Journal articles on the topic 'Ambulance'
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Puspita, Kumara, Samriananda Septiyani, and I. Gde Sandy Satria. "EFEKTIVITAS TIM ESCORT SEBAGAI PEMBUKA JALAN AMBULANS DI INDONESIA." Jurnal Hukum Bisnis Bonum Commune 3, no. 2 (July 22, 2020): 189–200. http://dx.doi.org/10.30996/jhbbc.v3i2.3576.
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AbstractThis study aims to identify the formation of the escort team community and the important role of the ambulance escort. Research methods used by researchers are empirical studies by obtaining live data from interviews via social media with escort teams and communities in Indonesia. Research on the role of escort team helps the ambulance travel quickly to the assigned hospital. Early in the development of the escort team in Indonesia, due to people's indifference to the presence of ambulances when the ambulance sirens went off, this caused patients to bet their lives on the streets. Several communities and police departments disagreed on the escort team's presence, as it was in the interest of security and order in police traffic that had the authority to escort ambulances. In this case the host team helps the ambulance, since the ambulance asks escort teams to escort ambulances, for a definite decision or discrete of the police force to provide a specific clearance for the escort team's communities.Keywords: ambulance escort; escort team community; roleAbstrakPenelitian ini bertujuan untuk mengetahui awal terbentuknya komunitas tim escort dan peranan penting dalam melakukan pengawalan ambulans. Metode penelitian yang digunakan peneliti adalah penelitian empiris dengan cara memperoleh data langsung dari hasil wawancara melalui media sosial dengan pihak tim escort dan masyarakat di Indonesia. Melalui penelitian ini peneliti peranan tim escort dapat membantu perjalanan ambulans agar cepat sampai ke rumah sakit yang dituju. Pada awal terbentuknya komunitas tim escort di Indonesia, disebabkan karena ketidakpedulian masyarakat akan keberadaan ambulans ketika sirine ambulans berbunyi, hal ini yang menyebabkan pasien bertaruh nyawa di jalan. Beberapa masyarakat dan pihak kepolisan tidak setuju akan keberadaan komunitas tim escort, karena demi keamanan dan ketertiban dalam berlalu lintas pihak kepolisian yang memiliki wewenang untuk melakukan pengawalan ambulans. Dalam hal ini keberadaan komunitas tim escort sangat membantu pihak ambulans, karena pihak ambulans yang meminta tim escort untuk mengawal ambulans, supaya adanya kepastian diperlukan keputusan atau diskresi kepolisian agar memberikan ketegasan berupa izin khusus untuk komunitas tim escort dalam melakukan pengawalan ambulans.Kata kunci: komunitas tim escort; pengawalan ambulans; peranan
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Tshokey, Tshokey, Ugyen Tshering, Karma Lhazeen, Arpine Abrahamyan, Collins Timire, Bikash Gurung, Devi Charan Subedi, Kencho Wangdi, Victor Del Rio Vilas, and Rony Zachariah. "Performance of an Emergency Road Ambulance Service in Bhutan: Response Time, Utilization, and Outcomes." Tropical Medicine and Infectious Disease 7, no. 6 (May 31, 2022): 87. http://dx.doi.org/10.3390/tropicalmed7060087.
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Background: An efficient ambulance service is a vital component of emergency medical services. We determined the emergency ambulance response and transport times and ambulance exit outcomes in Bhutan. Methods: A cross-sectional study involving real-time monitoring of emergency ambulance deployments managed by a central toll-free (112) hotline (20 October 2021 to 20 January 2022) was carried out. Results: Of 5092 ambulance deployments, 4291 (84%) were inter-facility transfers, and 801 (16%) were for emergencies. Of the latter, 703 (88%) were for non-pregnancy-related emergencies (i.e., medical, surgical, and accidents), while 98 (12%) were for pregnancy-related emergencies. The median ambulance response and patient transport times were 42 (IQR 3–271) and 41 (IQR 2–272) minutes, respectively. The median round-trip distance travelled by ambulances was 18 km (range 1–186 km). For ambulance exit outcomes that were pregnancy-related (n = 98), 89 (91%) reached the health facility successfully, 8 delivered prior to ambulance arrival at the scene or in the ambulance during transport, and 1 had no outcome record. For the remaining 703 non-pregnancy deployments, 29 (4.1%) deployments were deemed not required or refusals, and 656 (93.3%) reached the health facility successfully; 16 (2.3%) died before the ambulance’s arrival at the scene, and 2 (0.3%) were not recorded. Conclusions: This first countrywide real-time operational research showed acceptable ambulance exit outcomes. Improving ambulance response and transport times might reduce morbidities and mortalities further.
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Piórkowski, Adam. "Construction of a dynamic arrival time coverage map for emergency medical services." Open Geosciences 10, no. 1 (June 11, 2018): 167–73. http://dx.doi.org/10.1515/geo-2018-0013.
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Abstract This article presents a design of coverage maps for emergency journeys made by emergency medical services. The system was designed for the Malopolskie Voivodeship Office in Cracow, Poland. The proposed solution displays maps of the ambulance coverage of areas and ambulance’s potential journey times. There are two versions of the map: static and dynamic. The static version is used to appropriately allocate ambulances to cover an area with the ability to reach locations in less than 15 or 20 minutes; the dynamic version allows monitoring of ambulance fleets under normal conditions or in the event of a crisis. The article also presents the results of archival data related to the movement of ambulances on the roads of Malopolskie Voivodship. Particular attention was paid to the relation between the speed of vehicles and the traffic on the road, the day of the week or month, and long-term trends. The collected observations made it possible to assume a general model of ambulance movement in the voivodeship to calculate arrival time coverage maps.
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Ismail, Samina, Nukhba Zia, Khalid Samad, Rubaba Naeem, Haris Ahmad, Amir Raza, Muhammad Baqir, and Uzma Rahim Khan. "Prehospital Airway Management in Emergency and Trauma Patients: A Cross-sectional Study of Ambulance Service Providers and Staff in a Low- and Middle-income Country." Prehospital and Disaster Medicine 30, no. 6 (November 12, 2015): 606–12. http://dx.doi.org/10.1017/s1049023x15005385.
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AbstractBackgroundPrehospital airway management (AM) is the first priority in the care of emergency and trauma victims as it has shown to improve survival in these patients.ObjectiveThe aim of this study was to assess training and knowledge of ambulance staff and availability of AM equipment in ambulances of Karachi, Pakistan.MethodsThis cross-sectional study was conducted from June through September 2014. Interviews were conducted with management of six ambulance service providers and 165 ambulance staff. Data from the management included availability of AM equipment in the ambulances, number and designation of staff sent for emergency calls, and AM training of staff. Ambulance staff were assessed for their awareness, knowledge, and training pertaining to AM.ResultsAll the ambulance services (A through F) had basic equipment for AM but lacked qualified and trained staff. All services had solo drivers (98.3%) for emergency calls; however, Ambulance Service A also had doctors and paramedics. Only 35.7% (59/165) of ambulance staff had awareness regarding AM, out of which 77.9% (46/59) belonged to Ambulance Service A. Of these 59 staff, 81.4% received some form of AM training. Staff with AM awareness, when assessed for knowledge pertaining to AM steps and AM equipment, had a mean score of 4.7/5 and 8.4/12, respectively.ConclusionEven though ambulances are equipped with basic equipment, due to lack of trained staff, these ambulances only serve the mere purpose of transportation. There is a need to train ambulance staff and increase ambulance to staff ratio to improve prehospital AM and patient survival.IsmailS, ZiaN, SamadK, NaeemR, AhmadH, RazaA, BaqirM, KhanUR. Prehospital airway management in emergency and trauma patients: a cross-sectional study of ambulance service providers and staff in a low- and middle-income country. Prehosp Disaster Med. 2015;30(6):606–612.
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Meites, Elissa, and John F. Brown. "Ambulance Need at Mass Gatherings." Prehospital and Disaster Medicine 25, no. 6 (December 2010): 511–14. http://dx.doi.org/10.1017/s1049023x00008682.
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AbstractIntroduction:Scant evidence exists to guide policy-making around public health needs during mass gatherings. In 2006, the City and County of San Francisco began requiring standby ambulances at all mass gatherings with attendance of >15,500 people. The objectives were to evaluate needs for ambulances at mass gatherings, and to make evidence-based recommendations for public health policy-makers. The hypothesis was that the needs for ambulances at mass gatherings can be estimated using community baseline data.Methods:Emergency medical services plans were reviewed for all public events with an anticipated attendance of >1,000 people in San Francisco County during the 12-month period 01 August 2006 through 31 July 2007. Ambulance transport data were confirmed by event coordinators and ambulance company records, and the rate was calculated by dividing ambulance transports by event attendance. Baseline ambulance transport rate was calculated by dividing the annual ambulance transports in the county's computer-aided dispatch system by the census population estimate. The risk ratio was calculated using the risk of transport from a mass gathering compared with the baseline risk of ambulance transport for the local community. Significance testing and confidence intervals were calculated.Results:Descriptive information was available for 100% of events and ambulance transport data available for 97% of events. The majority of the mass gatherings (47 unique events; 59 event days) were outdoor, weekend festivals, parades, or concerts, though a large proportion were athletic events. The ambulance transport rate from mass gatherings was 1 per 59,000 people every six hours. Baseline ambulance transport rate in San Francisco was 1 per 20,000 people every six hours. The transport rate from mass gatherings was significantly lower than the community baseline (risk ratio [RR] = 0.15, 95% CI = 0.10–0.22, p <0.001). At events reserving a standby ambulance, 46% of ambulances were unused.Discussion:San Francisco mass gatherings appear to present a lower risk of ambulance transports compared to the community baseline, suggesting that the community baseline sets an appropriate standard for requiring standby ambulances at mass gatherings. The initial ambulance requirement policy in San Francisco may have been overly conservative.Conclusions:Local baseline data is a recommended starting point when setting policy for public health needs at mass gatherings.
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Ibsen, Stine, Birgitte Schantz Laursen, Erika Frischknecht Christensen, Ulla Møller Weinreich, Søren Mikkelsen, and Tim Alex Lindskou. "How Patients Who Are Transported by Ambulance Experience Dyspnea and the Use of a Dyspnea Scale: A Qualitative Study." Healthcare 10, no. 7 (June 28, 2022): 1208. http://dx.doi.org/10.3390/healthcare10071208.
