Depends on what time of day you have your emergency and what is happening.

The town I grew up in is 45-60m to an ER during the day, 30m at night. It’s a volunteer squad, so typical response time is ~20m, longer during the weekday. If someone else has an emergency, they will likely need a mutual aid call, which adds 15-30m. If you need ALS, the ambulance may need to pull over en route when a county paramedic responds. If you are further out, the times increase rapidly. Many common emergencies like stroke are guaranteed fatal.

In the small city that I live in, first responder for a medical emergency will arrive in <7m. Transport to hospital is ~5-10m.

City ambulances don't service counties. If the county outside the city has less available ambulances but high demand then wait times go up.

I can imagine scenarios where it might. Maybe that area is in a different service region (so they don't dispatch from the city) with a much lower ambulance density. If all the ambulances are busy and have long travel times, it's possible it could take more than an hour for one to free up for a new call.

If the ambulance is ran by the county and there is only one or two and you are 4th in line for pickup it could happen.