Emergency Medical Services Response Times in Rural, Suburban, and Urban Areas

Abstract

minutes; P < .001) (Table 2).Discussion | Through this quality improvement process, we found that the rapid retriage protocol identified critically injured patients at higher risk for poor outcomes who could benefit from the use of rapid retriage. For critically injured ED trauma transfer patients who died, especially those with blunt trauma rather than penetrating trauma, increased time at a nontrauma hospital prior to transfer could have contributed to the higher mortality rate. In California's exclusive trauma system, data for patients cared for in nontrauma hospitals are not systematically available, even for patients transferred to a trauma center. In this study, we identified important clinical data elements that are not routinely obtained from referring nontrauma hospitals. A regional trauma center committee is using this information to create a consensus-based trauma transfer performance improvement page within each site's current trauma registry. This would enable the recording of data necessary to understand the emergency transfer process to improve the care for this vulnerable critically injured population.

“Feeling confident and equipped”: Evaluating the acceptability and efficacy of an overdose response and naloxone administration intervention to service industry employees in New York City

“…This intervention instructs participants to call EMS immediately upon identifying a potential overdose, prior to naloxone administration, to ensure that EMS arrive as soon as possible. The average EMS response time for a life-threatening medical emergency in NYC in 2017 was 7.29 min (NYC 911 Reporting, 2018), similar to the US urban average of 7 min and a suburban average of 7.7 min while the rural average was 14.5 min (Mell et al, 2017). However, brain damage can occur from 3 to 5 min after breathing cessation (Harm Reduction Coalition, 2012) making SIE response and naloxone administration crucial and potentially lifesaving.…”

The effect of rural hospital closures on emergency medical service response and transport times

“…12,15,16 Nationwide, service times are longer in rural ZIP codes, nearly double that of urban ZIP codes. 10 This disparity in timely access to care is likely a large driver of urban-rural mortality differences in emergency conditions, such as AMI and motor vehicle collision.…”

“…Although most admissions to the ED are not via EMS, those that are via EMS tend to be far more acute (eg, myocardial infarction) and for trauma such as motor vehicle collision, where timely response is a key determinant of survival . Nationwide, service times are longer in rural ZIP codes, nearly double that of urban ZIP codes . This disparity in timely access to care is likely a large driver of urban‐rural mortality differences in emergency conditions, such as AMI and motor vehicle collision.…”

Immediate response to major incidents: defining an immediate responder!

“…will worsen the medical outcome [15][16][17][18]. Although most EMS try to respond quickly, a response time of about 10-20 min can often be registered depending on the size of the city, its infrastructure, and traffic situation [19]. This waiting period leaves a gap in time, a critical therapeutic window, where victims cannot receive proper care while waiting for the EMS [15,20,21].…”

“…Many video reports from real incidents show the will and availability of the public to help the victims immediately, before any first responder appears on the scene. The question raised has been whether it is possible and what are the requirements to use these "immediate responders" while waiting for the professionals [18,19,[24][25][26][27][28][29]? In the WHO report from 2007, "mass casualty management systems" strategies and guidelines, the importance of "a culture of preparedness" at the community level is emphasized.…”