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Approximately 7% of all dispatched ambulances in Denmark are for patients for whom breathing difficulties are the main cause for using ambulance services. Objective measurements are routinely carried out in the ambulances, but little is known of the patients’ subjective experience of dyspnea. The purpose of this study was to investigate how patients with acute dyspnea, transported to hospital by ambulance, experience their situation, along with their experience of the use of a dyspnea scale. The study was carried out in the North Denmark Region. Transcribed patient interviews and field notes were analyzed and interpreted with inspiration from Paul Ricoeur. For interviews, we included 12 patients with dyspnea who were transported to the hospital by ambulance: six women and six men all aged 60 years or above. Observations were made over six ambulance transports related to dyspnea. Three themes emerged: “anxiety”, “reassurance in the ambulance” and “acceptance of the dyspnea measurements in the ambulance”. Several patients expressed anxiety due to their dyspnea, which was substantiated by observations in the ambulance. The patients expressed different perspectives on what improved the situation (treatment, reassurance by ambulance professionals). The patients and the ambulance personnel were, in general, in favor of the dyspnea scale.
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Buzna, Ľuboš, and Peter Czimmermann. "On the Modelling of Emergency Ambulance Trips: The Case of the Žilina Region in Slovakia." Mathematics 9, no. 17 (September 5, 2021): 2165. http://dx.doi.org/10.3390/math9172165.
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The efficient operation of emergency medical services is critical for any society. Typically, optimisation and simulation models support decisions on emergency ambulance stations’ locations and ambulance management strategies. Essential inputs for such models are the spatiotemporal characteristics of ambulance trips. Access to data on the movements of ambulances is limited, and therefore modelling efforts often rely on assumptions (e.g., the Euclidean distance is used as a surrogate of the ambulance travel time; the closest available ambulance is dispatched to a call; or the travel time estimates, offered by application programming interfaces for ordinary vehicles, are applied to ambulances). These simplifying assumptions are often based on incomplete data or common sense without being fully supported by the evidence. Thus, data-driven research to model ambulance trips is required. We investigated a unique dataset of global positioning system-based measurements collected from seventeen emergency ambulances over three years. We enriched the data by exploring external sources and designed a rule-based procedure to extract ambulance trips for emergency cases. Trips were split into training and test sets. The training set was used to develop a series of statistical models that capture the spatiotemporal characteristics of emergency ambulance trips. The models were used to generate synthetic ambulance trips, and those were compared with the test set to decide which models are the most suitable and to evaluate degrees to which they fit the statistical properties of real-world trips. As confirmed by the low values of the Kullback–Leibler divergence (0.004–0.229) and by the Kolmogorov–Smirnov test at the significance level of 0.05, we found a very good fit between the probability distributions of spatiotemporal properties of synthetic and real trips. A reasonable modelling choice is a model where the exponential dependency on the population density is used to locate emergency cases, emergency cases are allocated to hospitals following empirical probabilities, and ambulances are routed using the fastest paths. The models we developed can be used in optimisations and simulations to improve their validity.
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Cortez, Eric J., Ashish R. Panchal, James E. Davis, and David P. Keseg. "The Effect of Ambulance Staffing Models in a Metropolitan, Fire-Based EMS System." Prehospital and Disaster Medicine 32, no. 2 (January 18, 2017): 175–79. http://dx.doi.org/10.1017/s1049023x16001539.
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AbstractIntroductionThe staffing of ambulances with different levels of Emergency Medical Service (EMS) providers is a difficult decision with evidence being mixed on the benefit of each model.Hypothesis/ProblemThe objective of this study was to describe a pilot program evaluating alternative staffing on two ambulances utilizing the paramedic-basic (PB) model (staffed with one paramedic and one emergency medical technician[EMT]).MethodsThis was a retrospective study conducted from September 17, 2013 through December 31, 2013. The PB ambulances were compared to geographically matched ambulances staffed with paramedic-paramedic (PP ambulances). One PP and one PB ambulance were based at Station A; one PP and one PB ambulance were based at Station B. The primary outcome was total on-scene time. Secondary outcomes included time-to-electrocardiogram (EKG), time-to-intravenous (IV) line insertion, IV-line success rate, and percentage of protocol violations. Inclusion criteria were all patients requesting prehospital services that were attended to by these teams. Patients were excluded if they were not attended to by the study ambulance vehicles. Descriptive statistics were reported as medians and interquartile ranges (IQR). Proportions were reported with 95% confidence intervals (CI). The Mann-Whitley U test was used for significance testing (P<.05).ResultsMedian on-scene times at Station A for the PP ambulance were shorter than the PB ambulance team (PP: 10.1 minutes, IQR 6.0-15; PB: 13.0 minutes, IQR 8.1-18; P=.01). This finding also was noted at Station B (PP: 13.5 minutes, IQR 8.5-19; PB: 14.3 minutes, IQR 9.9-20; P=.01). There were no differences between PP and PB ambulance teams at Station A or Station B in time-to-EKG, time-to-IV insertion, IV success rate, and protocol violation rates.ConclusionIn the setting of a well-developed EMS system utilizing an all-Advanced Life Support (ALS) response, this study suggests that PB ambulance teams may function well when compared to PP ambulances. Though longer scene times were observed, differences in time to ALS interventions and protocol violation rates were not different. Hybrid ambulance teams may be an effective staffing alternative, but decisions to use this model must address clinical and operational concerns.CortezEJ, PanchalAR, DavisJE, KesegDP. The effect of ambulance staffing models in a metropolitan, fire-based EMS system. Prehosp Disaster Med. 2017;32(2):175–179.
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Brismar, Bo. "The Alarm Center in Stockholm County Council." Prehospital and Disaster Medicine 1, S1 (1985): 131–32. http://dx.doi.org/10.1017/s1049023x00044125.
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During the last ten years, both in Western Europe and in the USA, the attitude towards medical transport activities has radically changed. From being a purely transportation vehicle the ambulance is now increasingly regarded as an extended arm of medical care. At the same time as ambulance crews have received more qualified medical training, the equipment of the ambulances themselves has been improved. In several countries such as the USA, France and West Germany, a differentiated ambulance organization has been built up, with specially equipped emergency ambulances manned by paramedics, and standard ambulances with emergency technicians for planned transports. During this time helicopters have been put into increasing use as a supplement to ambulances for emergency long distance transport to units such as trauma and burn centers.
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Sanddal, Teri L., Nels D. Sanddal, Nicolas Ward, and Laura Stanley. "Ambulance Crash Characteristics in the US Defined by the Popular Press: A Retrospective Analysis." Emergency Medicine International 2010 (2010): 1–7. http://dx.doi.org/10.1155/2010/525979.
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Ambulance crashes are a significant risk to prehospital care providers, the patients they are carrying, persons in other vehicles, and pedestrians. No uniform national transportation or medical database captures all ambulance crashes in the United States. A website captures many significant ambulance crashes by collecting reports in the popular media (the website is mentioned in the introduction). This report summaries findings from ambulance crashes for the time period of May 1, 2007 to April 30, 2009. Of the 466 crashes examined, 358 resulted in injuries to prehospital personnel, other vehicle occupants, patients being transported in the ambulance, or pedestrians. A total of 982 persons were injured as a result of ambulance crashes during the time period. Prehospital personnel were the most likely to be injured. Provider safety can and should be improved by ambulance vehicle redesign and the development of improved occupant safety restraints. Seventy-nine (79) crashes resulted in fatalities to some member of the same groups listed above. A total of 99 persons were killed in ambulance crashes during the time period. Persons in other vehicles involved in collisions with ambulances were the most likely to die as a result of crashes. In the urban environment, intersections are a particularly dangerous place for ambulances.
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Adetoyi, Helen N., Olatunde O. Solaja, Abiodun S. Abiodun, Tolulope G. Daini, and Obafemi A. Solesi. "The Impact of Ambulance usage on the Conveyance of Accident Victims in Lagos State Emergency Management Agency (Lasema)." Oct-Nov 2022, no. 26 (November 23, 2022): 1–5. http://dx.doi.org/10.55529/jnrpsp.26.1.5.
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The benefits of planning a reliable and effective ambulance and emergency service for healthcare delivery are an indicator of sustainable development. This study assessed the impact of ambulance usage on the conveyance of accident victims in the Lagos State Emergency Management Agency (LASEMA). Simple random sampling was used to sample respondents from the Agency. A total of fifty (50) structured questionnaires were administered to respondents. The questionnaire consists of twenty-one items and was prepared in such a way that it contains all the items under the survey. A simple frequency table was employed to analyze the data obtained. The research revealed that 62 % of the respondents were male and 38 % female while about 42 % accounted for insufficient ambulance vehicles which made the ambulance and emergency services not effective and efficient due to poor planning. Other factors include poor telecommunication service, negative perception that ambulances carry dead bodies, the demand for payment before patients are transported by ambulances, high cost of fuel, shortage of ambulances and the patients’ renege to fulfil an agreed bills and services. At a significant level of 0.05 using Pearson Correlation, Ho calculated (0.630) was less than H1 tabulated (1) and it was inferred that the positive impact of ambulance usage by accident victims can help promote sustainable ambulance usage and good healthcare delivery. The study concluded that public education on ambulance and emergency services will help rid of false perceptions.
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Kang, Kyunghee. "Analyzing the Frequency of Emergency Room Visits and the Use of 119 Ambulance Services." Fire Science and Engineering 34, no. 5 (October 31, 2020): 104–11. http://dx.doi.org/10.7731/kifse.2c0009d5.
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This study aimed to the socioeconomic and clinical characteristics associated with the use of 119 ambulance/private cars and the number of emergency room visits based on the 2017 data from the Korea Health Panel. The analysis revealed that during emergencies, the use of private cars (59.02%) was more common than 119 ambulance services (18.89%). Moreover, 119 ambulance users were significantly older, had a lower annual total household income, and had relatively more accidents than diseases when compared to private car users. On comparing the number of emergency room visits between single and multiple visits, there were statistically significant differences in age, total annual household income, season of use, and reasons for use for private car usage than 119 ambulances. The 119 ambulance service is an essential public safety net. Therefore, it is increasingly important to solve the frequent use of 119 ambulances by non-emergency patients, and efficiently utilize limited ambulance resources.
