This factsheet is a slightly updated version of the 2024 Traffic Safety Facts.
Emergency Medical Services (EMS) play a critical role post-crash to reduce fatalities and serious injuries. Studies have shown that an effective emergency trauma care system can improve survival rates for those with serious injuries and reduce overall deaths from crashes.
Data Source: United States Department of Transportation. (2022, January). National Roadway Safety Strategy (Version 1.1). Washington, DC. https://www.transit.dot.gov/sites/dot.gov/files/2022-02/USDOT-National-Roadway-Safety-Strategy.pdf
Effective emergency trauma care system can improve survival from serious injuries by 25 percent.
20 percent of fatalities can be prevented by optimal emergency and trauma care.
The Federal Highway Administration (FHWA) names Post-Crash Care as a key element of a Safe System. Specifically, post-crash care refers to emergency first response and transport to medical facilities, as well as forensic analysis of the crash site and traffic incident management.
The Haddon Matrix applies basic principles of public health to motor vehicle-related injuries. The matrix looks at the factors in the pre-crash, crash, and post-crash phases to see how the driver, vehicle, and environment affect the outcome. Specifically, it identifies the factors that impact the prevention, severity, and survivability of crashes. For EMS, some factors are response time, proximity to an appropriate trauma center, and access to first responders with the appropriate equipment and training.
Figure: National Highway Traffic Safety Administration. (2016). NHTSA strategic plan 2016‑2020 (Table 4, p. 11). U.S. Department of Transportation. Retrieved from https://www.nhtsa.gov/sites/nhtsa.gov/files/documents/12532-nhtsa-strategicplan-2016-2020.pdf
In 2023, there were 40,901 people killed in motor vehicle crashes and countless more who were injured on United States roadways.
Data Sources: i) Bureau of Transportation Statistics. (n.d.). Rural transportation. U.S. Department of Transportation. https://www.bts.gov/rural; ii) California Department of Transportation. (2022). HPMS 2022 PRD Final (Table 4, p. 10). Retrieved from https://dot.ca.gov/-/media/dot-media/programs/research-innovation-system-information/documents/hpms2022_prd_final.pdf
The national 911 system was implemented over 50 years ago to provide efficient public access to emergency assistance. While effective, the 911 system must also evolve with technological improvements, specifically upgrading from an analog to a digital system. Next Generation 911 (NG911) improves the success and reliability of the 911 system by allowing users to securely send text messages, video, and photos to 911, and in turn allows 911 dispatchers to transmit this information along with location information to first responders. NG911 will allow first responders to more accurately locate crash victims to assess their injuries, thereby improving patient outcomes.
Each crash puts motorists and first responders at risk of secondary crashes while also increasing congestion. In response, the Federal Highway Administration (FHWA) developed the National Traffic Incident Management (TIM) Responder Training to help transportation agencies and first responders establish coordinated processes to quickly:
detect,
respond to, and
remove traffic incidents to restore traffic capacity and flow as quickly and safely as possible.
TIM became the national standard of practice for law enforcement, EMS, and others responding to roadway incidents. As of September 2025, over 800,000 responders were trained to clear traffic incidents.
The latest FHWA Every Day Counts 7 (EDC-7) initiative continues to promote Next-Generation TIM technologies to improve safety for crash responders, including:
smart emergency vehicle lighting,
use of unmanned aerial systems to map crash scenes, and
also features an initiative to improve nighttime visibility, via traffic control devices and lighting, to reduce traffic fatalities.
Note: a multi-county EMS agency is defined as an entity of three or more counties.
Data Sources: i) EMS Authority. (2024). LEMSA Multi‑County Map [Map]. California Emergency Medical Services Authority. Retrieved September 23, 2025, from https://emsa.ca.gov/wp-content/uploads/sites/71/2024/05/LEMSA_MultiCounty_Map-scaled.jpg ii) EMS Authority. (n.d.). Multicounty EMS Agency Information. Retrieved September 23, 2025, from https://emsa.ca.gov/multicounty-info/
California’s EMS system management includes 34 local EMS systems that serve all 58 counties through seven regional EMS systems and 27 single-county agencies.
The single county agencies are found in the more densely populated urban areas while regional systems usually serve more rural ones.
