This song by Huey Lewis and the News was made popular by the movie Back to the Future in 1985. A couple of lines from the song go something like this:
Tell me, Doctor, Where are we going this time?
Is this the fifties? Or nineteen ninety-nine?
(Huey Lewis. “Back in Time.” Chrysalis Records, 1985)
The year is 2016, and we all know the value of time, whether it be personal, family or professional. In fire and EMS, time standards of generally eight minutes were the initial baseline measurement for responses to structure fires and cardiac arrests, and by 1999, most agencies had adopted this standard.
We’ve also used the golden hour, 30-minute SCBA bottles, 60-second turnout times and EMS scene-time goals of less than 10 minutes.
Most importantly, though, our message to our customers was that time is critical, and they needed to call 911 immediately to ensure we arrived quickly (in time) to solve their problems.
While the structure-fire and cardiac-arrest standards did have science to support them, others were adopted without any real science behind them. We know the golden hour can be shortened or lengthened depending on the severity of the injury, most firefighters don’t get 30 minutes out of their SCBA bottles, 60-second turnout times are almost impossible, and we may need to spend more than 10 minutes on an EMS scene to ensure proper care, a stable patient and good packaging.
In the last few years, science has led us down the path to validate what time really means for our profession.
Building materials have changed, and the science tells us that flashover is now occurring around the four-minute mark.
Cardiac and stroke transports are time-dependent because science has determined the greatest chance of success revolves around time. So today, we measure door-to-balloon or EMS-to-balloon times.
However, these call types represent a very small percentage of our overall call volume (maybe less than two percent in most organizations).
Collectively, we’ve taken an approach to measure time, measure outcomes and determine what resources we need to ensure we achieve the desired outcome. In doing so, we’ve found that most of our calls don’t require an immediate response; in fact, non-emergent responses are likely to result in the same outcomes.
So why do we put our personnel at risk by running red lights and siren (RLS) when we know the outcome is going to be the same?
A key factor may be our outstanding work in educating our customers about speed. As a result, a fast, efficient response time is what they’ve come to expect.
You’ve received that call, comment or question—“Why did it take 20 minutes for the fire department to arrive?”—when in reality the response time met your organization’s benchmark. For the customer experiencing the emergency, time does seem to slow down; they expect us to be there immediately because that’s what we’ve taught them.
The problem, which I think is small at present, is that our customers don’t understand why we don’t arrive at their emergency with RLS in the fastest manner possible. They don’t understand why time may not be of the essence as we continue to discover that it really doesn’t change outcomes.
All they know is they want our service and they want it now.
So, as we continue down the path of reducing risk for our personnel and the motoring public, we’re reducing the number of RLS responses. We also need to begin reeducating the public on when time really matters and how it may or may not impact their outcome.
Yes, their problem is important to us, and we’ll always do our best to resolve it for them. And, we are going to do that in the right amount of time.
The year is 2016, certainly not the Fifties or 1999, but we do have to step back in time and adopt the same strategies we used then to educate our communities on the true importance of time.
Besides, we don’t want to bet our future on one roll of the dice.