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Zonzini, Camilla, Sara Chiossi, and Stefano Musolesi. "Ambulance sanitation in Italy: a pilot study." infermieristica journal 1, no. 1 (June 29, 2022): 17–24. http://dx.doi.org/10.36253/if-1642.
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Abstract
Introduction: the assessment of biological agents' exposure in the work environment is an employer's duty. Air and surfaces could be transmission's vehicles of pathogens. We consider the ambulance as the work environment where, respecting hygienic targets of low risk, we can prevent out-of-hospital infections for workers and patients. Our study analyzes standard sanitation and fumigation; the aim is to reach the lower level of surfaces' contamination.
Materials and Methods: we chose, thanks to bibliography, three points of sampling: stretcher, oxygen knob and backdoor's handle. The points were tested before sanification on three different ambulances. We made thus standard sanitation with Sodium Hypochlorite on two ambulances and fumigation on the other one. After that, we sampled the same three points on each ambulance. Samples were analyzed with standard culture methods after 72 hours.
Results: first samples showed a high bacterial load on every surface. Both standard sanification and fumigation showed success in decreasing bacterial load. Without approved rating standards for ambulance's hygiene we refer to ISPESL's Guidelines about safety and hygiene in surgical wards. Here the standard is 50 cfu/sample, referred to a surface of 20 cm², without pathogens.
Discussion and Conclusions: our analysis is just quantitative, further qualitative analysis should be conducted in order to assess pathogens on ambulances. Both standard sanitation and fumigation show success in decreasing bacterial load however with higher levels than those indicated by guidelines. Further analysis would be needed to define load standards in order to ensure a safe environment for workers and patients.
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Jensen, Frederikke Bøgh, Kathrine Tornbjerg Ladefoged, Tim Alex Lindskou, Morten Breinholt Søvsø, Erika Frischknecht Christensen, and Maurizio Teli. "Understanding the Effect of Electronic Prehospital Medical Records in Ambulances: A Qualitative Observational Study in a Prehospital Setting." International Journal of Environmental Research and Public Health 18, no. 5 (February 27, 2021): 2330. http://dx.doi.org/10.3390/ijerph18052330.
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Little is known of ambulance professionals’ work practices regarding the use of medical records, their communication with patients, before and during hand over to Emergency Departments (ED). An electronic Prehospital Medical Record (ePMR) has been implemented in all Danish ambulances since 2015. Our aim was to investigate the use of ePMR and whether it affected the ambulance professionals’ clinical practice. We performed a qualitative study with observations of ePMR use in ambulance runs in the North Denmark Region. Furthermore, informal interviews with ambulance professionals was performed. Analysis was accomplished with inspiration from grounded theory. Our main findings were: (1) the ePMR is an essential work tool which aided ambulance professionals with overview of data collection and facilitated a checklist for ED hand overs, (2) mobility and flexibility of the ePMR facilitated conversations and relations with the patients, and (3) in acute severe situations, the ePMR could not stand alone in hand over or communication with the ED. The ePMR affected the ambulance professionals’ work practice in various ways and utilization of ePMR while simultaneously treating patients in ambulances does not obstruct the relation with the patient. To this end, the ePMR appears feasible in collaboration across the prehospital setting.
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Teo Sin Di, Mohd Boniami Yazid, Mohd Shaharudin Shah Che Hamzah, Tuan Hairulnizam Tuan Kamauzaman, Normalinda Yaacob, and Nik Hisamuddin Nik Ab. Rahman. "FACTORS ASSOCIATED WITH DELAYED AMBULANCE RESPONSE TIME IN HOSPITAL UNIVERSITI SAINS MALAYSIA, KUBANG KERIAN, KELANTAN." Malaysian Journal of Public Health Medicine 20, no. 1 (May 1, 2020): 9–14. http://dx.doi.org/10.37268/mjphm/vol.20/no.1/art.551.
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Ambulance response time is one of the key performance of ambulances services. The objective of this study is to determine the factors associated with delayed ambulance response time in Hospital Universiti Sains Malaysia (HUSM). This was a cross sectional study conducted in Department of Emergency Medicine, Hospital Universiti Sains Malaysia (EDHUSM) between January 2016 to January 2017. A total of 300 ambulance calls were included in our analysis. Data were collected by ambulance paramedic using validated ambulance form. All ambulance forms with missing data were excluded from this study. Of the 300 ambulance calls within the study periods, 254 cases (84.7%) were determined to have delayed ambulance response time. Current ambulance response time is 14 minutes with interquartile range of 5 minutes. Factors which showed significant association delayed ambulance response time include distance from hospital, location, type of emergency and ambulance mechanism. The odd of delayed ambulance response time by every increase in distance unit was 1.59 (95% CI, 1.37 to 1.85). For location type, the odd of delayed ambulance response time for public location as compared to road was 0.13 (95% CI, 0.04 to 0.45). For ambulance mechanism, the odd of delayed ambulance response time for beacon type as compared to siren type was 0.22 (95% CI, 0.01 to 0.69). Further intervention should be initiated based on our findings to improve current ambulance response time.
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Maguire, MSA, EMT-P, Brian J. "Ambulance safety in the United States." Journal of Emergency Management 1, no. 1 (April 1, 2003): 15. http://dx.doi.org/10.5055/jem.2003.0005.
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This paper reviews the dangers associated with ambulances in the United States. According to the National Highway Traffic Safety Administration (NHTSA) data, vehicle collisions involving ambulances result in twice as many injuries as the national average.Other dangers include: the safety of the vehicle itself; the lack of sufficient occupant protection in the ambulance patient compartment; distractions of the ambulance operator associated with operating lights, sirens, and communication equipment during emergency responses; drowsiness of the ambulance operator associated with extended work hours; and the lack of standardized or test- ed emergency vehicle operator training.Recommendations for improvement include: safety testing for vehicle crashworthiness, testing of diesel fume exposure among emergency medical services (EMS) personnel, and improved safety procedures for EMS personnel. Every effort must be made to make ambulances the safest vehicles on the roads of the United States.
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Aslam, Shiraz, Muhammad Akhlaq, Bilal Hussain, Farooq Tajjamal Khan, Lamia Yusuf, and Asif Mahmood. "Are ambulance drivers exposed to loud siren noise within their ambulances? Identifying the risks involved." Pakistan Postgraduate Medical Journal 30, no. 03 (January 2, 2021): 107–10. http://dx.doi.org/10.51642/ppmj.v30i03.249.
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Objective To identify the risk to the ambulance drivers from the siren systems of their rescue vehicles.
Study design This was a cross sectional study.
Place duration This study was carried out at two rescue centres, namely, Gulberg and Johar Town areas of Lahore, where the ambulances were parked.
Methodology A sound pressure meter was used to measure the sound intensity inside and in the vicinity of the ambulance in use. This was done in two centers in Lahore in 10 vehicles.
Result It was evident that the ambulance drivers are constantly exposed to unsuitable and noxious levels of noise which can over time damage their hearing. A recommendation is contributed regarding hearing assessment for ambulance drivers and their compulsory periodical hearing assessment.
Conclusion
The sirens in the Pakistani ambulances have almost the same sound intensity levels as the ones abroad which can have a damaging effect on the inner ear. Pakistani ambulance drivers should wear ear protection while in their vehicles to protect against ear damage.
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Bahari, Mohd Shahri, Farhana Aminuddin, Sivaraj Raman, Ainul Nadziha Mohd Hanafiah, Mohd Shaiful Jefri Mohd Nor Sham Kunusagaran, Nur Amalina Zaimi, Nor Zam Azihan Mohd Hassan, and Ahmad Tajuddin Mohamad Nor. "Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia." PLOS ONE 17, no. 11 (November 4, 2022): e0276632. http://dx.doi.org/10.1371/journal.pone.0276632.
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Background Despite emergency ambulance services playing a pivotal role in accessibility to life-saving treatments in Malaysia, there are still numerous gaps in knowledge in terms of their utilization and cost. This leads to current policies on procurement, maintenance, and allocation being predicated on historical evidence and expert opinions. This study thus aims to analyse the cost and utilization of ambulance services in selected public health facilities in Malaysia. Methods A cross-sectional study was employed involving 239 ambulances from selected hospitals and clinics. Ambulance service utilization was based on the number of trips, distance and duration of travel obtained from travel logbooks. A mixed top-down and activity-based costing approach was used to estimate the monthly cost of ambulance services. This constituted personnel, maintenance, fuel, overhead, consumables, ambulance, and medical equipment costs. The utilization and costs of ambulance services were further compared between settings and geographical locations. Results The average total cost of ambulance services was MYR 11,410.44 (US$ 2,756.14) for hospitals and MYR 9,574.39 (US$ 2,312.65) for clinics, albeit not significantly different. Personnel cost was found to be the main contributor to the total cost, at around 44% and 42% in hospitals and clinics, respectively. There was however a significant difference in the total cost in terms of the type and age of ambulances, in addition to their location. In terms of service utilization, the median number of trips and duration of ambulance usage was significantly higher in clinics (31.88 trips and 58.58 hours) compared to hospitals (16.25 trips and 39.25 hours). Conclusions The total cost of ambulance services was higher in hospitals compared to clinics, while its utilization showed a converse trend. The current findings evidence that despite the ambulance services being all under the MOH, their operating process and utilization reflected an inherent difference by setting.
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Lindskou, Tim Alex, Laura Pilgaard, Morten Breinholt Søvsø, Torben Anders Kløjgård, Thomas Mulvad Larsen, Flemming Bøgh Jensen, Ulla Møller Weinrich, and Erika Frischknecht Christensen. "Prehospital dyspnoea patients in the North Denmark Region." Dansk Tidsskrift for Akutmedicin 2, no. 3 (April 30, 2019): 41. http://dx.doi.org/10.7146/akut.v2i3.112947.
