PROBLEM IDENTIFICATION
During the 1990's, the Puerto Rico Emergency Medical System (EMS) began to experience difficulties in providing quick and efficient service to victims of traumatic injury. Indeed, the average response time was more than 35 minutes. The EMS identified the problem as two-fold:

• Lack of resources (ambulances, emergency medical technicians and an efficient emergency response system)
• An inefficient administration

GOALS AND OBJECTIVES
The goal of the Rapid Response Program is to improve access to emergency services care throughout the Commonwealth, particularly for persons injured in roadway crashes. Program objectives included:

• Development of an emergency response system to reach and stabilize victims within 10 minutes
• Purchase of proper equipment that would support achievement of a 10-minute response time

STRATEGIES AND ACTIVITIES
The Rapid Response Program was developed by the Puerto Rico Emergency Medical System during the last months of 1997, and implemented in February 1998, under the leadership of new EMS and 911 Directors. The new administration assessed the existing emergency response system and determined that in order to improve response times and deliver better services, equipment would need to be purchased that would be appropriate to the unique geography of Puerto Rico and the heavy traffic congestion which distinguished parts of the metropolitan area. Through funds provided by the Commonwealth, the EMS purchased 10 four-wheel drive vehicles, 10 motorcycles, and 38 bicycles. The motorcycles and bicycles, which could easily maneuver the narrow, mountainous roads and traffic-congested streets in some areas of Puerto Rico, were equipped with emergency response equipment contained within saddlebags strapped to the cycles. The new vehicles have been used most frequently to reach and stabilize an injury victim while awaiting the arrival of the larger ambulances. In some instances, the treatment received by the Rapid Response emergency medical technicians has been sufficient to cancel the need for an ambulance.