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The antiquated concept of fast response times

Editor's note: For non life-threatening calls in the UK, services will not be measured simply on time alone, but on how they treat patients and the outcomes of the treatment. Editorial Advisor Art Hsieh says the concept of fast response times as a "essential" component of all EMS calls is antiquated. Find out why.

The concept of fast response times as an "essential" component of all EMS calls is antiquated. Just like most of medicine, one size does not fit all. It certainly makes sense to have a fully functional system that can arrive at the side of a sudden cardiac arrest within a few minutes of collapse (meaning, it's essential that the system has an integrated layperson response as well as professional).

It doesn't make much sense to have a mandatory eight-minute response time for someone with flu like symptoms for one week, or a broken wrist after a fall. Now, I recognize that prearrival triaging can be imprecise. Coupled with a litigious society, we tend to err very conservatively and send the cavalry more times than we need to. That's not right either, but there's a lot beyond the control of EMS system leadership that results in having these issues.

How does it affect us?

  • Places unnecessary strain and cost on EMS systems.
  • Places responders at increased risk of injury and death from unnecessary lights and siren responses.
  • Sets up false public expectations that eventually will fail when someone who needs help urgently doesn't get it because the system is unavailable.
  • Contributes to higher frustration of EMS providers ("I ran through five stop lights and seven stop signs to manage a two- inch laceration that's not bleeding?") which in turn, might result in a less than professional attitude towards the patient.

I don't know all of the details of what's happening in the UK system profiled in this story; it does seem a tad coincidental that these changes are happening right on the heels of a newspaper report of poor system performance. However, if the outcome is a more reasonable approach to providing EMS care, that would be a step in the direction of progress.

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