health regulations children transportation
Are there any recommended or prescribed time limits for ambulance to reach a special need patient in case of emergency?
<p>When I look for ambulance and how fast it should come, I find information regarding allowed driving speed.</p>

<p>However, for planning hospitals and roads, one should no how much time is on average required to reach a hospital. Depending on the region and the roads it can be quite different than approximating from the actual <em>distance</em> like in this <a href="http://goaspro.com/detect-optimal-location-for-hospitals-in-bangalore/" rel="nofollow noreferrer">contribution</a>.</p>

<p>Are there any norms on that, or laws, or regulations? How does this compare internationally?</p>

<p>Special need patients:
- common issue, prenatal and newborn deceases require specialized teams and specially equipped environments
- rare genetic deceases may require for specialized emergency teams</p>

<p>The <a href="https://www.nfpa.org" rel="nofollow noreferrer">National Fire Protection Association</a> is an international organization that publishes standards related to fire safety as well as rescue services provided by emergency services. They publish a standard, <a href="https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=1710" rel="nofollow noreferrer">NFPA 1710</a>, which outlines emergency response time goals. Unfortunately, the only places I can find the actual standard requires membership in the NFPA to view it.</p>

<p>I have, however, been able to find summaries. In <a href="https://services.prod.iaff.org/ContentFile/Get/30541" rel="nofollow noreferrer">this summary</a> you can see Emergency Medical Services (EMTs, Paramedics) are expected to leave the station within one minute of a call being dispatched. Note that being dispatched isn't the time from when one initially calls emergency services; it is the time from when emergency services is able to determine what is needed and issue the dispatch request. <a href="https://www.lexipol.com/resources/blog/understanding-and-measuring-fire-department-response-times/" rel="nofollow noreferrer">This article describes</a> how fire and rescue organizations differ in how they measure responsiveness including identifying how some organizations start measuring response time at the point a call is first received.</p>

<p>First arrival on scene for EMS is targeted at four minutes after "turnout," when EMS is dispatched. EMS treatment levels include:</p>

<ul>
<li>First responder (includes provisioning of an Automatic External
Defibrillator (AED))</li>
<li>Basic Life Support (BLS)</li>
<li>Advanced Life Support (ALS)</li>
</ul>

<p>Note that this standard is based on how quickly life sustaining measures can be delivered to the person or people who need them. Transportation times to hospitals will depend on the specific transportation protocols that will be implemented once EMS has assessed the situation.</p>

<p>The State of Maryland, as an example, manages protocols through the <a href="http://miemss.org/home/" rel="nofollow noreferrer">Institute for Emergency Medical Services Systems</a> (MIEMSS). Their <a href="http://www.miemss.org/home/Portals/0/Docs/Guidelines_Protocols/MD-Medical-Protocols-2018-WEB.pdf?ver=2018-04-11-134820-493" rel="nofollow noreferrer">current protocol is available</a> for reading. On page 17, one of the steps EMS has to determine is the "mode of transportation."</p>

<p>Maryland's protocols highlight that transportation isn't to the closest hospital but, rather, to the closest <strong><em>appropriate</em></strong> hospital. The closest appropriate hospital is determined by EMS in consultation with their support system. The protocols and infrastructure that Maryland has put in place are designed to get the patient stabilized and to the most appropriate treatment facility based on the patient's need.</p>

<p>The NFPA is a recommended code and it is up to each state or local governing body to determine if and how they will implement them.</p>

<p>For the State of Maryland, the MIEMSS is an independent state agency appointed by the Governor.</p>

<p>I know from First aid training that brain death occurs in about 3 minutes without oxygen (and since this was for life guarding, you had to make sure someone was calling emergency services before you pulled someone out, if only ordering a bystanders to do it).  CPR will keep someone alive, but regaining consciousness at the stage you should give CPR happens more often in Movies than in real life.</p>

<p>There are no laws governing time other than the responding unit needs to take the victim to the nearest hospital possible, though EMS might have an optimal time they want to achieve with each call out.   The reason for this is simple:  Like every other enterprise, EMS is limited in resources and sometimes, all units might be on calls and there's no way they can get to you in time.  In the U.S. (and probably most countries), Police, Fire, and EMS cannot be held liable if they are late to arrival (provided they responded as soon as possible), and in triage situations, they will prioritize people who both need services and are likely to survive (if you're "walking wounded" they won't give you a ride because the person who needs CPR is in a more critical situation) and they also may be held if there is an ongoing threat (Say in an active shooter situation, the EMS will be "staged" away from the scene while police eliminate the threat... you never send the medics into a situation where they themselves will need medics.).</p>

<p>Again, in the situation where they are overwelmed, triage is the rule of the day and triage does not prioritize age, but rather how life threatening the injury is, how safe it is to transport the victim, and how likely the victim is to survive.   Any time they have to make a call on those lines, it's not going to be an easy day for EMS.</p>

<p>In Germany, unsurprisingly, there exist indeed laws for this ("Hilfsfrist", "Rettungsdienstgesetz"), though they vary from federal state to federal state, and are different in metropolitan and rural areas. And again unsurprisingly, it's a shame healthy trees are cut down for printing these totally worthless laws.</p>

<p>In metropolitan areas, the required response time (someone arrives at your location) is around 8-9 minutes, in rural areas around 16-17 minutes, depending on where you are.<br>
For firefighters it's similar, but it's not <em>laws</em>, rather there exist <em>communal plans</em> and <em>recommendations</em>. While times for these are actually a few minutes longer, in my experience firefighters are much, much, much faster to respond (under 3 minutes). Not sure <em>how</em> they do that, it's crazy.</p>

<p>Some states do not have hard requirements, but rather confidence intervals. Hessen, for example, requires 90% within 10 minutes, and 95% within 15 minutes. Sachsen and Saarland require 95% within 12 minutes.<br>
Which <strong>may</strong> very well mean that in your particular case it can take 45 or 50 minutes (or two hours?), and there are no consequences, it's just bad luck for you.</p>

<p>Also note that in half of the states, the time taken for the phone call and "planning stage" counts towards the total response time, but in the other half it doesn't.</p>
