Emergency care in America is due for emergency care itself, according to a new report by a national physicians group.

The American College of Emergency Physicians this week gave a near-failing "D+" grade to emergency medical services as a whole in the United States

"This report card is saying: The nation's policies are failing to support emergency patients," announced Alexander Rosenau, the trade group's president.

The report did not name any specific physicians or hospitals, but did show the success of states and the federal government in supporting emergency care, explained Jon Mark Hirshon, an emergency physician at the University of Maryland and a board member for the physicians organization.

The physicians group graded the states by using 136 different measures that covered a number of categories, including access to care and disaster preparedness.

The last time the nation's emergency services were assessed in 2009, the nation earned an overall "C-" grade.

Actually, some service categories this year fared better than they did five years ago: quality and patient safety environment got a C, as did public health and injury prevention and disaster preparedness.

But the medical liability system got a C-minus and access to emergency care only scored a D-minus.

"If I'm in a car crash and they bring me to hospital that's not ready for me, my chances of survival are less," Hirshon said. "So you want a state that has that type of trauma system. And when you look at patient safety, that's one of the components."

A hospital's medical liability environment affects a service provider's ability to access a specialist in an emergency, Hirshon said, because appropriate physicians, for liability reasons, may feel reluctant to treat patients they don't know.

State-by-state, the report card the District of Columbia leads in emergency care support, with a "B-" grade, followed by second-place Massachusetts, third Maine and fourth Nebraska, all of which also earned "B-" standings.

Colorado came in at 5th place with a "C+" grading.

Wyoming brought up the bottom of the list with an "F" grade outright, while Arkansas ranked a "D-" and New Mexico, Montana and Kentucky were assigned "D" grades.

Access to emergency care was an area particular concern, in which 21 states were given an "F."

A person "can have the best medicine in the world, but it won't matter if people can't get to it," Hirshon said.