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 On average in the U.S., the length of time between a call for help
and the arrival of emergency medical services is about eight minutes
- but that rose to 14 minutes in rural areas (where about 10 percent
of patients waited nearly 30 minutes), researchers found.
"It’s long enough that if CPR isn’t done before the ambulance gets
there, it’s not going to turn out well for the patient," said lead
author Dr. Howard Mell, of CEP-America and Presence Mercy Medical
Center in Aurora, Illinois.
Mell and colleagues write in JAMA Surgery that having to wait for
emergency responders to arrive is unavoidable, but few studies have
looked at the length of the wait and whether it varied by setting.
"We really wanted to focus on providing the proof that active
bystander training is necessary," Mell told Reuters Health.
For the new study, the researchers analyzed emergency medical
service data collected in 2015 from 486 U.S. agencies.
They had information on nearly 1.8 million emergency calls. About 4
percent were in rural areas, about 88 percent in suburban areas and
about 8 percent in urban areas.
On average, responders arrived 7.9 minutes after the call for help
was placed.
The average waiting time was 7 minutes in urban setting, 7.7 minutes
in suburban areas, and 14.5 minutes in rural areas.
The findings aren't meant to put rural emergency responders in a bad
light, said Mell. Realistically, those units face greater barriers.
"They’re often volunteer units," he said. "(They also need)
additional time to get to the station and additional time to get to
the location."
Mell said the difference in response times between rural, urban and
suburban settings was not as large as a person might expect.
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"What this tells us is that all persons need to be trained to really
assist – especially if you have family members at risk for these
sudden life threatening events," he said.
In an editorial published with the study, doctors say bystanders
need to be prepared to deal with injuries that involve bleeding.
"First, we must empower citizens with legal protection similar to
the good Samaritan coverage, which allows bystanders to engage in
rescue from a cardiac event with CPR or the Heimlich maneuver for
choking," they write. "Bleeding/hemorrhage control should be
included in these statutes."
How to stop bleeding should be taught alongside Basic Life Support
and CPR training, Dr. Adil Haider of Brigham and Women's Hospital in
Boston and colleagues believe.
A U.S. government program known as You Are the Help Until Help
Arrives (https://community.fema.gov/until-help-arrives) helps teach
people what to do while waiting for first responders, Mell said.
Also, he said, local emergency personnel can be good resources.
"Those people either run those courses or know where to go to get
those courses," he said.
SOURCE: http://bit.ly/2vDl03Q and http://bit.ly/2vDmpaP JAMA
Surgery, online July 19, 2017.
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