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Background: Prehospital dyspnoea patients are a frequent group with a high mortality. However, there is limited knowledge about their characteristics. We aimed to investigate causes for dispatched ambulances to patients diagnosed with dyspnoea, and diagnoses given to patients to whom an ambulance was dispatched due to dyspnoea.
Method: Retrospective cohort study in the North Denmark region in the period 2012-2015. We included all emergency ambulance patients where the main cause for a dispatched ambulance was “Breathing difficulty”, and all emergency ambulance patients who were diagnosed within the ICD-10 chapter “Diseases of the respiratory system” at hospital.
Results: 4933 patients had an ambulance dispatched due to “Breathing difficulty”. Their most frequent diagnoses at hospital were ICD-10 chapter “Diseases of the respiratory system” (49.45%), “Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified” (18.56%), “Diseases of the circulatory system” (9.20%), and “Factors influencing health status and contact with health services” (5.71%). Contrariwise, 5163 emergency ambulance patients received a diagnosis within ICD-10 chapter “Diseases of the respiratory system” at hospital. The most frequent causes for dispatched ambulances to these patients were “Breathing difficulty” (49.45%), “Unclarified problem” (11.16%), and “Chest pain - heart disease” (9.55%). 16.00% of dispatches were without cause.
Conclusion: Only half of the patients had both ambulance dispatch and hospital diagnose related to breathing difficulties. The variation and distribution of causes for ambulance dispatch and diagnoses given at hospital, suggests that dyspnoea is a symptom present in many conditions and the patient group is complex.
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Sharma, Sushil, Uma Tomar, Sarthak ., Piyush Saini, and Abhishek Chauhan. "Ambulance Booking Mobile Application." International Journal for Research in Applied Science and Engineering Technology 10, no. V (May 31, 2022): 3340–46. http://dx.doi.org/10.22214/ijraset.2022.43113.
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As in India, a person dies on every crack of the timepiece so, we've proposed an operation that will give an exigency health response to the case. The main purpose of this design will fill the gap between the case and ambulance response time. Ambulances are a vital part of exigency medical services. Generally, cases have a finite range of ambulance connections; therefore whenever in an exigency, they find difficulty. With this design, it's proposed that the operation would enable the case to bespeak a lift to the sanitarium. The case can detect themselves or can upload their current position as well as their destination position into the operation. The system would also show the nearly available ambulances and the case can choose its applicable lifts by comparing the citations and distance of every lift over a region. Eventually, billing at the end. The design further trials to contribute blood force-delivery services to the hospitals. On the other hand, the ambulance motorist would get a prompt about the booking made by the case. The ambulance motorist has to confirm the booking made and the operation will guide the motorist towards the destination.
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Buhmann, Volker, Guido Schüpfer, and Christoph Konrad. "Anästhesie für ambulantes Operieren." Therapeutische Umschau 74, no. 7 (December 2017): 389–97. http://dx.doi.org/10.1024/0040-5930/a000931.
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Zusammenfassung. Das ambulante Operieren ist eine Möglichkeit das Gesundheitssystem zu entlasten, ohne dabei eine qualitative Verschlechterung der Versorgung in Kauf nehmen zu müssen. Die Zahl der operativen Eingriffe, die routinemässig ambulant erbracht werden, steigt stetig an und gerade weil Länder wie die Schweiz und Deutschland im internationalen Vergleich diesem Trend noch immer hinterherhinken, ist mit einer deutlichen Zunahme ambulanter Operationen in den nächsten Jahren zu rechnen. Dieser Artikel soll den Anästhesisten in den Mittelpunkt stellen, der als perioperativer Mediziner eine Schlüsselrolle im Behandlungsprozess des ambulanten Operierens einnimmt. Durch eine konzise Beurteilung und einer daraus abgeleiteten Strategie zur Modifizierung von Risiken, die der Patient auf Grund von Vorerkrankungen mit sich bringt, kann ambulantes Operieren sicher und erfolgreich geleistet werden.
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Coid, Donald R. "Measurement for Management: Report of a Pilot Project to Quantify Ambulance Misuse for Managers of a Fife Hospital." Health Services Management Research 2, no. 3 (November 1989): 213–16. http://dx.doi.org/10.1177/095148488900200305.
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Ambulance services appear to be under increasing pressure to provide a full range of services to the Community. It is important, therefore, that the service is appropriately utilised by patients. Health Service Managers, however, have little readily available information which identifies ‘appropriate’ utilisation. A simple technique is suggested to measure ‘appropriateness’ of utilisation of ambulances and a pilot survey of ambulance use by patients attending Dunfermline and West Fife Hospital Out-Patient clinics is described. In each case of ambulance use a panel of health professionals evaluated the ‘appropriateness’ of the patient having utilised this service. In the clinics surveyed, 91% of the sample of 328 patients did not use an ambulance to travel to clinics; in only two cases was use of the ambulance considered to be ‘probably inappropriate’. Misuse of the ambulance service was minimal during this study. Health Service Managers have been provided with some evidence to refute suggestions of substantial, inappropriate use of the ambulance service.
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Caliskan, Cuneyt, and K. Hakan Altintas. "Time, island and ambulance type characteristics of patient transfers from two Turkish islands." International Journal of Emergency Services 9, no. 1 (October 2, 2019): 47–55. http://dx.doi.org/10.1108/ijes-12-2018-0065.
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Purpose The purpose of this paper is to evaluate the time, place and ambulance types specified on the ambulance patient registry forms for cases transferred through 112 EMS in the Bozcaada and Gökçeada island districts of the province of Çanakkale. Design/methodology/approach The universe of the descriptive – cross-sectional epidemiological study was composed of the ambulance patient registration forms of the cases which were transferred from Bozcaada and Gökçeada islands between January 1, 2009 and December 31, 2013. Findings Of the transfers made, 28.1 percent were in the year 2012, 39.5 percent were in summer, 16.6 percent were in July, 17.9 percent were on Monday, 37.1 percent were between 12.00 and 17.59 h and 61.5 percent were from Gökçeada island. Ground ambulances were more common in the transfers from Bozcaada island, while ambulance boat and helicopter ambulance were more common for transfers from Gökçeada island. Helicopter-Emergency Medical Service (HEMS) (p<0.001), which is commonly preferred for patient transfers, inversely affects the use of Ambulance Boat-Emergency Medical Service (BEMS) and ground ambulances. Transfers from Bozcaada island were found to be shorter in duration, and the number of transfers from Bozcaada island between 00.00 and 05.59 h were found to be higher than from Gökçeada island (p<0.001), while the number of transfers via ground ambulance between 00.00 and 05.59 h were found to be higher than the other ambulance types (p<0.001). Practical implications This study reveals the current state of the various referral routes from the islands. Originality/value This paper is the first study to demonstrate the characteristics of patients referred from the island belongs to Turkey.
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Zehra, Fatima Tuz, Diya Nisar, Abeeha Zehra, Mahnoor Javed, Mahnoor Usman, and Syed Uzair Mahmood. "Pervasiveness of ambulance etiquette and knowledge in general population: a perspective from Pakistan." International Journal Of Community Medicine And Public Health 7, no. 4 (March 26, 2020): 1244. http://dx.doi.org/10.18203/2394-6040.ijcmph20201427.
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Background: Ambulance ethics refers to the principles of moral conduct that make the journey of an ambulance safe, convenient whereby ensuring provision of effective pre-hospital care to the patient. It concerns three sets of population: the paramedical staff, the patient and family and also the general population.Methods: Cross-sectional comparative study, conducted from February to May 2018. A questionnaire consisting of 25 questions was filled by 412 participants who were older than 15 years of age and their responses were collected via a 5-point likert scale. Chi-square analysis was done to compare the responses of medical and non-medical participants.Results: Vast majority of individuals agreed that they should give way to ambulances by switching their lanes or by breaking the signal. Half of the individuals were of the idea that ambulances should maintain their speed limit while some favored disregarding the speed limit if it meant saving someone’s life, while others remained neutral. A large percentage of participants agreed that a vehicle must meet certain standards in order for it to act as an ambulance. A number of participants agreed that an ambulance should have basic life support (BLS), the ambulance staff should be skilled enough to give cardiopulmonary resuscitation (CPR) en route to the hospital.Conclusions: The general population supports the idea that ambulances should have a hassle-free route to transport the patient to the hospital and to hasten the treatment even if that means breaking signals, switching lanes and exceeding speed limit.
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Acharya, Rija, Angur Badhu, Tara Shah, and Sharmila Shrestha. "Availability of Life Support Equipment and its Utilization by Ambulance Drivers." Journal of Nepal Health Research Council 15, no. 2 (September 15, 2017): 182–86. http://dx.doi.org/10.3126/jnhrc.v15i2.18197.
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Background: An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers.Methods: Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method. Self- constructed observation checklist and semi structured interview schedule was used for data collection. Results: More than half of the respondents had less than five years of experience and were not trained in first aid. About two-third of the respondents had adequate knowledge on first aid. About 90% of the ambulance had oxygen cylinder and adult oxygen mask which was ‘usually’ used equipment. More than half of ambulance had equipment less than 23% as compared to that of national guidelines. There was significant association of knowledge with the experience (p = 0.004) and training (p = 0.001). Availability of equipment was associated with training received (p = 0.007), organization (p= 0.032)and district (p = 0.023) in which the ambulance is registered.Conclusions: The study concludes that maximum ambulance linked to BPKIHS, Nepal did not have even one fourth of the equipment for basic life support. Equipment usually used was oxygen cylinder and oxygen mask. Majority of driver had adequate knowledge on first aid and it was associated with training and experience.
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Nandhini, S., Saravana Kumar, Aditya Kumawat, and Mansi Sharma. "Efficient Ambulance Routing." Journal of Computational and Theoretical Nanoscience 16, no. 8 (August 1, 2019): 3192–95. http://dx.doi.org/10.1166/jctn.2019.8159.
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Road traffic has become a major issue in highly crowded metropolitan cities. Ambulance services which are provided by the government and private organizations struggle to get the patient to the hospital, resulting in unfortunate events which affect the people vastly. We are applying Internet Of Things (IoT) and cloud based services that can bring up an effective route and smoothen the ambulance movement throughout. Our attempt is to alert people on the road in prior about incoming ambulances by using smart lighting and managing them via cloud. Internet Of Things helps in collaboration of these different devices, accessing and monitoring them remotely.
