The EMS workforce has grown by over 30% in the last decade, with more clinicians trained in advanced skills than ever before. However, opportunities to perform high-acuity interventions have not increased at the same rate.

As advanced airway alternatives and expanded capabilities across systems reduce the frequency of procedures like endotracheal intubation, these critical skills are performed less often and distributed across a larger group of clinicians. Additionally, training disruptions during the COVID-19 pandemic further limited hands-on clinical experience for many learners.

The result is skill dilution: EMTs and paramedics who are trained and credentialed, but with fewer real-world repetitions when it matters most. This session explores the impact of skill dilution on performance and outlines practical strategies to improve readiness for high-risk, low-frequency events.