |
298 |
27.19% |
|
21-30 |
27 |
8.23% |
46 |
5.99% |
73 |
6.66% |
|
31-40 |
4 |
1.22% |
6 |
0.78% |
10 |
0.91% |
|
Total |
328 |
100.00% |
768 |
100.00% |
1096 |
100.00% |
The following table provides EMPA data results for the current monthly or annual clinical time spent in an emergency medicine or urgent care setting.
|
Time percentage |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
Less than 25% |
8 |
2.44% |
37 |
4.82% |
45 |
4.11% |
|
25%-49% |
8 |
2.44% |
24 |
3.13% |
32 |
2.92% |
|
50%-75% |
9 |
2.74% |
24 |
3.13% |
33 |
3.01% |
|
75%-100% |
25 |
7.62% |
64 |
8.33% |
89 |
8.12% |
|
100% |
278 |
84.76% |
619 |
80.60% |
897 |
81.84% |
|
Total |
328 |
100.00% |
768 |
100.00% |
1096 |
100.00% |
The following table provides data results for EMPA primary practice sites.
|
Primary Practice |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
Emergency Department |
246 |
75.00% |
501 |
65.75% |
747 |
68.53% |
|
Fast Track |
57 |
17.38% |
154 |
20.21% |
211 |
19.36% |
|
Triage |
5 |
1.52% |
3 |
0.39% |
8 |
0.73% |
|
Urgent Care |
20 |
6.10% |
104 |
13.65% |
124 |
11.38% |
|
Total |
328 |
100.00% |
762 |
100.00% |
1090 |
100.00% |
The following table provides data results on EMPAs practicing in state of residence.
|
Practice in State of Residence |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
Yes |
311 |
94.82% |
737 |
95.96% |
1048 |
95.62% |
|
No |
17 |
5.18% |
31 |
4.04% |
48 |
4.38% |
|
Total |
328 |
100.00% |
768 |
100.00% |
1096 |
100.00% |
The following table provides EMPA data results on population size of the community or service area.
|
Population Size |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
Metro (250,000 - 1 million) |
78 |
24.30% |
225 |
29.53% |
303 |
27.98% |
|
Metro (1 - 3 million) |
36 |
11.21% |
87 |
11.42% |
123 |
11.36% |
|
Metro (Greater than 3 million) |
21 |
6.54% |
39 |
5.12% |
60 |
5.54% |
|
Non-metro(Less than 2500) |
5 |
1.56% |
16 |
2.10% |
21 |
1.94% |
|
Non-metro (2500-10,000) |
27 |
8.41% |
42 |
5.51% |
69 |
6.37% |
|
Non-metro (10,000-25,000) |
40 |
12.46% |
55 |
7.22% |
95 |
8.77% |
|
Non-metro (25,000-250,000) |
114 |
35.51% |
298 |
39.11% |
412 |
38.04% |
|
Total |
321 |
100.00% |
762 |
100.00% |
1083 |
100.00% |
The following table provides data results on the numbers of PAs providing locum work.
|
Status of Providing Locum Work |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
Yes |
53 |
16.16% |
107 |
13.93% |
160 |
14.60% |
|
No |
275 |
83.84% |
661 |
86.07% |
936 |
85.40% |
|
Total |
328 |
100.00% |
768 |
100.00% |
1096 |
100.00% |
The following table provides data results on the percentage of on-site physician supervision by an emergency medicine attending.
|
Frequency |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
Less than 25% |
30 |
9.15% |
60 |
7.81% |
90 |
8.21% |
|
25-50% |
15 |
4.57% |
17 |
2.21% |
32 |
2.92% |
|
50-75% |
6 |
1.83% |
16 |
2.08% |
22 |
2.01% |
|
75-100% |
11 |
3.35% |
60 |
7.81% |
71 |
6.48% |
|
100% |
241 |
73.48% |
575 |
74.87% |
816 |
74.45% |
|
Never on-site |
25 |
7.62% |
40 |
5.21% |
65 |
5.93% |
|
Total |
328 |
100.00% |
768 |
100.00% |
1096 |
100.00% |
The following table provides EMPA data results on the method of logging procedures.
|
Logging Method |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
Manually |
190 |
58.10% |
410 |
53.46% |
600 |
54.84% |
|
On line |
50 |
15.29% |
148 |
19.30% |
198 |
18.10% |
|
Other |
87 |
26.61% |
209 |
27.25% |
296 |
27.06% |
|
Total |
327 |
100.00% |
767 |
100.00% |
1094 |
100.00% |
The following table provides EMPA data results on the method of tracking procedures logged.
|
Tracking Method |
SEMPA |
Non SEMPA |
All Respondents |
|||
|
Frequency |
Percent |
Frequency |
Percent |
Frequency |
Percent |
|
|
By professional society |
14 |
4.28% |
30 |
3.91% |
44 |
4.02% |
|
By the PA |
165 |
50.46% |
380 |
49.54% |
545 |
49.82% |
|
By supervising physician |
52 |
15.90% |
176 |
22.95% |
228 |
20.84% |
|
Others |
96 |
29.36% |
181 |
23.60% |
277 |
25.32% |
|
Total |
327 |
100.00% |
767 |
100.00% |
1094 |
100.00% |