A medical protocol is a set of steps to assure uniformity in treatment procedures, and specifying one requires medical direction. But the End-to-End Protocol is somewhat open-ended, because the actual treatment delivered may vary with each patient – nonetheless its purpose is early intervention, and that is what its observance seeks to guarantee above all else.
Early intervention is a key link in the Chain of Survival, and it often goes missing in high rises. The reason for this is our century-long reliance on vehicular EMS (fire/ambulance) to the detriment of onsite alternatives. In crowded cities you can bet your life that 9-1-1 can get help to you in less than ten minutes – and you will lose it.
It’s physically impossible to get a big pumper truck across town to you within the useful 6 minute limit of an AED, or to address strokes, overdoses and other medical crises in time to prevent severe organ damage or premature death. A protocol that can get a trained responder alongside a patient 75% sooner is not an incremental improvement – it becomes the prime protective factor. If Block EMS is in place, the paramedic can be alongside in 3 to 6 minutes.
For high rises, this has compelling implications.
The injuries and costs avoided by enabling early intervention, combined with reduced pressure on 9-1-1 dispatchers and their vehicles, promises radical savings for all stakeholders, and addresses an intractable and needless public health problem (e.g. most sudden cardiac arrests are not witnessed), here a single icon press can allow a victim to summon a medic in time for successful defibrillation – healthcare ownership.
This will require vision, courage and action on the part of public health officials, but eventually its day will come, perhaps as a LEED or Green Building standard.
Cellular communications will be heard, and life safety will move into real time.