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Saputra, Dedi, Haryani Haryani, Martias Martias, Artika Surniandari, and Kudiantoro Widianto. "RANCANG BANGUN APLIKASI PESAMLINE (PEMESANAN AMBULANCE ONLINE) BERBASIS ANDROID." JUSIM (Jurnal Sistem Informasi Musirawas) 6, no. 2 (December 9, 2021): 110–22. http://dx.doi.org/10.32767/jusim.v6i2.1188.
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Android adalah sistem operasi yang berbasis Linux untuk telepon seluler seperti telepon pintar dan komputer tablet seperti smartphone yang banyak beredar di pasaran atau bahkan yang kita gunakan dalam kegiatan sehari-hari. Android menyediakan platform terbuka bagi para pengembang untuk menciptakan aplikasi mereka sendiri yang dapat digunakan oleh bermacam-macam peranti bergerak. Penelitian ini dibuat untuk membantu masyarakat yang membutuhkan pelayanan Ambulance secara Online dalam situasi darurat, seperti pertolongan untuk korban kecelakaan, ibu melahirkan, dan situasi darurat lainya. Aplikasi pemesanan ambulan berbasis android ini akan menampilkan layanan pemesanan ambulan dimana sebagai sampel penelitiannya layanan Ambulan yang berada di wilayah Kota pontianak, dapat mengirimkan pemesanan darurat ke Ambulance terdekat dari lokasi pemesan melalui aplikasi PESAMLINE yang terpasang di smartphone, sehingga mempermudah pengguna dalam mendapatkan pelayanan Ambulance. Penelitian ini menggunakan Android Studio dan menggunakan bahasa pemograman java dalam pembuatan Aplikasinya. Untuk pengembangan perangkat lunaknya menggunakan model waterfall. Hasil dari penelitian ini diharapkan pengguna dapat mengakses aplikasi untuk mengirim pesan darurat ke Ambulance terdekat yang sudah terdaftar di aplikasi.
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Oshita, Yusuke, Koki Tsuchiya, Koji Ishikawa, Kodai Hirabayashi, and Tetsuya Nemoto. "Ambulance Use by International Travelers in Japan: A Retrospective Descriptive Study." International Journal of Travel Medicine and Global Health 8, no. 1 (March 11, 2020): 13–17. http://dx.doi.org/10.34172/ijtmgh.2020.02.
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Introduction: Reports indicate that 22%–64% of travelers experience some illness when in a foreign country. To date, no prior study has reported the use of ambulances by travelers or the epidemiology of travel-related injury. Methods: In this retrospective study, we aimed to describe ambulance use by international travelers, including the rates of travel-related injury and illness. To do so, ambulance dispatch data from January 1, 2010 to December 31, 2018 was used. Results: Overall, of the 43201 cases of ambulance use during the study period, 524 (1.2%) were international travelers. Ambulance use by international travelers increased from 0.35% in 2010 (15/4311) to 2.54% in 2018 (125/4913), an average annual increase of 0.27%. Of the international travelers, 392 (74.8%) had minor complaints, 110 cases (21.0%) had moderate complaints, 280 (53.4%) had internal disease, and 223 cases (42.6%) had suffered trauma. Regarding location, 253 (48.3%) were from a hotel/lodge, 83 (15.8%) were from a road/parking, and 30 (5.7%) were in the forest/mountain. Conclusion: Most international travelers use ambulances for minor complaints, typically internal disease or trauma, and approximately half access the service from a hotel or lodge.
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Nono, Raneem, Rawan Alsudais, Raghad Alshmrani, Sumayyah Alamoudi, and Asia Othaman Aljahdali. "Intelligent Traffic Light for Ambulance Clearance." ADCAIJ: Advances in Distributed Computing and Artificial Intelligence Journal 9, no. 3 (November 7, 2020): 89–104. http://dx.doi.org/10.14201/adcaij20209389104.
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Human life is a serious matter, so we should not neglect anything that might threaten it. It must be protected in all possible ways. Consequently, all health services such as hospitals, medicines, ambulances and so on need to evolve continuously to overcome life-threatening problems. Since many people could lose their life because of an ambulance delay. We proposed a system that provides a way to overcome the ambulance delay problem. With the current traffic light system, the ambulance can get stuck in the traffic or may cause an accident while it crosses the red light. To avoid that, the proposed system enables the ambulance to control the traffic light. Thus, the system will facilitate the ambulance movement to save people's life. The hardware used to implement this project includes Arduino UNO and mega with network shield (ZigBee). We have used C++ language and Arduino IDE to program the Arduino and the ZigBee.
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Tsai, Yihjia, Kuan-Wu Chang, Giou-Teng Yiang, and Hwei-Jen Lin. "Demand Forecast and Multi-Objective Ambulance Allocation." International Journal of Pattern Recognition and Artificial Intelligence 32, no. 07 (March 14, 2018): 1859011. http://dx.doi.org/10.1142/s0218001418590115.
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This study considers the two-fold dynamic ambulance allocation problem, which includes forecasting the distribution of Emergency Medical Service (EMS) requesters and allocating ambulances dynamically according to the predicted distribution of requesters. EMSs demand distribution forecasting is based on on-record historical demands. Subsequently, a multi-objective ambulance allocation model (MOAAM) is solved by a mechanism called Jumping Particle Swarm Optimization (JPSO) according to the forecasted distribution of demands. Experiments were conducted using recorded historical data for EMS requesters in New Taipei City, Taiwan, for the years 2014 and 2015. EMS demand distribution for 2015 is forecasted according to the on-record historical demand of 2014. Ambulance allocation for 2015 is determined according to the anticipated demand distribution. The predicted demand distribution and ambulance allocation solved by JPSO are compared with historic data of 2015. The comparisons verify that the proposed methods yield lower forecasting error rates and better ambulance allocation than the actual one.
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Gaievskyi, Stanislav, Oleksandr Linchevskyy, and Colin Meghoo. "A Workplace-Based Observation Strategy to Assess Prehospital Care Delivery by Public Ambulances in Ukraine." Prehospital and Disaster Medicine 34, s1 (May 2019): s179—s180. http://dx.doi.org/10.1017/s1049023x19004138.
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Introduction:Current methods to evaluate the delivery of urgent prehospital care often rely on inadequate surrogate measures or unreliable self-reported data. A workplace-based strategy may be feasible to assess the delivery of prehospital care by ambulances in selected populations.Aim:To perform a nationwide assessment of the psychomotor performance of public ambulance workers in Ukraine, we created a plan of workplace-based observation. We conducted a post-hoc analysis of this strategy to assess feasibility, strengths, and limitations for future use in assessing prehospital ambulance performance.Methods:With support from the Ministry of Health, we sent teams of trained observers to 30 ambulance substations across Ukraine. Using data collection tools on mobile devices, these observers accompanied Advanced Life Support ambulances on urgent calls for periods of 72 hours. We evaluated this program for collecting patient encounter data against the investment of time, personnel, and financial resources.Results:Over a two-month period, we directly observed 524 patient encounters by public ambulances responding to urgent calls at 30 ambulance substations across Ukraine. We employed 6 observers and 2 administrators over this time period. Collecting our observations required 2,160 person-hours at the ambulance substations. The total distance traveled to these sites was 11,375 kilometers. Project costs amounted to 37,000 USD, equating to 71 USD per observed patient encounter.Discussion:Workplace-based assessments are a cost-effective strategy to collect data on the delivery of prehospital care in select populations. This data can be useful for identifying the current state of EMS care delivered and evaluating compliance with established treatment protocols. Successful implementation depends on effective planning and coordination with a commitment of time, personnel, and financial resources. Issues of patient privacy, legal permission, and observer training must be considered.
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Gongal, Rajesh, B. Dhungana, S. Regmi, M. Nakarmi, and B. Yadav. "Need of Improvement in Emergency Medical Service in Urban Cities." Journal of Nepal Medical Association 48, no. 174 (April 1, 2009): 139–43. http://dx.doi.org/10.31729/jnma.230.
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Introduction: An effective Emergency Medical Service system does not exist in Nepal. For an effective EMS system to be developed the scale of the problem and the existing facilities need to be studied. Methods: Prospective observational study was carried out on 1964 patients attending Emergency Department at Patan Hospital during one month period of September 2006. The patients were specifically enquired on mode of transport used, place of origin and whether they called for an ambulance or not. Patients triage category at the time of triaging was also noted. Information on ambulance service were collected by direct interview with the service providers and the total number of patients attending Emergency Departments daily were collected from the major hospitals of the urban Lalitpur and Kathmandu. MS Excel and SPSS software were used for data entry, editing and analysis.Results: Total 9.9% patients arrived in ambulance whereas 53.6% came in a Taxi, 11.4% came in private vehicle, 13.5 % came by bus, 5.4% came by bike and the rest 6.2% came by other modes of transportation. Only 13.5% of triage category I patients took the ambulance. There were 31 service providers with 49 ambulances and 720 patients per day attend Emergency Departments in the surveyed area. Conclusions: Very less number of patients use the ambulance service for emergency services. The available ambulances are not properly equipped and do not have trained staff and as such are only a means of transportation to the hospitals of urban Lalitpur and Kathmandu.Key Words: ambulance, emergency medical service, para-medics, triage Need of Improvement in Emergency Medical Service in Urban Cities Gongal R,1Dhungana B,1Regmi S,1Nakarmi M,2Yadav B11Patan Hospital, Lalitpur, Nepal, 2Health Care Foundation, Kathmandu, NepalCorrespondence:Dr. Rajesh GongalDepartment of SurgeryPatan Hospital, Patan, Nepal.Email: rajgongal@yahoo.comORIGINAL ARTICLE J Nepal Med Assoc 2009;48(174):139-43INTRODUCTIONThe sophisticated Emergency Medical Service (EMS) is limited to developed country only. Many developing countries are now slowly developing such system although most services are localized to the urban areas.1-5 Although inadquate ambulance services are available in the capital city of Nepa
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Akhumukhi, Vidyasagar, Sharmila Gaikwad, and Vishal Kumar. "Systematic Literature Survey on Emergency Medical Services." International Journal on Recent and Innovation Trends in Computing and Communication 9, no. 4 (April 30, 2021): 06–12. http://dx.doi.org/10.17762/ijritcc.v9i4.5459.
