Time saved with high speed driving of ambulances

Petzäll, Kerstin; Petzäll, Jan; Jansson, Jörgen; Nordström, Gun

doi:10.1016/j.aap.2010.10.032

Cited by 50 publications

(28 citation statements)

References 18 publications

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“…It also revealed that more than 45% of all request calls and 43% of request calls to hospitals indicating a status of ‘Accepting patients’ resulted in failure. Driving ambulances at high speed,32 helicopter transportation33–35 and centralisation of hospitals36 might be solutions to reduce transportation time. However, the risk of traffic accidents,37 costs for helicopter EMS38 39 and time and cost for centralising hospitals are difficult problems to solve.…”

Section: Discussionmentioning

confidence: 99%

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan

et al. 2016

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ObjectivesIn Japan, ambulance staff sometimes must make request calls to find hospitals that can accept patients because of an inadequate information sharing system. This study aimed to quantify effects of the number of request calls on the time interval between an emergency call and hospital arrival.Design and settingA cross-sectional study of an ambulance records database in Nara prefecture, Japan.CasesA total of 43 663 patients (50% women; 31.2% aged 80 years and over): (1) transported by ambulance from April 2013 to March 2014, (2) aged 15 years and over, and (3) with suspected major illness.Primary outcome measuresThe time from call to hospital arrival, defined as the time interval from receipt of an emergency call to ambulance arrival at a hospital.ResultsThe mean time interval from emergency call to hospital arrival was 44.5 min, and the mean number of requests was 1.8. Multilevel linear regression analysis showed that ∼43.8% of variations in transportation times were explained by patient age, sex, season, day of the week, time, category of suspected illness, person calling for the ambulance, emergency status at request call, area and number of request calls. A higher number of request calls was associated with longer time intervals to hospital arrival (addition of 6.3 min per request call; p<0.001). In an analysis dividing areas into three groups, there were differences in transportation time for diseases needing cardiologists, neurologists, neurosurgeons and orthopaedists.ConclusionsThe study revealed 6.3 additional minutes needed in transportation time for every refusal of a request call, and also revealed disease-specific delays among specific areas. An effective system should be collaboratively established by policymakers and physicians to ensure the rapid identification of an available hospital for patient transportation in order to reduce the time from the initial emergency call to hospital arrival.

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Section: Discussionmentioning

confidence: 99%

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan

et al. 2016

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“…This may potentially reduce transportability to more rural services with longer responses where traffic obstructions may influence the difference in response times to a lesser degree. An emergency response analysis conducted in Sweden found a mean time saved of 2.9 and 8.9 min in urban and rural areas, respectively 7. This indicates that the presented time efficacy of an emergency response might be even larger in rural areas.…”

Section: Discussionmentioning

confidence: 96%

Emergency versus standard response: time efficacy of London’s Air Ambulance rapid response vehicle

et al. 2017

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“…We assumed that EMS would travel at the average speed of other vehicles based on discussions with individuals familiar with EMS practices and from existing literature. 12,13 Additional methodological details are provided in the Supplement.…”

Section: Methodsmentioning

confidence: 99%

Regional Evaluation of the Severity-Based Stroke Triage Algorithm for Emergency Medical Services Using Discrete Event Simulation

Bogle

Asimos

Rosamond

2017

Stroke

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Background and Purpose The Severity-Based Stroke Triage Algorithm for EMS endorses routing patients with suspected large vessel occlusion (LVO) acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region. Methods We developed a discrete event simulation environment to model suspected stroke patients transported according to algorithm specifications which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs. We simulated King County, Washington, and Mecklenburg County, North Carolina, distributing patients geographically into census tracts. Transport time to the nearest hospital and ESC was estimated using traffic-based travel times. We assessed undertriage, overtriage, transport time, and the number-needed-to-route, defined as the number of patients enduring additional transport to route one LVO patient to an ESC. Results Undertriage was higher and overtriage was lower in King County compared with Mecklenburg County for each specification. Overtriage variation was primarily driven by screen (e.g. 13% to 55% in Mecklenburg County; 10% to 40% in King County). Transportation time specifications beyond 20 minutes increased overtriage and decreased undertriage in King County but not Mecklenburg County. A low versus high specificity screen routed 3.7-times more patients to ESCs. EMS spent nearly twice the time routing patients to ESCs in King County compared to Mecklenburg County. Conclusions Our results demonstrate how discrete event simulation can facilitate informed decision-making to optimize EMS stroke severity based triage algorithms. This is the first step towards developing a mature simulation to predict patient outcomes.

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Time saved with high speed driving of ambulances

Cited by 50 publications

References 18 publications

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan

Emergency versus standard response: time efficacy of London’s Air Ambulance rapid response vehicle

Regional Evaluation of the Severity-Based Stroke Triage Algorithm for Emergency Medical Services Using Discrete Event Simulation

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