It can be done.

A lot of people say that one of the hazards of rural living is poorer medical care.   In some cases, that’s true.  And poorer patient outcomes are considered part of that choice.

Not always, though.  A service where I volunteer as a paramedic has a roughly 45 mile transport from their home station to the closest facility with an interventional cath lab.  Last week, two of my colleagues proved that living in a rural area isn’t a death sentence when you have “the big one.”

Within five minutes of meeting their patient, they obtained a 12-lead EKG and identified that the patient was having a STEMI.  They began transport to the closest hospital with an interventional cath lab within 15 minutes (actually, in this case 12 minutes, to be exact).  They performed all of their interventions and treatment en route to the facility.  The crew notified the receiving hospital early so as to allow for the cath lab to “spin up.”  The ambulance arrived at the emergency department 52 minutes from initial patient contact (and remember, we’re talking about roughly a 45 mile transport over surface roads with no Interstate).  The patient received catheterization 73 minutes from first EMS contact and is recovering.

Those times represent numbers that many urban EMS systems are still trying to meet on a regular basis!

I’m sometimes negative about the state of EMS, but data — and most importantly, patient outcomes — remind me that what we do makes a difference.  Excellence is attainable.  We only have to want it.  And in this case, we excelled.  Kudos to my unnamed colleagues!