Be prepared for ambulance wait times

Be prepared for ambulance wait times

(Reuters Health) — Bystanders should be prepared to give first aid during an emergency until responders arrive on the scene, experts say.

On average in the U.S., the length of time between a call for help and the arrival of emergency medical services is about eight minutes — but that rose to 14 minutes in rural areas (where about 10 percent of patients waited nearly 30 minutes), researchers found.

“It’s long enough that if CPR isn’t done before the ambulance gets there, it’s not going to turn out well for the patient,” said lead author Dr. Howard Mell, of CEP-America and Presence Mercy Medical Center in Aurora, Illinois.

Mell and colleagues write in JAMA Surgery that having to wait for emergency responders to arrive is unavoidable, but few studies have looked at the length of the wait and whether it varied by setting.

“We really wanted to focus on providing the proof that active bystander training is necessary,” Mell told Reuters Health.

For the new study, the researchers analyzed emergency medical service data collected in 2015 from 486 U.S. agencies.

They had information on nearly 1.8 million emergency calls. About 4 percent were in rural areas, about 88 percent in suburban areas and about 8 percent in urban areas.

On average, responders arrived 7.9 minutes after the call for help was placed.

The average waiting time was 7 minutes in urban setting, 7.7 minutes in suburban areas, and 14.5 minutes in rural areas.

The findings aren’t meant to put rural emergency responders in a bad light, said Mell. Realistically, those units face greater barriers.

“They’re often volunteer units,” he said. “(They also need) additional time to get to the station and additional time to get to the location.”

Mell said the difference in response times between rural, urban and suburban settings was not as large as a person might expect.

“What this tells us is that all persons need to be trained to really assist – especially if you have family members at risk for these sudden life threatening events,” he said.

In an editorial published with the study, doctors say bystanders need to be prepared to deal with injuries that involve bleeding.

“First, we must empower citizens with legal protection similar to the good Samaritan coverage, which allows bystanders to engage in rescue from a cardiac event with CPR or the Heimlich maneuver for choking,” they write. “Bleeding/hemorrhage control should be included in these statutes.”

How to stop bleeding should be taught alongside Basic Life Support and CPR training, Dr. Adil Haider of Brigham and Women’s Hospital in Boston and colleagues believe.

A U.S. government program known as You Are the Help Until Help Arrives (here) helps teach people what to do while waiting for first responders, Mell said.

Also, he said, local emergency personnel can be good resources. “Those people either run those courses or know where to go to get those courses,” he said.

What Happens After You Call 911?

Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

You’ve called 911. Now what? Who’s going to walk in the door and how long will it take for them to get there? Is there anything you need to do before help arrives?

The answers to these questions depend on the reason you called 911 and where you are. You’ll get a completely different response to your 911 call if you’re in Monterey, CA then you will in Monterey, TN. And, you probably don’t want the same folks to show up if your car is on fire as you do for an intruder in your house.

Calling for Help

First, calling for help can be scary and may even seem overwhelming at the time. It doesn’t really matter how fast rescuers get to you; it will seem like an eternity.

Remember, the person who answers the phone when you call 911 is trained to walk you through the process. Be calm and listen to the questions that they ask. Answer as clearly as you can and stay on the line. Never hang up until you are told to do so by the 911 dispatcher.

That doesn’t mean there aren’t a few tips that can help ensure that help arrives as quickly as possible and brings the right equipment. Here are the two things you should really know when you make that call:

  • Your location: It sounds ridiculous, but any doubt about your location will slow things down. Be clear, especially if you’re calling 911 on a mobile phone. The dispatcher might not be able to use your phone to find you, so it’s especially important to know where you are and where the person who needs help is located.
  • What you need: Do you need an ambulance, the fire department, or a police officer? Say it up front. In many places around the country (and around the world) the people who answer your 911 call might not be the folks who will ultimately be sending what you need. Often, the police department will answer 911 initially, but then transfer the call to a medical dispatch center once they figure out you are having a medical emergency.

