Emergency care: If the place of residence decides on life and death

With every minute, the emergency doctor or ambulance arrives later, the chance drops that a person will survive a cardiovascular arrest well. With a delay of five minutes, the likelihood that the brain will not take away any permanent damage after a revival is reduced by 19 percent. This is the result of a current study by authors of the Federal Association of the Working Groups of Emergency Hospital in Germany (volume) in the medical magazine “Die Anaesthesiology”.

This means that the chances of survival depend significantly from the state in which an emergency is happening. Because the rules of how quickly professional help has to arrive are very different; In Berlin, for example, it is eight minutes, 15 minutes in Lower Saxony and Brandenburg. The study with more than 100,000 patients over ten years shows for the first time that there are also very clear differences in the incoming times in practice.

To standardize this was actually part of a planned reform of the emergency care of the past federal government. But the reform fell victim to the break of the traffic light coalition last November.

Valuable time can also be lost if an emergency occurs near a country or district border. If there is a rescue vehicle beyond the border, which is much closer to the scene of the accident than the next side of the border, this does not automatically mean that it is also ordered there. “Often the control centers responsible in a district or city circle or a federal state have different software systems,” says Florian Reifferscheid, emergency doctor in Kiel and chairman of the Association. The exchange of information is therefore often carried out by phone, if at all.

In order to bridge long waiting times until professional first aiders arrive with a rescue or emergency vehicle, there are emergency call systems in some federal states, in which trained laypersons can register as first aiders via app. If an accident happens, the control center determines the nearest registered first aider and asks him if he can come to the scene of the accident. “It usually happens,” says the emergency doctor from Kiel.

But this system also has a catch, it only works in the respective federal state. “If you are registered as first aiders in Hamburg and go on vacation on the Baltic Sea, you will not be informed if someone has a cardiovascular arrest in the beach chair next door,” complains Reifferscheid.

He hopes that the new federal government will put the reform of emergency care back on the agenda. The Björn Steiger Foundation based in Baden-Württemberg no longer wants to wait any longer. In March of this year, she filed a lawsuit from the Federal Constitutional Court. It says: “In an emergency, citizens must have the same chances of survival, regardless of the state they live in, whether in the city or in the country.”

The article first appeared in early September 2025 and was updated.