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Comprehensive Assessment of Emergency Medical Services 28 <br /> DRAFT REPORT and 911/Communications Center Operations Study <br /> Issue: Response Time <br /> For the purposes of this report and as referenced in Subsection 2.3, EMS ambulance response time is: <br /> The time from the initial alert or announcement by the Communications Center (also called "tone", <br /> "page", or "dispatch")of the reported emergency, to the time that the service vehicle and appropriate <br /> personnel arrive on the scene. <br /> The factors that most commonly impact response time include: <br /> • The time required to access and engage the vehicle, <br /> • The speed at which the emergency vehicle is able to travel, <br /> • The distance that must be covered to the incident dispatched, and <br /> • Under what conditions. <br /> Consequently, the basis upon which pre-hospital emergency medical response criteria has been <br /> established is medical case history data regarding the body's need for oxygen. Simply, the human body <br /> needs oxygen to survive. While some cells may tolerate short periods without oxygen, most require a <br /> constant supply of oxygen to survive. Figure 38 illustrates the significance of time in this equation. <br /> Figure 21 <br /> Concerns and subsequent standards regarding <br /> emergency medical response times are based on the � <br /> findings of various significant medical organizations n i <br /> • _ 0-1 minute;cardiac irritability <br /> and professional associations. Among these, the <br /> 04 minutes;brain damage not likely <br /> American College of Emergency Physicians (ACEP) <br /> 1 ' �, <br /> [ 4-6 minutes;brain damage possible <br /> and the American Heart Association has each 11 <br /> 10 <br /> +6-10 minutes;brain damage very likely <br /> similarly stated: �— <br /> 9 t >10 minutes;irreversible brain damage <br /> "The most important factor in successfully ' -_8 <br /> resuscitating a patient in cardiac arrest is the speed 7 6 <br /> of response. The survival rate from untreated vt <br /> ventricular fibrillation decreases up to 10% for every <br /> minute that passes and definitive care is not <br /> provided." <br /> The American Heart Association, ACEP, and other respected organizations recommend that EMS <br /> vehicles should respond to deliver BLS (basic life support) skills within 3 to 4 minutes, with ALS <br /> (advanced life support) skills available within 6 to 8 minutes. The ALS-within-8-minute concept was <br /> developed from research that showed the survival rate of cardiac arrest victims decreases significantly <br /> with each passing minute, and that optimal probabilities for survival increase when BLS has been <br /> provided within 4 minutes followed by ALS within 8 minutes." <br /> In addition, <br /> • The American Association of Orthopedic Surgeons (source of Figure _) suggests that "in an <br /> incident involving lack of oxygen, brain damage is very likely at 6 to 8 minutes; irreversible after <br /> 10 minutes." <br /> • The National Fire Protection Association states in NFPA 1710 that AED (BLS) capabilities must <br /> arrive within a 4-minute response time to 90% of the incidents; and that ALS capabilities shall be <br /> deployed to arrive within an 8-minute response time to 90%of the incidents. <br /> American College of Emergency Physicians;"Principles of EMS Systems";2006 <br /> Solutions for Local Government,Inc. 26 <br />