An Ambulance Is on the Way. and Who Else?

As soon as it is clear to the dispatcher what type of emergency you are having and where you are located, he or she will start the crews rolling. Let’s start by taking a look at 911 calls for medical emergencies.

Most of the time, the ambulance isn’t going to come without some help. There are usually two caregivers on an ambulance. Often, it’s a paramedic and an EMT. On the way to the hospital, one is going to drive while the other provides medical care in the back. In dire situations, especially on the top floor of a four-story building or when multiple people are needed to provide care (such as performing CPR), the ambulance will be joined by some other form of first responders.

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That extra help for the ambulance crew comes in many forms depending on where you live. In most places, the first responders are firefighters in a fire engine, but it can also be a lone paramedic in an SUV or a police officer in a patrol car. In some parts of the country, it might be a whole slew of volunteer firefighters in their own personal pickup trucks arriving well ahead of the ambulance.

Is there something the responders need to know to find you once they get to your address? Is your home clearly marked? Are you able to describe that weird side driveway to your apartment complex? These are things you should know so you can tell the dispatcher while crews are on their way to your home. Write them down. Ask your neighbors if they’ve had trouble getting help and ask them what the pitfalls were.

In some cases, an ambulance all by itself is enough to take care of your medical issue. Indeed, maybe the ambulance doesn’t even need to turn on the lights and siren. Regardless whether your medical condition is deemed an emergency where flashing lights and a wailing siren are necessary or not, there are a few things you can do while waiting for the ambulance to make the whole process smoother.

What to Do While Waiting

Follow any instructions the 911 dispatcher has for you. Remember not to hang up. The ambulance can be on the way long before the dispatcher is finished asking you questions or giving you instructions.

Before the first firefighter or paramedic walks in your door, make sure you have everything you need. Gather your medical information. Do you have any chronic illnesses, especially related to your heart, lungs, brain, or blood pressure? Do you take medications? Do you have any allergies to medications?

Write all of this down. today. Don’t wait until you have to call an ambulance to get ready. Put all of this information on one page of paper so you can quickly provide your medical history to the caregivers who arrive.

Do you have pets? If they will try to attack the paramedics or try to escape when the front door is opened, lock them up if you can. If you can’t secure them, tell the dispatcher before the emergency crews arrive. Dealing with a chaotic pet can distract the paramedics from your medical care or put extra stress on you.

What Happens When They Get There?

As soon as the paramedics or the firefighters walk in, they’re going to take stock of the situation. They’ll do it very quickly; you might not even notice it. They’ll look around and note the conditions of your home. They’ll look at your skin to see if you’re flushed or pale. They’ll notice whether your skin is dry or sweaty.

Before they ask the first question or set their equipment down next to you, they’ll know if you’re dangerously sick or if they have a few minutes to assess you some more. Regardless, you are in good hands now.

When it’s time to put you in the ambulance and take you to the emergency department, the decision of where to take you will be made through a combination of asking your preference and taking advantage of the strengths of each hospital. If you’re having a heart attack, for example, it makes sense to take you to a hospital with the ability to perform heart catheterization. The paramedics might even have protocols that dictate where they must go. Express your preferences, then work with them to figure out what’s best.

When the Emergency Is Not Medical

Medical emergencies are only one kind of 911 call. Police and firefighters respond to plenty of other types of calls for help. How you behave in those situations depends entirely on what it is. There are too many different examples to go through every possibility here, but you can plan for a couple of common emergencies.

Active shooter emergencies are violent attacks usually carried out by lone gunmen against unarmed groups of people in a public location. The way to respond to these incidents is to run if you can, hide if you can’t, and fight if you have no other choice. Call 911 when you get the chance, but get yourself to safety first.  

Fires can build much faster than you might realize. Even a small fire will grow to engulf an entire room in under two minutes. Get out of the building before you call 911. It could seem as if you have time, but you don’t.