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Now-a-days considering the fast-paced world, particularly in massive cities, several services get delayed due to traffic jams. Ambulance service is one among the crucial services that get delayed fairly often. Additionally, generally onsite doctors aren't obtainable. Therefore, the patient doesn't get medical attention forthwith. ‘Traffic Control System for Smart Ambulance’ is a system which creates a ‘green corridor’ for the ambulance to reach the hospital. Also, it monitors the patient’s health and sends the data to the hospital beforehand. In health monitoring system, the patient’s very important health parameters like heart rate and body temperature are monitored. These parameters are sent to the hospital via message. In traffic control an android application is used in which the traffic control room controls the signals based on the traffic conditions and the location of ambulance and hospital seen on the app. The objective of this paper is to understand the various systems that can be used for ambulances in traffic and help the ambulance to faster reach the hospital.
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Lowthian, Judy A., Peter A. Cameron, Johannes U. Stoelwinder, Andrea Curtis, Alex Currell, Matthew W. Cooke, and John J. McNeil. "Increasing utilisation of emergency ambulances." Australian Health Review 35, no. 1 (2011): 63. http://dx.doi.org/10.1071/ah09866.
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Background. Increased ambulance utilisation is closely linked with Emergency Department (ED) attendances. Pressures on hospital systems are widely acknowledged with ED overcrowding reported regularly in the media and peer-reviewed literature. Strains on ambulance services are less well-documented or studied. Aims. To review the literature to determine the trends in utilisation of emergency ambulances throughout the developed world and to discuss the major underlying drivers perceived as contributing to this increase. Method. A search of online databases, search engines, peer-reviewed journals and audit reports was undertaken. Findings. Ambulance utilisation has increased in many developed countries over the past 20 years. Annual growth rates throughout Australia and the United Kingdom are similar. Population ageing, changes in social support, accessibility and pricing, and increasing community health awareness have been proposed as associated factors. As the extent of their contribution has not yet been established these factors were reviewed. Conclusion. The continued rise in utilisation of emergency ambulances is placing increasing demands on ambulance services and the wider health system, potentially compromising access, quality, safety and outcomes. A variety of factors may contribute to this increase and targeted strategies to reduce utilisation will require an accurate identification of the major drivers of demand. What is known about the topic? Ambulance utilisation is increasing annually throughout the developed world, with previous research suggesting numerous underlying factors. What does this paper add? These factors have not been previously synthesised in the international literature. This narrative review clearly articulates the underlying problems. What are the implications for practitioners? This paper outlines the need for further research of the causes of increased emergency ambulance utilisation, to enable the development of appropriate strategies to manage demand in the future.
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Harmer, Luke, and Sue Hignett. "Smaller, lighter, faster? Reducing the carbon footprint of ambulances." Journal of Paramedic Practice 13, no. 10 (October 2, 2021): 1–7. http://dx.doi.org/10.12968/jpar.2021.13.10.cpd1.
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This paper outlines a feasibility project investigating the potential for smaller, lighter rapid response vehicles (RRVs) in reducing the carbon footprint and response times of ambulances. Five stakeholder consultations were held with two ambulance trusts, an ambulance manufacturer, a paramedic and the Ultra-Light Vehicle Group to generate three novel design concepts for RRVs, which were then reviewed by four UK feet managers and four clinicians. The results indicated that the integrated clinician service model could create a future market for smaller, lighter vehicles. Reducing carbon emissions in the short term will most likely be achieved using lower emission engines and improving engine and power management for dual-crewed ambulances. In the medium term (5–10 years), there will be a demand for low emission, composite light-weight dual-crewed ambulances.
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Pniewski, Roman, Daniel Pietruszczak, and Michał Ciupak. "Logistics in collective transport of emergency medical services." AUTOBUSY – Technika, Eksploatacja, Systemy Transportowe 19, no. 12 (December 31, 2018): 955–58. http://dx.doi.org/10.24136/atest.2018.531.
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The paper discusses the subject of logistics in ambulance transport based on the example of an ambulance service. When discussing this subject, it is worth noting that an interesting issue related to its functioning is that relating to its relationship with transport logistics regarding travel time to the patient. Discussing this topic will be the subject of this paper. A logistics process will be presented on the example of logistics in the transport of ambulances.
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Breeman, Wim, Mark G. Van Vledder, Michael H. J. Verhofstad, Albert Visser, and Esther M. M. Van Lieshout. "First attempt success of video versus direct laryngoscopy for endotracheal intubation by ambulance nurses: a prospective observational study." European Journal of Trauma and Emergency Surgery 46, no. 5 (February 19, 2020): 1039–45. http://dx.doi.org/10.1007/s00068-020-01326-z.
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Abstract Purpose The aim of this study was to compare the rate of first attempt success of endotracheal intubation performed by ambulance nurses in patients with a Glasgow Coma Scale (GCS) of 3 using video laryngoscopy versus direct laryngoscopy. Methods A prospective cohort study was conducted in a single, independent ambulance service. Twenty of a total of 65 nurse-staffed ambulances were equipped with a video laryngoscope; a classic direct laryngoscope (Macintosh) was available on all 65 ambulances. The primary outcome was first attempt success of the intubation. Secondary outcomes were overall success, time needed for intubation, adverse events, technical or environmental issues encountered, and return of spontaneous circulation (ROSC). Ambulance nurses were asked if the intubation device had affected the outcome of the intubation. Results The first attempt success rate in the video laryngoscopy group [53 of 93 attempts (57%)] did not differ from that in the direct laryngoscopy group [61 of 126 (48%); p = 0.221]. However, the second attempt success rate was higher in the video laryngoscopy group [77/93 (83%) versus 80/126 (63%), p = 0.002]. The median time needed for the intubation (53 versus 56 s) was similar in both groups. Ambulance nurses more often expected a positive effect when performing endotracheal intubation with a video laryngoscope (n = 72, 81%) compared with a direct laryngoscope (n = 49, 52%; p < 0.001). Conclusion Although no significant effect on the first attempt success was found, video laryngoscopy did increase the overall success rate. Ambulance nurses had a more positive valuation of the video laryngoscope with respect to success chances.
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Lin, Adrian Xi, Andrew Fu Wah Ho, Kang Hao Cheong, Zengxiang Li, Wentong Cai, Marcel Lucas Chee, Yih Yng Ng, Xiaokui Xiao, and Marcus Eng Hock Ong. "Leveraging Machine Learning Techniques and Engineering of Multi-Nature Features for National Daily Regional Ambulance Demand Prediction." International Journal of Environmental Research and Public Health 17, no. 11 (June 11, 2020): 4179. http://dx.doi.org/10.3390/ijerph17114179.
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The accurate prediction of ambulance demand provides great value to emergency service providers and people living within a city. It supports the rational and dynamic allocation of ambulances and hospital staffing, and ensures patients have timely access to such resources. However, this task has been challenging due to complex multi-nature dependencies and nonlinear dynamics within ambulance demand, such as spatial characteristics involving the region of the city at which the demand is estimated, short and long-term historical demands, as well as the demographics of a region. Machine learning techniques are thus useful to quantify these characteristics of ambulance demand. However, there is generally a lack of studies that use machine learning tools for a comprehensive modeling of the important demand dependencies to predict ambulance demands. In this paper, an original and novel approach that leverages machine learning tools and extraction of features based on the multi-nature insights of ambulance demands is proposed. We experimentally evaluate the performance of next-day demand prediction across several state-of-the-art machine learning techniques and ambulance demand prediction methods, using real-world ambulatory and demographical datasets obtained from Singapore. We also provide an analysis of this ambulatory dataset and demonstrate the accuracy in modeling dependencies of different natures using various machine learning techniques.
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Puspita, Sartika, Denny Anggoro Prakoso, and Romadhon Yuan Aziz. "PENINGKATAN KETERAMPILAN PETUGAS AMBULANMU DI ERA KEBIASAAN BARU PANDEMI COVID-19." SELAPARANG: Jurnal Pengabdian Masyarakat Berkemajuan 6, no. 1 (March 6, 2022): 49. http://dx.doi.org/10.31764/jpmb.v6i1.7351.
