Emergency medical services response times to motor vehicle crashes increased in the USA over the period 1987–2020

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INTRODUCTION: The timing of Emergency Medical Services (EMS) notification, crash scene arrival, and hospital arrival may impact motor vehicle fatalities. We examined EMS response time intervals over the past three decades, considering the effects of weather, vehicles involved, time of day, and location. METHODS: We used the Fatal Accident Reporting System to compute and describe annual (1987-2020) EMS response time intervals. This included total time (i.e., crash-to-hospital), as well as the intervals between four key timepoints: crash, crash notification, crash scene arrival, and hospital arrival. We examined the proportion of fatal crashes with total intervals under 60 min (i.e., the "golden hour"), and where the crash arrival-to-hospital interval was under 30 min (the "beneficial timeframe"). Additionally, analyses were stratified by crash factors including weather (poor/clear) number of vehicles involved (single/multiple), time of day (early morning/rest of the day), and location (urban/rural). RESULTS: A total of 310,001 fatal crashes were analyzed. Between 1987-1994 total median response times ranged between 40 and 42 min. By 1999, intervals had increased to 45 min; elevated intervals were evident through 2009. By 2020, observed intervals had returned to 41 min. Paralleling this pattern, crashes with "golden hour" intervals decreased from 77.0% in 1987 to 72.4% in 2009 and increased to 78.0% by 2020. Similarly, crashes with a "beneficial timeframe" decreased from 60% in 1987 to 52% in 2009 and increased to 56.0% by 2020. The largest discrepancies for crash strata were evident for location: rural crash total response time intervals were 15-23 min longer than urban. CONCLUSIONS: From 1987-2020, the total time response interval following a fatal crash remained relatively stable. However, steady increases in intervals between crash notification and both crash scene and hospital arrival are evident. PRACTICAL APPLICATIONS: Future research should focus on approaches to reduce response time intervals.

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