What if the ambulance never shows up? Emergency medical services are inadequate in rural America.

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 EMS director and paramedic Melissa Peddie operates the lone ambulance that provides service to Liberty County in far north Florida.

Only two full-time paramedics operate the lone truck across the 1,176 square mile, thinly populated county at any given time.

A few weeks ago, when the ambulance was on another call, Peddie and her husband, the local fire chief, drove their own car to stabilise an elderly man who had fallen and was unable to get up. The pair awaited the arrival of an ambulance from a county 30 minutes away so that they could accompany the patient and his family as they travelled an hour east to the state capital and closest trauma centre hospital in Tallahassee.

She responded, "We've done it quite a bit. Jump in my car, go over to the spot, stabilise the situation, and keep it that way until a crew or someone else arrives.

She frequently has to make calls to two or three nearby counties to locate an ambulance for mutual help.

According to a recent national research by the Maine Rural Health Research Centre and the Rural Health Research Centres, more than half of the almost 4.5 million Americans who live in an ambulance desert, which is 25 minutes or more from an ambulance station, are citizens of rural counties.

As rural hospitals around the country continue to close, decreasing emergency medical services are also forced to travel great distances to the closest hospital or trauma centre. In order to help rural and underserved urban populations, experts and practitioners agree that EMS needs a more organised finance approach.

"We need to come up with remedies since this is such a severe situation. People believe that someone is coming in when you phone 911, according to the primary author and deputy director of the Maine Rural Health Research Centre, Yvonne Jonk. The majority of individuals are unaware that their neighbourhoods don't truly have enough coverage.