EMS’ greater need

To the editor:

The number of life-threatening medical emergencies in NYC went up by 28,000 in Fiscal Year 2024. The Mayor's Management Report, published last week, documents the increase. In FY 2023, there had been a 7-percent increase. There was a further 5-percent increase last fiscal year, with the total number of medical emergencies requiring ambulance transport increasing by 53,000. 

It also takes longer for EMS to reach patients.  In FY 2023, the average ambulance response time to life-threatening medical emergencies increased 26 seconds. In FY 2024, it increased a further 17 seconds. Already in the first eight months of 2024, 18,832 patients with life-threatening medical emergencies waited more than 20 minutes for medics in an advanced life support ambulance.

Speed is of the essence. For cardiac arrest patients, survival decreases 10 percent for every minute of delay in defibrillation, and neurological survival in these patients improves when epinephrine is administered in under 5 to 10 minutes after cardiac arrest. For typical ischemic stroke patients, as each minute passes 1.9 million neurons, 14 billion synapses and 7.5 miles of myelinated fibers are destroyed.

Two basic items affect EMS response time: the number of ambulances ready to go, and sufficient EMS personnel to staff them. The mayor's report dispassionately admits, "The ability of ambulances to keep up with increasing demand has been strained and the average ambulance in service hours has remained about the same over the past two fiscal years." In fact, on the day the report was released, Sept. 16, just 78 percent of the FDNY's own target of 500 ambulances were operational.

The NYC Independent Budget Office report issued a fiscal brief 11 years ago entitled, "With More Ambulances on the Streets, Response Times to Serious Medical Emergencies Improve.” Is this a solution that Adams and the City Council might consider?

Helen Northmore