Plenty of other emergencies are worthy of a call to 911. In every case, follow the instructions of the 911 dispatcher. They are your lifeline.

What to do if someone is bitten by a funnel web spider

Would you know what to do if someone is bitten by a funnel web spider?

The venomous spiders are more likely to attack during summer, as they like hot, moist weather.

If you do get bitten, you will get sick very quickly. St John’s Ambulance lists the following signs and symptoms of being bitten by a funnel web spider:

  • sharp pain at bite site;
  • profuse sweating, nausea, vomiting; and
  • abdominal pain.

What to do if someone is bitten by a funnel web spider

St John’s Ambulance recommends the following First Aid procedure:

  1. Lie the patient down.
  2. Calm and reassure the patient.
  3. If they are bitten on a limb, apply a broad crepe bandage over the bite site as soon as possible.
  4. Apply a heavy crepe or elasticised roller bandage starting just above the fingers or toes of the bitten limb, and move upwards on the limb as far as can be reached (include the bite). Apply firmly without stopping blood supply to the limb.
  5. Immobilise the injured limb with splints and ensure the patient does not move.
  6. Ensure an ambulance has been called.

If possible, it is a good idea to capture the spider for identification so that the correct anti-venom is administered at hospital.

The hospital will also send the live funnel web spiders to a zoo for milking so that anti-venom can be created.

How to catch a funnel-web spider

Funnel-webs are deadly venomous and only adults should attempt capturing a spider.

According to The Australian Museum, you can reduce the risk of a bite by wearing gardening gloves and long trousers tucked into socks with sturdy shoes or boots.

  • Find a glass jar with a wide mouth.
  • Remove the lid and pierce it with air holes.
  • Invert the jar over the spider. Take care as funnel-webs are highly defensive and may strike; however, they cannot jump or climb glass.
  • When the spider is within the jar, slide a piece of heavy cardboard or solid plastic under the opening to completely cover it.
  • Invert the jar, keeping the top covered.
  • Check the spider is in the bottom, carefully drop a moist cotton bud into the jar with the spider, then put on the lid.
  • Keep it away from direct sun and heat.

Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

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Funnel web spider ready to strike

Spider bites

It can be difficult to know if a bite from a spider is dangerous or not. This article explains the best first aid treatment depending on the type of spider involved.

It’s important to be aware that bites from spiders can cause a severe allergic reaction (anaphylaxis) in some people. Learn more about first aid treatment for severe allergic reactions in the ‘anaphylaxis’ section below.

Different types of spider bites

Spider bites are best considered in 3 medically relevant groups: big black spiders, redback spiders and all other spiders.

Big black spiders are funnel web spiders and any large black-looking spiders that may be a funnel-web spider. If you’ve been bitten by a big black spider, you need to treat it as a medical emergency.

Redback spiders are fairly easy to identify and their bites do not cause rapidly developing or life-threatening effects but many cause significant pain and other problems in your body.

All other spiders in Australia are more or less harmless.

Funnel-web spider

The funnel-web spider, which is found on the east coast of Australia, is the most venomous spider in the world. It’s a medium to large spider varying from 1 to 5 cm. Male funnel web-spiders are more lightly built than female ones. Their body colour can vary from black to brown and the bite from a funnel web spider can be extremely painful.

First aid for a big black spider’s bite

Bites from a funnel-web or mouse spider can be very dangerous. Provide emergency care including cardiopulmonary resuscitation (CPR) if needed. Calm the person and call triple zero (000) for an ambulance.

Steps to take if someone gets bitten:

  • apply a pressure immobilisation bandage
  • keep the victim from moving around
  • keep the bitten limb down
  • bandage the limb from the area of the bite to the hand or foot, then back up to the body
  • immobilise the limb by splinting if possible
  • tell the victim to keep calm
  • do not move them at all
  • wait for the ambulance

First aid for other spider bites

For all other spider bites, including from redbacked spiders, apply a cold compress or ice pack directly over the bite site for 15 minutes to help relieve the pain and reapply as needed. Seek medical assistance if further symptoms or signs of infection develop.