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ABSTRAKEra kebiasaan baru pandemi Covid-19 saat ini perlu dilakukan pelatihan petugas dan relawan Ambulanmu Pimpinan ranting Muhammadiyah (PRM) Nitikan Umbulharjo Yogyakarta yang berasal dari anggota Komando Kesiapsiagaan Angkatan Muda Muhammadiyah (KOKAM). Di masa Covid-19 ini perlu pembekalan petugas dan relawan mengenai cara mengoperasikan ambulanmu secara aman terhadap transmisi virus. Tujuan pengabdian masyarakat ini adalah anggota KOKAM PRM Nitikan sebagai petugas Ambulanmu dapat memiliki pengetahuan dan keterampilan yang meningkat di era kebiasaan baru. Metode pelaksanaan pengabdian ini meliputi penyuluhan dan pelatihan di aula Masjid Sulthonain PRM Nitikan dengan peserta terbatas dengan protokol kesehatan yang ketat. Metode yang digunakan adalah penyuluhan melalui kuliah, forum diskusi berkelompok dan praktik keterampilan kerja (skills lab) dengan narasumber Palang Merah Indonesia (PMI) Kota Yogyakarta serta tim rukti jenazah PKU Muhammadiyah Yogyakarta. Hasil pengabdian ini terdapat peningkatan pengetahuan dan keterampilan petugas ambulanmu dalam menggunakan alat pelindung diri (APD), rukti jenazah, teknik disinfektanisasi jenazah, peribadatan, sterilisasi ambulans dan petugasnya serta protokol pelayanan jenazah sampai penguburannya. Implikasi kesgiatan ini anggota kokam sebagai relawan ambulanmu siap menghadapi pasien dan jenazah Covid-19. Hasil kegiatan ini terdapat peningkatan pengetahuan dan keterampilan KOKAM petugas ambulanmu dalam situasi era pandemi Covid-19. Kata Kunci: ambulanmu; covid-19, KOKAM; nitikan; PRM ABSTRACTIn the new era of the Covid-19 pandemic, it is necessary to train Ambulanmu officers and volunteers. The leadership of the Muhammadiyah branch (PRM) Nitikan Umbulharjo Yogyakarta who comes from members of the Muhammadiyah Youth Preparedness Command (KOKAM). During this Covid-19 period, it is necessary to equip officers and volunteers on how to operate ambulance safely against virus transmission. The purpose of this community service is that members of KOKAM PRM Nitikan as Ambulanmu officers can have increased knowledge and skills in the era of new habits. The method of implementing this service includes counseling and training in the hall of the Sulthonain PRM Nitikan Mosque with limited participants with strict health protocols. The method used is counseling through lectures, group discussion forums and work practices (skills lab) with speakers from the Indonesian Red Cross (PMI) of Yogyakarta City and the PKU Muhammadiyah Yogyakarta mortuary team. The results of this service are an increase in the knowledge and skills of your ambulance officers in using personal protective equipment (PPE), burial of corpses, body disinfection techniques, worship, sterilization of ambulances and their officers as well as protocols for service bodies to burial. The implication of this activity is that the kokam members as ambulanmu volunteers are ready to Covid-19 patients and corpses. The result of this activity is an increase in the knowledge and skills of ambulanmu officer KOKAM in the the Covid-19 pandemic era. Keywords: ambulanmu; covid-19; KOKAM; nitikan; PRM
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KRISHNAN, SUREN, RAJAN THANGAVELOO, SHAPI-EE BIN ABD RAHMAN, and SIVA RAJA SINDIRAMUTTY. "Smart Ambulance Traffic Control System." Trends in Undergraduate Research 4, no. 1 (June 29, 2021): c28–34. http://dx.doi.org/10.33736/tur.2831.2021.
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The traffic lights control system is broadly implemented to track and control the flow of vehicles through the intersection of multiple roads. Nevertheless, the synchronization of traffic light system at adjacent junctions is an intricate issue given the different parameters involved. Existing traffic light control systems do not control many flows approaching the same junctions. This results in traffic jams and congestion at urban areas or major cities with high volume traffic consisting of various types of vehicles. This includes emergency ambulances travelling on the same traffic junction during peak hour traffic. Thus, an enhanced traffic light control system is imperative to provide a smooth and free flow for an ambulance on the way to its destination. The Smart Ambulance Traffic Control System proposed in this paper is an integrated system of traffic light control for emergency ambulance service. The traffic lights can be controlled in a timely and efficient manner every time an emergency ambulance is approaching. The Radio-Frequency Identification (RFID) is used as an instrument to communicate with traffic lights during traffic congestion. The emergency ambulance driver needs to activate the RFID tag to allow the detection of RFID readers to control the traffic light operation at the upcoming traffic light junctions. The traffic lights in the path of the ambulance are forced to be green to allow the emergency ambulance to pass through the junction with top priority. Immediately after the ambulance has passed the junction, the control system will reset and return to normal operations.
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Waseem, H., S. Shahbaz, and J. Razzak. "(A154) Overcrowding of Ambulances at the Scene of a Disaster: Pitfalls and Implications." Prehospital and Disaster Medicine 26, S1 (May 2011): s53. http://dx.doi.org/10.1017/s1049023x11001713.
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IntroductionPakistan is a developing country with a basic prehospital system in some cities. The prehospital services are a mixture of government and private ambulances.There is no central regulatory body for them and no central command to control the influx and out flux of ambulances from the scene.ObjectiveIn this paper, five episodes of terrorist incidents in the country and will try to estimate the number of ambulances on the scene.MethodsRetrospective data was collected and triangulation was done by three sources: (1) ambulance records; (2) visual estimation; and (3) print media. An estimate of total ambulances was reached along with dead and injured. Furthermore medical transport capacity was calculated where possible.ResultsIn majority of the incidents, it was found that there was a huge influx of ambulances beyond the need. This further adds to the chaos and confusion already present on the scene of disaster.ConclusionsA Command and Control Center should be established to direct all ambulance control and movements.
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Lindridge, Jaqualine, Kevin Reynard, Rob Kemp, Richard Brownhill, and Jerry Penn-Ashman. "PP31 Ambulance handover: a thematic review of delays in 2018/19." Emergency Medicine Journal 37, no. 10 (September 25, 2020): e14.2-e14. http://dx.doi.org/10.1136/emermed-2020-999abs.31.
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BackgroundAmbulance handover delays are an important indicator of an emergency care system under pressure. Delayed handovers compromise patient safety in the Emergency Department (ED). As a direct consequence patients wait longer for an emergency ambulance response, and as a result patient safety in the community is also compromised. We explored factors perceived to contribute to ambulance handover delays at EDs in an urban area of England, in order to inform delay reduction strategies.MethodsFifteen EDs were visited as part of a regional improvement programme. Ambulance handover processes were observed, and staff involved in the process were informally interviewed. A data corpus of twenty-nine written reports was generated. These reports were anonymised and thematic analysis was used inductively to explore the phenomenon of ambulance handover delay. Pattern coding was used to identify and cluster common themes, with magnitude coding added to identify the most prevalent themes.ResultsPerceived reasons for ambulance handover delay arose from a number of factors. A mismatch was frequently seen between handover capacity and demand. This occurred alongside, but was also frequently observed to be independent of, ED exit block. Approaches to escalation were often sub-optimal. This was observed both before and after an ambulance queue developed. Processes were often uneconomical by design, and pathways were frequently inefficient. Inter-professional culture was identified as an important, cross-cutting theme, with a lack of urgency to release ambulances frequently observed.ConclusionsOur results suggest several factors influence ambulance handover delays. Programmes which aim to improve overall hospital flow, streamline pathways and processes, and improve escalation are needed. Programmes should also seek to improve the inter-professional culture relating to ambulance handover. Limitations to this enquiry include an opportunistic, retrospective approach and use of a convenience sample. There are few empirical studies which address the causes of ambulance handover delay. More research is needed on this important patient safety issue.
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Awad, A., H. Ali, S. K. M. Abujayyab, I. R. Karas, and D. R. S. Sumunar. "MEASURING THE SPATIAL READINESS OF AMBULANCE FACILITIES FOR NATURAL DISASTERS USING GIS NETWORKS ANALYSIS." ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences XLIV-4/W3-2020 (November 23, 2020): 81–84. http://dx.doi.org/10.5194/isprs-archives-xliv-4-w3-2020-81-2020.
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Abstract. The massive disasters that arise by nature and humanity are significantly leads to several losses in lives and infrastructures. Disasters such as chemical explosions, flash floods and volcanoes. The high level of preparedness from the governments and administration authorities and ambulance services can significantly reduce the losses in lives. The aim of this paper is to measure the spatial readiness of ambulance facilities for natural disasters using GIS networks analysis. The measurement performed based on three standards, the area covered by the ambulance service, speed of service and the proportion to the population. ArcGIS spatial analysis and network analysis tools employed to develop the coverage maps of the three measured standards. According to the analysis, 94.4% from the study area appeared within the standard distance (20 km) from the ambulance stations, while 91% from the study area appeared within the time response standard (15 minutes) from the ambulance stations. The study area has a deficit of 256,714 people and needs 5 additional ambulances to achieve the demographic standard. The main recommendation of this study is to apply this methodology regularly in the study area to avoid any weakness before the disasters and to increase the level of preparedness.
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Liu, Zhenghong, Mian Jie Lim, Pin Pin Pek, Aaron Sung Lung Wong, Kenneth Boon Kiat Tan, Khung Keong Yeo, and Marcus Eng Hock Ong. "Improved door-to-balloon time for primary percutaneous coronary intervention for patients conveyed via emergency ambulance service." Annals of the Academy of Medicine, Singapore 50, no. 9 (September 30, 2021): 671–78. http://dx.doi.org/10.47102/annals-acadmedsg.2021153.
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ABSTRACT Introduction: Early reperfusion of ST-segment elevation myocardial infarction (STEMI) results in better outcomes. Interventions that have resulted in shorter door-to-balloon (DTB) time include prehospital cardiovascular laboratory activation and prehospital electrocardiogram (ECG) transmission, which are only available for patients who arrive via emergency ambulances. We assessed the impact of mode of transport on DTB time in a single tertiary institution and evaluated the factors that affected various components of DTB time. Methods: We conducted a retrospective cohort study using registry data of patients diagnosed with STEMI in the emergency department (ED) who underwent primary percutaneous coronary intervention. We compared patients who arrived by emergency ambulances with those who came via their own transport. The primary study end point was DTB, defined as the earliest time a patient arrived in the ED to balloon inflation. As deidentified data was used, ethics review was waived. Results: A total of 321 patients were included for analysis after excluding 7 with missing data. The mean age was 61.4±11.4 years old with 49 (15.3%) females. Ninety-nine (30.8%) patients arrived by emergency ambulance. The median DTB time was shorter for patients arriving by ambulance versus own transport (52min, interquartile range [IQR] 45–61 vs 67min, IQR 59–74; P<0.001), with shorter door-to-ECG and door-to-activation time. Conclusion: Arrival via emergency ambulance was associated with a decreased DTB for STEMI patients compared to arriving via own transport. There is a need for public education to increase the usage of emergency ambulances for suspected heart attacks to improve outcomes. Keywords: Cardiovascular lab activation, door-to-balloon time, emergency ambulance, primary PCI, STEMI
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Liu, Zhenghong, Mian Jie Lim, Pin Pin Pek, Aaron Sung Lung Wong, Kenneth Boon Kiat Tan, Khung Keong Yeo, and Marcus Eng Hock Ong. "Improved door-to-balloon time for primary percutaneous coronary intervention for patients conveyed via emergency ambulance service." Annals of the Academy of Medicine, Singapore 50, no. 9 (September 30, 2021): 671–78. http://dx.doi.org/10.47102/annals-acadmedsg.2021153.
