Emergency medical services (EMS) personnel in the United States respond to an estimated 37 million 911 calls every year.
While first responders are the preferred choice to attend to sick and injured individuals, these individuals also rely on friends, family, and bystanders to improve their chances of survival.
This has prompted the development of a public education campaign, Until Help Arrives, which is a joint effort between emergency care and emergency management experts within the US government.
The aim of the initiative is to empower laypersons to provide care for the ill or injured during ambulance response times until EMS personnel arrive on the scene.
A review of EMS records determined the interval between receipt of a 911 call and arrival of first responders to an emergency scene. Their results were published in JAMA Surgery.
The authors reviewed EMS records from the year 2015 from 485 EMS agencies distributed throughout the US. The encounters were classified as rural (population of less than 2500), urban (population greater than 50,000) or suburban (population between 2,500 50,000) based on US Census Bureau categorization of the zip code.
Of these, they only included emergency 911 pre-hospital encounters: patient transfers, aborted encounters, encounters with arrival times 120 minutes or longer, and transport times 180 minutes or longer were excluded.
The 1,275,529 encounters resulted in the transport of a patient by the primary EMS unit. Of these, 70,189 were from rural zip codes, 1,576,019 were from suburban zip codes and 150,779 were from urban zip codes.
The average ambulance response time – for an EMS unit to arrive on the scene from the time of a 911 call – was seven minutes. This emergency response time increased to more than 14 minutes in rural settings.
Nearly one in ten encounters waits up to a half-hour for EMS personnel to arrive.
Longer EMS response times are associated with worse outcomes in trauma patients. The authors indicate that data limitations led to more of the encounters deriving from urban cluster zip codes, as well as deriving from convenience sampling versus a selected series of representative tracts, and this is a study limitation.
There is research to suggest that bystanders with first-aid training can and will effectively assist injured or ill individuals.
It may be of benefit to introduce widespread campaigns to encourage individuals to obtain basic first-aid training, as they may be able to provide critical care to injured or ill individuals in the interim between dispatch and arrival of Emergency Medical Services personnel.
Ambulance response time is a benchmark for health system performance and can be affected by various factors – these can include the distance from the emergency or even the time of the day. These factors can affect ambulance response times during an emergency.
References:
Mell, H., Mumma, S., Hiestand, B., Carr, B., Holland, T., Stopyra, J. (2017, July 19). Emergency medical response times in rural, suburban, and urban areas [Editorial]. JAMA Surgery DOI: 10.1001/jamasurg. 2017. 2230
(2016) Factors Influencing the Timeliness of Emergency Medical Service Response to Time Critical Emergencies, Prehospital Emergency Care, 20:6, 783-791, DOI: 10.3109/10903127.2016.1164776
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