You can’t get there from here

April 22nd, 2009 | Sources: Annals of Emergency Med., BurrillReport

Subjects:

Nearly 25% of Americans live at least an hour from an Emergency Department that’s equipped to save lives in the event of a heart attack, stroke, bacterial bloodstream infection or major trauma.

whichwaytotheER?To reach this conclusion, Brendan Carr and colleagues from the University of Pennsylvania School of Medicine queried the National Emergency Department Inventories–USA to identify the location and visit volume for all EDs in the country.

They estimated driving distances, driving speeds and population density, and measured ED access as the total population that could reach any particular ED within specified time intervals.

The scientists determined that 71% of Americans can access an ED within 30 minutes, and 98% can do so within an hour. But many of these facilities can’t handle the life-threatening stuff. Only high volume EDs are staffed, trained and equipped to do that.

In Montana for example, just 8% of the population resides within an hour of an ED that sees at least 3 patients per hour.
 
The write-up appears in the Annals of Emergency Medicine.

“Whether you are bleeding to death from an injury, having a heart attack or a stroke, the common denominator is time,” lead author Brendan Carr told BurrillReport.

Ireconwe'llbetherebydinnerThe assistant professor of Emergency Medicine and Epidemiology added “in life-threatening emergencies, we must rely upon the system to deliver us to the care that we need.”

“If we knew what services were provided where, we could design a system that would do that everywhere in the country.”
 
The scientists suggest EMTs should be empowered to bypass the closest hospital in lieu of facilities better equipped to handle appropriately sick patients, ED facilities at rural hospitals should be beefed up, and incentives should be offered for physicians to practice in remote locations.


 

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