There are two studies, one in Singapore and one in New York, that both estimate the “Vertical Response Interval” – the time added by dealing with high rise building issues – to be 2.7 minutes.
The New York study best documents this aggravation of a serious public health problem. It establishes that these elegant towers, the darlings of the Green Building, LEED and ICC movements, are among the most dangerous to live and work in.
Doing the Math
The response time standard in North America is usually “8:59” so right away you can see the will to hide the truth. Wikipedia states that “There is no jurisdiction in Canada that is currently reporting successful achievement of this response time standard.” But never mind, we’ll just add the two: 9 + 2.7= 11.7 minutes from the time the call was received from the dispatcher. So these two intervals are pretty much givens, and will apply to most high rises over three stories.
But that 11.7 interval is not from the first onset of the “event”. Medically, we have to backtrack to when the patient first sensed the chest pain, or had difficulty breathing, began losing consciousness, etc. as the case may be.
Let’s estimate that 78 seconds (1.3 minutes) then elapse, comprised of the time lost before deciding to call 911, the dispatcher’s Q&A, then the assigning of the call to a particular vehicle. Assuming that the 8:59 goal is actually met, this will leave a 13 minute response and a full 10 minute gap between what EMS can do alone, versus what can be achieved by implementing an onsite patient access protocol.
If Not Now, When?
With the advent of universal cellphones, we have an opportunity to repair this crucial broken link (early intervention) in the chain of survival, to supplement 1914 vehicular EMS with cellular.
The protocol will expand paramedic career options and relieve EMS at the wheel, as the sole responder. As with fire extinguishers, a direct onsite protocol can rescue situations that become irretrievable after just a few minutes. An interval of ten minutes is absolutely unforgiving – consuming – whether for fires or life emergencies.
The protocol works in tandem, with EMR’s providing first care, then EMS consolidating with after care and transport to hospital. Fire culture may object, but will likely accede when they understand that the protocol provides continuing employment for their late career paramedics, who educate Security about EMS and hospital policies, and the realities of resuscitation.
All we need is some courage on the part of our public health regulators – this ball is in their court – and it is self-evident to anyone watching.