Cardiopulmonary resuscitation (CPR)

Read these articles for an overview of:

For printable charts, see St John Ambulance Australia’s first aid resuscitation procedures (DRSABCD) poster, as well as their quick guide to first aid management of bites and stings.

Pressure immobilisation bandage

A pressure immobilisation bandage is recommended for anyone bitten by a funnel-web or mouse spider.

This involves firmly bandaging the area of the body involved, such as the arm or leg, and keeping the person calm and still until medical help arrives.

First put a pressure bandage over the bite itself. It should be tight and you should not be able to easily slide a finger between the bandage and the skin.

Then use a heavy crepe or elasticised roller bandage to immobilise the whole limb. Start just above the fingers or toes of the bitten limb, and move upwards on the limb as far as the body.

Splint the limb including joints on either side of the bite. Keep the person and the limb completely at rest. If possible, mark the site of the bite on the bandage with a pen.

A guide to pressure immobilisation bandages can be found on the Australian Resuscitation Council website.

Anaphylactic shock

Spider bites can be painful. Occasionally some people have a severe allergic reaction to being bitten or stung.

In cases of severe allergic reaction, the whole body can react within minutes to the bite or sting which can lead to anaphylactic shock. Anaphylactic shock is very serious and can be fatal.

Symptoms of anaphylactic shock may include:

  • difficult or noisy breathing
  • difficulty talking and/or hoarse voice
  • a swollen tongue
  • persistent dizziness or collapse
  • swelling or tightness in the throat
  • pale and floppy (young children)
  • wheeze or persistent cough
  • abdominal pain or vomiting

Call triple zero (000) for an ambulance. If the person has a ‘personal action plan’ to manage a known severe allergy, they may need assistance to follow their plan. This may include administering adrenaline to the person via an autoinjector (such as an Epipen®) if one is available.

The Australasian Society of Clinical Immunology and Allergy recommends that for a severe allergic reaction adrenaline is the only treatment. For further information, visit the Choosing Wisely Australia website.

The St John Ambulance Australia first aid fact sheet for spiders can be found on their website. For more information on anaphylaxis, including setting up a personal action plan, go to

If you can, catch the spider so it can be identified. The Australian Museum has instructions for catching a spider.

Not sure what to do next?

If you are still concerned about your spider bite, why not use healthdirect’s online Symptom Checker to get advice on when to seek medical attention.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self care, talking to a health professional, going to a hospital or calling triple zero (000).

Source s :

Last reviewed: September 2019

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Something New

Everything We Know About Spider-Man PS4 Sequel

Although Insomniac Games has not officially announced it, Marvel’s Spider-Man will probably get a sequel; here’s what we know about it so far.

Insomniac Games’ Marvel’s Spider-Man for the PS4 was enormously successful, so what does that mean for Marvel’s Spider-Man 2? In Marvel’s Spider-Man, players took on the role of Peter Parker and got to climb, swing, and run around New York City in a way that no other video game had allowed them to do before. The game was an immediate hit with fans and sold over 9 million copies as of January 2019.

Although Insomniac has not officially announced a sequel to Marvel’s Spider-Man, its success suggests that it’s a no-brainer. The last DLC arrived in December 2018, meaning that it’s now time for Insomniac to look forward to potentially making a Spider-Man PS4 sequel. But what would it look like? This game teased some classic Spider-Man villains, as well as offered some clues as to what a sequel could bring to the table.

Insomniac has a lot more cards up their sleeves and players should get to see some of what those cards hold when the sequel gets an official announcement. Granted, much of this is still speculation, but it’s a guarantee that it’s a question of when and not if on Insomniac making an official announcement about Marvel’s Spider-Man 2 soon.

