Background <p>As a&#xa0;result of demographic developments the emergency medical service (EMS) is experiencing a&#xa0;significant shortage of skilled workers. This situation leads to bottlenecks and overloads that can impair the quality of public healthcare, while simultaneously increasing the demands on emergency personnel. The aim of this study was to obtain an up to date assessment of the physical and psychological stress and professional commitment of German emergency medical personnel in the context of changing framework conditions.</p> Methods <p>As part of the EMS health study 2023, a&#xa0;nationwide survey was conducted among German emergency services personnel. Questions based on a&#xa0;study by the Bavarian State Office for Health and Food Safety, supplemented by additional stress factors, were used to gather information on stress factors and potential improvement options.</p> Results <p>The study found that over 40% of respondents are considering a&#xa0;career change, primarily due to the working conditions or have already taken concrete steps in this direction. Additionally, the results indicate that employees in emergency services face numerous stress factors, with the highest stress levels being in the organizational area, which affects the process and structure of emergency services. According to the employees’ knowledge, with respect to the existing measures important prevention and intervention measures are lacking in approximately 50% of the facilities.</p> Conclusion <p>The study data reveal a significant potential for optimizing the working conditions of German prehospital emergency medical services and underline the need to implement corresponding measures.</p>