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ABSTRACT Introduction: Early reperfusion of ST-segment elevation myocardial infarction (STEMI) results in better outcomes. Interventions that have resulted in shorter door-to-balloon (DTB) time include prehospital cardiovascular laboratory activation and prehospital electrocardiogram (ECG) transmission, which are only available for patients who arrive via emergency ambulances. We assessed the impact of mode of transport on DTB time in a single tertiary institution and evaluated the factors that affected various components of DTB time. Methods: We conducted a retrospective cohort study using registry data of patients diagnosed with STEMI in the emergency department (ED) who underwent primary percutaneous coronary intervention. We compared patients who arrived by emergency ambulances with those who came via their own transport. The primary study end point was DTB, defined as the earliest time a patient arrived in the ED to balloon inflation. As deidentified data was used, ethics review was waived. Results: A total of 321 patients were included for analysis after excluding 7 with missing data. The mean age was 61.4±11.4 years old with 49 (15.3%) females. Ninety-nine (30.8%) patients arrived by emergency ambulance. The median DTB time was shorter for patients arriving by ambulance versus own transport (52min, interquartile range [IQR] 45–61 vs 67min, IQR 59–74; P<0.001), with shorter door-to-ECG and door-to-activation time. Conclusion: Arrival via emergency ambulance was associated with a decreased DTB for STEMI patients compared to arriving via own transport. There is a need for public education to increase the usage of emergency ambulances for suspected heart attacks to improve outcomes. Keywords: Cardiovascular lab activation, door-to-balloon time, emergency ambulance, primary PCI, STEMI
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Sookram, Sunil, Kent Riddle, Eddie Chang, and Terry Sosnowski. "Description of Ambulance Diversions in the Edmonton Region." Prehospital and Disaster Medicine 17, no. 2 (June 2002): 91–95. http://dx.doi.org/10.1017/s1049023x00000236.
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AbstractBackground:Diversion of ambulances by hospital emergency departments has become a day-to-day occurrence in many jurisdictions within Canada. Yet, despite the increasing prevalence of this phenomenon, its impact on transported patients, on the EMS system, and on the health care system overall has not, to date, been well quantified. Despite the increasing sophistication and capabilities of North American EMS systems, it is difficult to argue with the principle that unstable or potentially unstable patients are best served by expeditious transport for definitive care to acute care facilities. T o this end, this study represents an effort to assess the systemic and patient care impacts of ambulance diversions.Methods:Patient-care and corresponding ambulance trip records for all patients transported by this EMS system for a five week period were abstracted to identify those patients in which an ambulance was diverted from its initial destination. Adverse events include hypotensive episodes, airway compromise, changes in level of consciousness, and the onset of violent behavior. Response and transport times also were abstracted, comparisons utilized student's t-test and 95% Confidence Intervals. Results: Ambulance diversions increased EMS response times and prehospital transport times. Adverse medical events occurred during 4.3% of diverted ambulance runs. Patients, when faced with the prospect of transport to other than their hospital of choice, not infrequently cancelled EMS transport and sought other means of transport. Subsequent interfacility transport was required for 4.3% of the diverted patients.Conclusions:Diversion of ambulances impacts the EMS system by increasing response and transport times; the region, by generating subsequent interfacility transports; and patients, as adverse medical events can occur during the diverted transport.
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Roslin, E. N., M. Z. Zakaria, N. Mohd Nur, E. H. Sukadarin, M. Widia, and A. Hamzah. "An Overview of the Ambulance Safety: Towards the Improvement in ASEAN Countries." Journal of the Society of Automotive Engineers Malaysia 5, no. 3 (September 1, 2021): 369–80. http://dx.doi.org/10.56381/jsaem.v5i3.179.
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Ambulances have been utilized as one of the important vehicles in operating the Emergency Medical Services (EMS) system. As safety is the utmost priority for an EMS crashes involving ambulances would not only delay patient transfers but would also endanger its occupants and other road users. Although the numbers of accidents involving ambulances are considered to be low as compared to other types of vehicles, preventive measures need to be taken in order to eliminate the high risk of accidents occurring as ambulances should be able to provide reliable and safe emergency transport services for the benefit of the public. An overview of ambulance accidents is highlighted in this paper. Based on the literature reviews, four main factors have been identified as the contributor to the causes of the accidents involving ambulances – driver-related factor, vehicle-related factor, task-related factor, and environment-related factor. From the findings, future research should be focused on creating mitigation plans on a structured preventive measure that could be implemented particularly in reducing fatal accidents involving the ambulance in ASEAN countries.
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Winter, Scott R., Joseph R. Keebler, Stephen Rice, Rian Mehta, and Bradley S. Baugh. "Driverless Ambulances: A Possibility, but Will Patients Ride?" Proceedings of the Human Factors and Ergonomics Society Annual Meeting 62, no. 1 (September 2018): 1176. http://dx.doi.org/10.1177/1541931218621270.
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Emergency Medical Services (EMS) provide a needed and necessary service in the healthcare industry worldwide. However, many EMS agencies find themselves understaffed to fill the needs of the communities they serve. As a result, this can lead to decreases in the quality of service provided in times of emergencies. Simultaneously, technology is advancing in driverless vehicles which pose the question of the possibility of building driverless ambulances and if so, patients’ willingness to ride in them. Therefore, the purpose of this study was to determine patients’ willingness to ride in an ambulance operated autonomously as opposed to one driven by a human. Affect measures were collected to determine if affect mediated the relationship between willingness to ride and the type of ambulance configuration. The research used a three-study approach to answer the research questions. First, a general scenario was used to examine patient's willingness to ride in an ambulance based on a human or driverless condition. In Study 2, the affect was implemented to serve as a mediator between the type of operator, human or driverless. In Study 3, the researchers used the six universal facial expressions to determine if specific emotions could be identified as mediators between the condition and willingness to ride score. Through the three studies, the findings indicated that patients were less willing to ride in the scenario where the ambulance was operated autonomously than in the traditional configuration. A significant interaction was found between gender and type of ambulance configuration, where females were less willing to ride in the autonomous ambulance than males. Affect was found to act as a mediator between willingness to ride and the type of ambulance. Additionally, through the use of the six universal facial expressions, it was determined that the mediating emotions for males were fear and happiness, and the mediating emotion for females was anger. In general, participants were not willing to ride in driverless ambulances; however, this finding is also limited by the hypothetical scenario posed in this study which was the need to be transported to the hospital due to phoning 911 in an emergency. Additional research should investigate how patients would feel about riding in a driverless ambulance based on the type of condition as it is possible the willingness to ride may be different in a non-emergency scenario. There may also be other factors that could predict a patient’s willingness to ride in a driverless ambulance. In summary, while driverless technology is becoming a near-term possibility, further research is needed into whether patients would be willing to accept this technology for usage.
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Puolakka, Tuukka, Taneli Väyrynen, Elja-Pekka Erkkilä, and Markku Kuisma. "Fire Engine Support and On-scene Time in Prehospital Stroke Care – A Prospective Observational Study." Prehospital and Disaster Medicine 31, no. 3 (March 28, 2016): 278–81. http://dx.doi.org/10.1017/s1049023x16000303.
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AbstractIntroductionOn-scene time (OST) previously has been shown to be a significant component of Emergency Medical Services’ (EMS’) operational delay in acute stroke. Since stroke patients are managed routinely by two-person ambulance crews, increasing the number of personnel available on the scene is a possible method to improve their performance.HypothesisUsing fire engine crews to support ambulances on the scene in acute stroke is hypothesized to be associated with a shorter OST.MethodsAll patients transported to hospital as thrombolysis candidates during a one-year study period were registered by the ambulance crews using a case report form that included patient characteristics and operational EMS data.ResultsSeventy-seven patients (41 [53%] male; mean age of 68.9 years [SD=15]; mean Glasgow Coma Score [GCS] of 15 points [IQR=14-15]) were eligible for the study. Forty-five cases were managed by ambulance and fire engine crews together and 32 by the ambulance crews alone. The median ambulance response time was seven minutes (IQR=5-10) and the fire engine response time was six minutes (IQR=5-8). The number of EMS personnel on the scene was six (IQR=5-7) and two (IQR=2-2), and the OST was 21 minutes (IQR=18-26) and 24 minutes (IQR=20-32; P =.073) for the groups, respectively. In a following regression analysis, using stroke as the dispatch code was the only variable associated with short (<22 minutes) OST with an odds ratio of 3.952 (95% CI, 1.279-12.207).ConclusionDispatching fire engine crews to support ambulances in acute stroke care was not associated with a shorter on-scene stay when compared to standard management by two-person ambulance crews alone. Using stroke as the dispatch code was the only variable that was associated independently with a short OST.PuolakkaT, VäyrynenT, ErkkiläE-P, KuismaM. Fire engine support and on-scene time in prehospital stroke care – a prospective observational study. Prehosp Disaster Med. 2016;31(3):278–281.
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Park, Seong Hyeon, and Young Hoon Lee. "Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors." Journal of Healthcare Engineering 2019 (December 9, 2019): 1–14. http://dx.doi.org/10.1155/2019/6031789.
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A two-tiered ambulance system, consisting of advanced and basic life support for emergency and nonemergency patient care, respectively, can provide a cost-efficient emergency medical service. However, such a system requires accurate classification of patient severity to avoid complications. Thus, this study considers a two-tiered ambulance dispatch and redeployment problem in which the average patient severity classification errors are known. This study builds on previous research into the ambulance dispatch and redeployment problem by additionally considering multiple types of patients and ambulances, and patient classification errors. We formulate this dynamic decision-making problem as a semi-Markov decision process and propose a mini-batch monotone-approximate dynamic programming (ADP) algorithm to solve the problem within a reasonable computation time. Computational experiments using realistic system dynamics based on historical data from Seoul reveal that the proposed approach and algorithm reduce the risk level index (RLI) for all patients by an average of 11.2% compared to the greedy policy. In this numerical study, we identify the influence of certain system parameters such as the percentage of advanced-life support units among all ambulances and patient classification errors. A key finding is that an increase in undertriage rates has a greater negative effect on patient RLI than an increase in overtriage rates. The proposed algorithm delivers an efficient two-tiered ambulance management strategy. Furthermore, our findings could provide useful guidelines for practitioners, enabling them to classify patient severity in order to minimize undertriage rates.