# Border Region Emergency Medical Services in Migrant Emergency Care

## TL;DR

EMS clinicians in Arizona border regions face unsustainable strain due to high numbers of migrant crossings, requiring increased federal support.

## Contribution

This study provides new qualitative insights into how migration impacts EMS clinicians along the U.S.-Mexico border.

## Key findings

- EMS clinicians serve multiple populations and face complex calls and mass casualty-like scenarios.
- Deterrence policies have not reduced crossings but increased injuries and deaths, straining EMS systems.
- Participants called for greater federal financial support to sustain border EMS operations.

## Abstract

How do emergency medical services (EMS) clinicians along the US southern land border in Arizona characterize the impact of migration on their work?

This qualitative study among 67 EMS professionals found that these clinicians serve multiple populations, often respond to complex calls, and experience limited downtime and mass casualty–like scenarios when there are high numbers of border crossings.

The findings of this study suggest that the strain placed on local border EMS clinicians is unsustainable and that further federal-level support is required.

This qualitative study among emergency medical services professionals in 3 Arizona communities on the border with Mexico examines how these clinicians perceive the impact of migration on their work.

Focusing on the US southern land border only through a security lens minimizes the impact of security infrastructure and migrant health needs on local emergency medical services (EMS) clinicians.

To explore the perceptions and experiences regarding the impact of migration on EMS clinicians in the communities of study.

This qualitative study included in-depth interviews with fire department–based EMS clinicians in 3 Arizona communities on the Mexico border from June 23 to 27, 2024. Interviews were conducted 1-on-1 while clinicians were on shift. Participants were recruited with the help of fire department leadership in each fire department.

This was an exploratory study designed to identify how EMS clinicians perceive the influence of migration in the study communities. Thematic analysis was conducted using inductive, latent coding.

The 67 participants were predominately male (62 [93%]), which is reflective of the EMS profession in the border region. Years of experience as EMS clinicians were fairly evenly distributed: 5 years or less (14 [21%]), 6 to 10 years (18 [27%]), 11 to 20 years (18 [27%]), and 21 or more years (17 [25%]). EMS clinicians in these communities reported serving multiple populations, often responding to complex calls, and experiencing limited downtime and mass casualty–like scenarios when there are high numbers of border crossings. Participants perceived that the local EMS system was strained, and occasionally overwhelmed, and that greater financial support from the federal government was necessary.

The findings of this qualitative study of EMS clinicians suggest that migration has a complex, multidimensional influence on EMS clinicians in the border region. Deterrence-focused actions have not decreased the number of crossings but rather pushed migrants to cross in more dangerous ways, leading to more injuries and deaths. Our findings suggest that the strain placed on local EMS clinicians is unsustainable and may be exacerbated by increased deterrence-based policies. Instead, border-region EMS clinicians need increased federal funding to support their work.