By Dhyey Maharaja

The ‘Golden Hour’ in Emergency Medical Services (EMS) is the hour after a traumatic RMCevent, where prompt medical treatment at a hospital has the highest chance of preventing death. EMS staff, who need to sustain and transport patients to the hospital, need to arrive at the location as quickly as possible, usually in 10 minutes (called the response time). This time is rarely achieved in rural areas. This is one of many serious problems facing EMS systems all around the world. In both America and China, new technology is being used to solve vital problems in the pre-hospital EMS system, and the country to solve these problems will be much safer and resilient.

In the United States, the biggest issues with the pre-hospital systems are the disparity between rural and urban areas and the cost of the ambulance and hospital care. The paramedics in rural areas have less training than their urban counterparts. Ambulances have to travel much further to trauma centers or EDs, and arriving to the location takes roughly 25 minutes.

 In China, this disparity is heightened. Road infrastructure is inefficient compared to urban areas, and arriving at the location takes much longer. The call center technology is frequently overburdened, with patients sometimes waiting several minutes for 120 (China’s 911) to pick up. Due to this, the average response time is 46 minutes in Hengyang,  with rural areas having even slower times. The decision to not use an ambulance is widespread, with the perception that a private car may go faster.¹⁰ This creates an unsafe situation due to the lack of medical professionals and sophisticated medical equipment on board private cars. Ambulances in rural areas lack reliable communication devices, so hospitals often do not know what issues the patient is facing until they arrive, meaning they do not have time to prepare for medical procedures.

 During the COVID pandemic, weaknesses in the pre-hospital system were shown. This  led to new innovations in this field. Telemedicine, proven to be effective during epidemics, was implemented more broadly after the pandemic. In both the United States and China, the pandemic led to greater funding of initiatives. However, under the new Trump administration, this funding is being cut. In China, however, the initiatives are not cut. The EV-Call 120, is a new innovation. It is a modern communications system, connecting EMS to hospitals through voice and video. Computer assisted decision making, with specialist clinicians on the other line, makes the EV-Call 120 more effective and advanced than the 911 systems used in America. In instances where the first aid is extremely time critical, an emergency medical drone has been tested in China to deliver critical ‘blood lines’ to have blood and other first aid delivered quickly to EMS on the scene. If China succeeds in carrying out these initiatives, the country will be healthier and more productive. The United States should follow in its footsteps.