How to Respond When EMS Is Delayed: Tips for Rural and Winter Emergencies

When an emergency strikes, every minute counts. In rural areas and regions hit by winter storms, those minutes can turn into life-or-death situations — where every action before professional help arrives can determine the outcome. For anyone living in or visiting these areas, knowing how to respond when EMS is delayed can save lives and reduce long-term complications for the victim.

Unique challenges of delayed EMS in rural and winter settings

For people living in rural communities, limited access to rapid medical care is a reality that can turn even moderate injuries or health conditions into critical situations. Unlike urban environments, where emergency services are often just minutes away, rural EMS teams must cover long distances over rural roads. These roads can often be hazardous due to narrow lanes, sharp curves, and poor maintenance. Rural ambulances frequently travel over rolling hills and through remote areas with few (if any) road markers, making it challenging for EMS crews to locate patients quickly. These additional minutes can be critical during medical emergencies, such as cardiac arrests or severe bleeding where early intervention is vital.

Adding severe weather into the mix creates an even greater challenge for EMS crews across the country. During the winter season, heavy snowfall and icy roads may block key routes, forcing ambulances to take longer, less direct paths and make travel dangerous for first responders, patients, and their families. Additionally, EMS vehicles may experience mechanical issues or get stuck in the snow, reducing available resources for the community. Even in urban settings, extreme winter conditions can impact emergency services.

For residents and visitors in these areas, risk reduction, prompt action, and having a clear emergency plan for situations where “help is coming, but it’ll take longer” can dramatically improve outcomes.

What to do while waiting for EMS to arrive

When you call 911 in rural settings or during severe weather conditions, understand that EMS response may take longer than usual. Mentally preparing for a longer response interval and transport time can help you stay calm, act safely, and focus on stabilizing the victim until help arrives.

Early action is key. While waiting for EMS personnel to arrive, you can take steps to reduce risk and support the victim:

1. Assess the emergency

Start by ensuring your personal safety and that of the victim. If the victim is in immediate danger, move them to a safer area. Use personal protective equipment (PPE), such as gloves and eye protection, to prevent exposure to potentially infectious body fluids. Call 911 immediately, and if possible, send someone to grab a first aid kit and an AED.

Check the victim for responsiveness and look for signs of a medical emergency. Assess breathing by watching the chest and face for normal movement. If the person is unresponsive and not breathing normally, begin CPR immediately.

2. Use your CPR, AED, and First Aid training

CPR, AED, and First Aid skills can bridge the gap until professional care arrives. Depending on the situation, you may need to provide first aid care including but not limited to:

• Maintain body temperature in cold weather by removing wet clothing and covering the victim with blankets or any available insulating materials. If EMS is delayed, begin actively rewarming the person by placing warm water bottles in their armpits and applying an electric heat pad or blanket to their chest and back.
• Control severe bleeding with a tourniquet or through direct manual pressure and bandaging.
• Support spinal injuries by keeping the head and neck aligned.
• Assist with medical conditions, such as diabetic emergencies that require fast-acting sugars or severe allergic reactions by administering an epinephrine auto-injector.

Even basic interventions from a bystander can make a real difference when every minute counts.

3. Support first responders with a smooth handoff

Make it as easy as possible for ambulances to access the scene. Clear driveways, open gates, and unlock doors if needed. Provide accurate landmarks, road names, and specific details about rural roads or other obstacles that could slow their response.

Have relevant medical information ready to pass off, including known medical conditions, medications, allergies, and the timeline of events. This can help first responders provide faster, more effective care and ensures nothing is overlooked during the handoff.

Be prepared to further support EMS once they arrive, which may include continuing to perform chest compressions, assisting with positioning, or helping manage the scene until the victim is safely transported.

Tips for rural and winter emergencies

Being prepared when traveling or living in rural areas and during winter storms can save lives by reducing risk and protecting those most vulnerable if EMS is delayed.

• Create a winter storm plan. Review the winter storm outlook and identify alternate routes. Keep fuel topped off in vehicles and heaters, and gather winter storm preparedness supplies, such as blankets, emergency heating equipment, food, and water. Make sure medications and medical supplies are accessible for all family members.
• Stay with your vehicle if stranded in remote areas. Unless there’s immediate danger, remain with your car to stay visible and protected. Avoid wandering into unknown terrain, which could lead to injury or getting lost. If stuck in the snow, use a snow shovel or another object to clear around tires and confirm the exhaust pipe isn’t blocked by snow or ice. Always keep a first aid kit, warm blankets, and emergency supplies stocked in the car.
• Protect vulnerable individuals. Some people are at higher risk when EMS is delayed, including older adults, young children or infants, those with mobility limitations or recent injuries, and individuals with chronic medical conditions. Whenever possible, involve these individuals in emergency planning to make sure they understand basic safety steps, such as how to stay warm, when to call for help, and how to access emergency supplies if you’re not immediately available.

Be sure to regularly check on neighbors who may live alone or in more secluded areas to ensure that everyone in your community stays safe and supported during winter storms or other emergencies.

Be prepared, stay safe, and save lives

Delays in EMS response are a reality in rural or remote areas and during winter storms. But preparation, early action, and proper training can make all the difference.

Having a first aid kit, emergency supplies, and a clear emergency plan can help you respond safely and effectively while waiting for EMS to arrive. Additionally, formal CPR, AED, and First Aid training can equip you with the skills and knowledge to act confidently in stressful emergency situations.

Reach out to your local HSI Training Center to learn about convenient training that fits your schedule, including in-person, blended and remote training options. Or consider becoming an HSI Instructor to help prepare your community for natural disasters and medical emergencies.