What metrics are you using for that? The US ranks fairly close to the top for out of hospital heart attack survival, which is a good proxy for emergency medicine in general.
The US also has decent EMS response times. If you adjust for population density, the US has fantastic response times.
In retrospect, I think my wording might be misleading - I didn't mean to imply the US is doing significantly worse than developed world, just that none of the developed world does significantly worse than the US either.
I.e. I was responding to the original "in 'most of the world' EMS quality is ass.", trying to say that you only get that outcome if you compare apples and oranges (developed vs developing)
8-10 minutes in urban areas is pretty much universal (for the developed world). Rural areas are where differences come in, and even there standards for the developed world are somewhat on the same level.