Be prepared for ambulance wait times

(Reuters Health) - Bystanders should be prepared to give first aid during an emergency until responders arrive on the scene, experts say.

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.

“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 (here) 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: and JAMA Surgery, online July 19, 2017.