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WEDNESDAY, Feb. 6, 2019 (HealthDay News) – According to a new study, the speed with which medical help arrives at the scene of a car accident plays an important role in the patient's survival.
Looking at US collisions between 2013 and 2015, researchers attributed below average EMS response times to 14% of deaths in cities and suburbs. 10% of deaths in rural areas have been poorly programmed.
"The prehospital response time is crucial for traumatized patients, probably because of the importance of prehospital care, such as intravenous fluid administration, fracture stabilization, and bleeding control," he said. Dr. Marie Crandall. She is a professor of surgery at the College of Medicine at the University of Florida in Jacksonville.
"Our prehospital care providers provide life-saving essential care," said Crandall. But these systems need additional funds to improve their efficiency, she said.
Crandall wrote an editorial accompanying the study. Both were published on February 6 in JAMA Surgery.
The study was led by Dr. James Byrne of Sunnybrook Health Sciences Center in Toronto. With his team, he examined the crash response time of EMS in nearly 2,300 US counties over three years.
"Extended responses" were 10 minutes or more in rural areas and 7 minutes or more in urban and suburban areas.
If the response time was even slower by 5 minutes, for example 12 minutes against 7, the probabilities of death increased by 46%, reveals the study.
The researchers found that the late arrival of ambulances was linked to higher mortality rates, even after taking into account regional differences in medical response time, access to trauma centers, code of road and population density.
An expert who was not part of the study said that he was not surprised.
"We know that longer transport times are badociated with adverse consequences," said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York.
But he pointed out that one of the weaknesses of the new study is that researchers can not take into account the differences between each EMS system.
"We need to have studies that include several EMS systems of greater diversity to see if these results can be replicated," said Glatter.
Glatter suspects that traffic plays a role in slow reactions in cities and suburbs. Similarly, longer distances have an impact on rapid processing in rural areas. He emphasized that traffic laws must be respected. "You can not put pedestrians and other drivers at risk so that patients arrive more quickly," he said.
In rural areas, MHE teams are largely volunteers, and it can take time to get a team together, said Glatter. It can also delay the response time.
Having electronic routing systems in ambulances to identify the best routes is one way to improve response time, said Glatter.
Victims of hospital trauma are also considered to affect survival, said Glatter. For the seriously injured, "if you can take your patients to a level 1 trauma center, it will improve the results," he said.
"It's time to bring patients to a trauma center as soon as possible," he said.
Glatter, however, acknowledged that in many cases patients need to go to the nearest emergency room.
In addition, he suggested having more paramedics in ambulances because they can provide higher levels of care than paramedics.
More information
The US Road Safety Administration has more EMS systems.
SOURCES: Marie Crandall, M.D., M.P.H., Professor of Surgery, College of Medicine, University of Florida, Jacksonville; Robert Glatter, MD, emergency physician, Lenox Hill Hospital, New York; February 6, 2019, JAMA Surgeryonline
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