Marvel’s Spider-Man 2 Will Feature The Green Goblin

At the end of Marvel’s Spider-Man, Norman Osborn resigns as mayor and it’s evident that he’s very close to embracing the villain that lies within, Green Goblin. Mary Jane is the first to discover a prototype mask that hints the arrival of the villain, along with prototypes of Green Goblin’s signature purple grenades. The tech is already there, so by the time a sequel to the game arrives, Osborn will likely have become the Green Goblin and be one of the main villains in the new game that Spidey will have to face.

Marvel’s Spider-Man 2 Will Turn Harry Into A Venom-like Creature

Another interesting thing to happen at the end of the Spider-Man game is that Norman is doing everything he can to save his son, Harry, who suffers from the same illness that killed his mother. A scene shows Harry suspended in a tank full of green, suggesting that Norman is using a version of the Green Goblin serum to keep his son alive. But there is also black goo around, implying that Norman is also experimenting with a Venom-like symbiote. Is Normal also using the symbiote to help save his son? Will Harry become something like Venom?

Marvel’s Spider-Man 2 Could Feature Other Villains

One thing that the original title did well was setting up the appearances of other villains from the Spider-Man comics for an appearance in a sequel. One of those is Mysterio, whose existence within the game universe gets teased via a shard of his helmet and a book written by Dr. Ludwig Rineheart, Mysterio’s alias. On the other hand, there’s a vial of sand in a backpack on top of the Avengers Tower, suggesting that Sandman is out there somewhere, too. Peter’s college thesis was graded by Dr. Miles Warren, aka the Jackal.

Marvel’s Spider-Man 2 Will Have Two Spider-Men

Players also got introduced to Miles Morales at the end of the original game. He eventually tells Peter Parker that a radioactive spider bit him, giving him the powers of Spider-Man. Parker then admits to Miles that he is also Spider-Man. The DLC also features more conversations between Peter and Miles, with Miles finally getting a shot at putting on a mask and leaping off a building. It’s highly likely that the next title will feature both Miles and Peter as Spider-Man. Perhaps players will get to choose which version of Spider-Man they want to play, or even better, get a chance to switch between the two during gameplay.

Marvel’s Spider-Man 2 Will Help Set Up The Marvel Game Universe

Marvel likes its properties to have a very cohesive vision. That’s why the first Iron-Man film launched the beginning of what eventually became the Marvel Cinematic Universe: every TV show and movie has a connection somehow within the MCU. Just like the cinematic universe, Marvel wishes to set up a video game universe, with every game finding continuity with the titles that came before it. This is something Marvel has expressed an interest in, suggesting that Marvel’s Spider-Man 2 could introduce other superheroes into that universe for their own future games.

Marvel’s Spider-Man 2 Could Feature The Symbiote Suit

One thing that disappointed fans about Marvel’s Spider-Man is that it did not include the infamous symbiote suit. However, game director Brian Intihar teased that it might show up later (as in the sequel). Here’s what he said to Kinda Funny Games:

«I think something like that suit (symbiote suit) deserves its day in the spotlight,» said Intihar. «I think just making it an unlockable suit wouldn’t be doing it justice. It’s one of the best stories for Spider-Man. I think it’s a complex story. And I think it’s a story that needs to be told, and it needs to be told the way Insomniac would tell it.»

That story could very well get told in Marvel’s Spider-Man 2. And there’s probably nothing that would please fans more.

Marvel’s Spider-Man 2 Would Release On PS5

It’s no secret that the current generation of console gaming is coming to the end of its life cycle. The PS4, in particular, has been around for nearly six years. Speculation has already started about the PS5’s development and hardware, with industry insiders and analysts expecting it to arrive as early as 2020. As far as anyone knows, Insomniac has not started production on the next Spider-Man game yet, meaning that it will probably be at least a few years before it’s ready. That means that new consoles will already likely be on the market by the time a new title is ready. This means that the next Marvel’s Spider-Man game will appear on the PS5.

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