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367 points DustinEchoes | 2 comments | | HN request time: 0.545s | source
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pugio ◴[] No.45910134[source]
I can speak to this. I recently joined a community first responder association (I've always wanted to know what to do in case of a medical emergency) and was shocked to hear the members' horror stories of how long it can take an ambulance to arrive. Like the author, I grew up with the narrative "in trouble, call the ambulance, they'll scream through the streets to get to you in moments".

That might still be true where I grew up, in the US, but that's certainly not a guarantee in Melbourne, where I now live. On joining the local volunteer organization, I went from thinking "oh this will be a useful bonus for the community" to "wow, we can literally be essential". Since our org is composed of people living within the community, average response time to ANY call is <5 minutes (lower for cardiac arrest, when people really move). Sometimes one of us is right next door.

We can't do everything an ambulance paramedic can, but we can give aspirin, GTN, oxygen, CPR, and defibrillation. We can also usually navigate/bypass the usual triage system to get the ambulance priority upgraded to Code 1 (highest priority, lights + sirens, etc.) If for some reason the ambulance is far away (it backs up all the time), we can go in the patient's car with them to the hospital, with our gear, in case of further issues in transit.

I tell everyone now to always call us first (since our dispatcher will also call the ambulance) but while I feel more confident in how I'd handle an emergency, I feel less safe overall, with the system's faults and failings more exposed, and the illusion of security stripped away.

My condolences to the author.

In terms of updating - consider whether The System is really working. If not, what can you do yourself (or within your larger network) to better prepare...

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1. evanelias ◴[] No.45910916[source]
Even in the US, response times can really vary. As an extreme example, in Jersey City (population ~300k) there were a bunch of incidents a couple years ago where residents called 911 in an emergency and no one answered.
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2. burnt-resistor ◴[] No.45912343[source]
E911 (location information sharing) also doesn't work consistently.

The advantages of coming in an ambulance are traffic priority, priority attention in the ER, and medical triaging and coordination. The disadvantages in the US can be extremely expensive to some people if they don't have the correct insurance and inconsistent timeliness.

The advantage of coming in a private vehicle are speed (usually), but at the disadvantage of having to get past ER gatekeepers and lack of information and preparedness. It is probably wise if possible to have a third person in the vehicle call the ER at the destination hospital to let them know what generally should be expected.

Another issue is that it's inherently risky to live more than 30 minutes driving distance from a major city hospital. To do so basically necessitates a life flight which is extremely expensive and not necessarily quick either.

The for-profit, gotcha capitalism monopolization of hospitals and medical services by private equity also results in worse, deadlier patient outcomes, hospital closures, and more expenses. Medicare for all (m4a) isn't a fix because of the Medicare Advantage scam, the medigap scam, the part D scam, and the lack of long-term care, skilled nursing, dental, vision/glasses, mental healthcare, and hearing aid coverage that doesn't provide true comprehensive single-payer healthcare at a sane cost per patient and with better outcomes.