Differences Between Rural and Urban Emergency Medical Services

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Emergency medical services (EMS) were formally introduced in the late 1960s to reduce traffic-related deaths, and since then a great many lives have been saved through medical intervention (Emergency, 2006). The factors involved in these services throughout the United States depend largely on geographical location, whether rural, urban, or frontier.


Frontier areas are the most sparsely populated areas of the United States. According to the 2000 U.S. Census, this area covers about 56% of the land and 3% of the U.S. population, and includes rural farm land, natural resources, national parks, and military installations (2000 Update, 2002). There are more miles of rural roads than any other type of roadway in the United States, and it is on these roads that around 60% of fatal accidents occur. In keeping with the 60% fatality figure, "rural" is defined as anything bordering population centers of 5,000 or less (Complexity, 2004).
The challenge for EMS in responding to a crash scene becomes greater in rural areas because of geography, distances, and budget constraints. The Traffic Safety Center reports that, "on average, the rural area EMS response times come dangerously close to exceeding that critical window of opportunity beyond which mortality rates rise drastically" (Complexity, 2004, par. 19). This period of time is known as the "Golden Hour," and the ability of EMS to arrive at the scene in time becomes a factor in whether a fatality occurs.
Comparing urban and rural EMS is difficult because of differing urban-rural population characteristics and roles for rural ambulance teams. ...
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