The Use of Emergency Lights and Sirens by Ambulances and Their Effect on Patient Outcomes and Public Safety: A Comprehensive Review of the Literature

Murray, Brett; Kue, Ricky

doi:10.1017/s1049023x16001503

Cited by 43 publications

(24 citation statements)

References 31 publications

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“…The results are in line with previous studies (18)(19)(20)(21)(22)(23). The benefit of LS driving in MFR operations is less significant than often thought.…”

Section: Discussionsupporting

confidence: 91%

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

Pappinen

Olkinuora²,

Laukkanen-Nevala³

2021

Australasian Journal of Paramedicine

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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.

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“…The results are in line with previous studies (18)(19)(20)(21)(22)(23). The benefit of LS driving in MFR operations is less significant than often thought.…”

Section: Discussionsupporting

confidence: 91%

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

Pappinen

Olkinuora²,

Laukkanen-Nevala³

2021

Australasian Journal of Paramedicine

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“…Quality was also perceived in relation to different measurements such as time of response from the initial call to the emergency dispatch center to arrival at the scene. The preparedness to reach the patient as quickly as possible is in line with a study by Holmberg and Fagerberg [41], but utilization of lights and sirens is not entirely positive [50]. While lights and sirens improve the response and transport time, their use has no clinical effect on patient outcomes.…”

Section: Discussionsupporting

confidence: 60%

“…While lights and sirens improve the response and transport time, their use has no clinical effect on patient outcomes. Furthermore, as lights and sirens have unfavourable effects on patient safety, ACs and the general public, it is recommended that a protocol should be developed to minimize their usage [50]. Another quality indicator related to response time is cardiac arrest survival [22]…”

Section: Discussionmentioning

confidence: 99%

Quality Is in the Eye of the Beholder—A Focus Group Study from the Perspective of Ambulance Clinicians, Physicians, and Managers

2019

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Quality within all areas of healthcare should be systemically monitored and ensured. However, the definition of quality is complex and diverse. In the ambulance service (AS), quality has traditionally been defined as response time, but this measurement eliminates the possibility of addressing other characteristics of quality, such as the care provided. This study aimed to explore what constitutes quality in the context of the ambulance service as experienced by ambulance clinicians, physicians, and managers. A focus group study was conducted with 18 participants. The three focus groups were analyzed with the focus group method developed by Kreuger and Casey. The participants highlighted patient involvement, information and care, as well as adherence to policies, regulations, and their own standards as representing quality in the AS. This study demonstrates that quality is in the eye of the beholder. As quality seems to be viewed similarly by patients and ambulance clinicians, physicians, and managers, stakeholders should aim for a paradigm shift where patients’ experience of the care is just as important as various time measures.

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“…The open source GraphHopper [24] routing tool and OpenStreetMap [25] data were used to determine normal driving times, which were decreased by 20% to simulate a drive with the lights and siren based on literature [26]. Flight times were calculated via the great circle route and a flight speed of 220 km/h.…”

Section: Methodsmentioning

confidence: 99%

The selection of an optimal transportation strategy in urgent stroke missions: a simulation study

Pappinen

Miettinen

Laukkanen-Nevala³

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: Stroke causes death, disability and increases the use of healthcare resources worldwide. The outcome of intravenous thrombolysis and mechanical endovascular thrombectomy highly depends on the delay from symptom onset to initiation of definitive treatment. The purpose of this study was to compare the various patient transportation strategies to minimize pre-hospital delays. Methods: Emergency medical services (EMS) mission locations and ambulance response times in Finland with urgent stroke-suspected dispatch codes were collected from Emergency Response Centre (ERC) records between 1 January 2016 and 31 December 2016. Four transport scenarios were simulated for each mission, comparing ground and helicopter transportation to hospital with different treatment capabilities. Results: In 2016, a total of 20,513 urgent stroke-suspected missions occurred in Finland. Of these, we were able to locate and calculate a route to scenario-based hospitals in 98.7% (20,240) of the missions. For ground transport, the estimated median pre-hospital time to a thrombolysis-capable and thrombectomycapable hospital were 54.5 min (95% confidence interval (CI), 31.7-111.4) and 94.4 min (95% CI, 33.3-195.8), respectively. Should patients be transported on the ground to thrombectomy-capable hospitals only, the prehospital time would increase in 11,003 (54.4%) of missions, most of which were in rural areas. With the fastest possible transportation method, the estimated mean transport time to a thrombectomy-capable hospital was 80.84 min (median, 80.80 min; 95% CI, 33.3-143.1). Helicopter transportation was the fastest method in 68.8% (13,921) of missions, and the time saved was greater than 30 min in 27.1% (5475) of missions. In rural areas, helicopter transportation was the fastest option in nearly all missions if dispatched simultaneously with ground ambulance. Conclusion: Helicopter transportation may significantly decrease pre-hospital delays for stroke patients, especially in rural areas, but the selection of an optimal transportation method or chain of methods should be determined caseby-case.

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The Use of Emergency Lights and Sirens by Ambulances and Their Effect on Patient Outcomes and Public Safety: A Comprehensive Review of the Literature

Cited by 43 publications

References 31 publications

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

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

Quality Is in the Eye of the Beholder—A Focus Group Study from the Perspective of Ambulance Clinicians, Physicians, and Managers

The selection of an optimal transportation strategy in urgent stroke missions: a simulation study

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