Of the seven regional EMS systems, six are multi-county agencies serving thirty counties in rural areas with extensive tourism.
As of September 2025, the state’s trauma center network consisted of 86designated trauma centers (Level I, II, and III, and IV) and admitted over 117,000 trauma patients per year, though not all related to motor vehicle crashes.
Almost three-quarters of the designated trauma centers (71.4 percent) offer Level I or Level II trauma services alongside other comprehensive resources needed for providing definitive care. Nearly one quarter (16.3 percent) of the designated trauma centers are designated pediatric trauma centers, each with a minium designation of Level I or Level II.
According to the California Emergency Medical Services Authority, the following counties constitute each of the regions:
Bay Area region: Alameda, Contra Costa, Marin, Monterey, San Benito, San Francisco, San Mateo, Santa Clara, Santa Cruz, & Solano counties.
North region: Mendocino, Sonoma, El Dorado, Napa, Humboldt, Del Norte, Lake, Lassen, Sacramento, San Joaquin, Siskiyou, Shasta, Tehama, Butte, Yuba, Placer, & Yolo counties.
Central region: Fresno, Tulare, Madera, Kern, Merced, Stanislaus, & Tuolumne counties.
South East region: Imperial, San Bernardino, Riverside, & San Diego counties.
South West region: Los Angeles, Orange, San Luis Obispo, Santa Barbara, & Ventura counties.
| Region | ACS Adult Designation - Level I | ACS Adult Designation - Level II | ACS Adult Designation - Level III | ACS Adult Designation - IV | Total |
|---|---|---|---|---|---|
| Bay Area | 4 | 6 | 1 | 1 | 12 |
| Central | 1 | 1 | 1 | 0 | 3 |
| North | 1 | 8 | 6 | 1 | 16 |
| South East | 8 | 3 | 0 | 0 | 11 |
| South West | 6 | 15 | 1 | 0 | 22 |
| Grand Total | 20 | 33 | 9 | 2 | 64 |
| Region | ACS Peds Designation - Level I | ACS Peds Designation - Level II | Total |
|---|---|---|---|
| Bay Area | 2 | 1 | 3 |
| Central | 0 | 1 | 1 |
| North | 1 | 0 | 1 |
| South East | 2 | 0 | 2 |
| South West | 2 | 6 | 8 |
| Grand Total | 7 | 8 | 15 |
Data Source: California Emergency Medical Services Authority, 2025.
Equity in access to EMS is a significant concern. Rural California faces more barriers to trauma care due to limited access to higher level trauma centers and farther distances to care. The above tables show locations of Level I to III and unspecified trauma centers in California. Six counties do not have a designated trauma center within their boundaries but have approved trauma plans. Tribal communities in California experience long EMS response times due in large part to the greater average distance of crashes from EMS responders.
Data Source: Gregory Harasym and David Ragland. (2022). EMS Response TIME in Tribal Areas. UC Berkeley SafeTREC. Pre-publication paper
In 2021, California Senate Bill 156 was passed, expanding broadband access in rural California.
This bill may reduce EMS response time in rural and Tribal communities.
Data Source: Tribal Broadband Connectivity Program, US Department of Commerce. https://www.ntia.gov/funding-programs/internet-all/tribal-broadband-connectivity-program Accessed Sept 15th, 2025.
Preliminary data indicates that there were 3,727 fatal crashes and 14,412 serious injury crashes on California roadways in 2023.
Data Source: i) Fatality Analysis Reporting System (FARS) ARF 2023; ii) Provisional Statewide Integrated Traffic Records System (SWITRS) 2023
In 2021, California extended “Move Over, Slow Down” provisions to apply to local streets and roads in addition to freeways. Despite this, first responders continue to be killed in the line of duty.
Data Source: Federal Highway Administration. (n.d.). Traffic Incident Management (TIM). U.S. Department of Transportation. Retrieved September 23rd, 2025 from https://fhwaapps.fhwa.dot.gov/tim
As of September 2025, California had 33,521 first responders trained in training incident management (TIM), which represented 39 percent of the state’s first responder workforce.
California ranked 36th based on its TIM’s percentage and made it one of the 23 states that fell below the national goal of 65 percent.
By improving TIM training, California could reduce traffic crashes related to stopped vehicles and the subsequent risk of secondary crashes.
