Medical First Response Models in Rural Villages and Towns: A Simulation Study of Response Times

Abstract

Introduction Medical first responders (MFR) shorten the response times and improve outcomes in, for example, out-of-hospital cardiac arrests. This study demonstrates the usability of open geographic data for analysing MFR service performance by comparing simulated response times of different MFR models in rural town and village settings in Finland. Methods Community first response (CFR) models with one to three responders obeying the speed limit were compared to a volunteer/retained fire department (FD) model where three responders first gather at a fire station and then drive to the scene with lights and siren. Five villages/towns, each with a volunteer/retained FD but no ambulance base within a 10 km radius, were selected to test the models. A total of 50,000 MFR responses with randomly selected buildings as potential responder and patient locations were simulated. Results In central areas, the simulated median response time for the one-responder model was 1.6 minutes, outperforming the FD model’s simulated response time median by 4.5 minutes. In surrounding rural areas, the median response times of one- and two-responder CFR models were still shorter (15.0 and 15.9 minutes, respectively) than in the FD model (16.4 minutes), but the FD model outperformed the three-responder CFR model (16.8 minutes). Conclusion Open geographic datasets were useful in performing logistic simulations of MFR. Based on the simulations, CFR without emergency vehicles may reach patients faster than FD-based MFR in central areas, whereas in surrounding rural areas the difference is less pronounced.

Prehospital Time Interval for Urban and Rural Emergency Medical Services: A Systematic Literature Review

“…Moreover, in South Korea, the National Ambulance Service suggested that EMS for specific events (like cardiac arrest) might be conducted by moderate care ambulances and non-front-line officers to reduce response time, as such events might not require high levels of training and management resources, which might save time in those situations [ 56 ]. Moreover, an RCT by Pappinen et al [ 42 ] compared response times for community first-response models with 1–3 responders and the fire department model. The authors reported that community first-response models might have reduced pre-hospital time compared to the fire department model when emergency vehicles are not used in these events.…”