scholarly journals A comparison of pre-hospital emergency medical services’ response and duration times in urban versus rural areas of Saudi Arabia

2020 ◽  
Vol 17 ◽  
Author(s):  
Ahmed Ramdan M Alanazy ◽  
Stuart Wark ◽  
John Fraser ◽  
Amanda Nagle
Keyword(s):  
Saudi Arabia ◽  
Response Time ◽  
Emergency Medical Services ◽  
Outcome Measures ◽  
Rural Areas ◽  
Response Times ◽  
Medical Services ◽  
Industrial Accidents ◽  
Emergency Medical ◽  
Urban Versus

Background Response impacts on treatment outcomes, particularly for time-sensitive illnesses, including trauma. This study compares key outcome measures for emergency medical services (EMS) operating in urban versus rural areas in the Riyadh region of Saudi Arabia. Methods A cross-sectional study of EMS users was conducted using a random sampling method. Primary outcome measures were response time, on-scene time, transport time interval and survival rates. Secondary outcomes were the length of stay in the intensive care unit and hospital. Data were compared between the urban and rural groups using the t-test and chi-square test. Results Eight-hundred patients (n=400 urban, n=400 rural) were included in the final analysis. Cases in rural areas had significantly higher response times and duration times (median response 15 vs. 22 minutes, median duration 43 vs. 62 minutes). Response times were significantly longer for rural areas for MVC, industrial accidents, medical incidents and trauma, but there was no significant difference in duration time for industrial accidents. While urban areas had significantly shorter response times for all incident types, there was no difference with rural areas in duration time for chest injury, gastrointestinal, neurological or respiratory problems. Conclusion The findings indicate that response time and duration differs between urban and rural locations in a number of key areas. The factors underlying these differences need to be the subject of specific follow-up research in order to make recommendations as to the best way to improve EMS in Saudi Arabia and to close the gap in rural and urban service delivery.

scholarly journals Disparities between Rural and Urban Areas of the Central Region of Saudi Arabia in the Utilization and Time-Centeredness of Emergency Medical Services

2020 ◽  
Vol 17 (21) ◽  
pp. 7944
Author(s):  
Hassan N. Moafa ◽  
Sander Martijn Job van Kuijk ◽  
Dhafer M. Alqahtani ◽  
Mohammed E. Moukhyer ◽  
Harm R. Haak
Keyword(s):  
Saudi Arabia ◽  
Emergency Medical Services ◽  
Central Region ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Services ◽  
Utilization Rate ◽  
Rural And Urban Areas ◽  
Emergency Medical ◽  
Rural And Urban

The purpose of this study was to explore differences in characteristics of missions dispatched by Emergency Medical Services (EMS) between rural and urban areas of Riyadh province in Saudi Arabia (SA). It also aimed at identifying weaknesses related to utilization and Response Time (RT). The study retrospectively evaluated 146,639 completed missions in 2018 by measuring the utilization rate in rural and urban areas. The study shows there are six times more ambulance crews available for rural areas compared to urban. There were 22.1 missions per 1000 urban inhabitants and 11.2 missions per 1000 in rural areas. The median RT for high urgent trauma cases was 20.2 min in rural compared to 15.2 min in urban areas (p < 0.001). In urban areas, the median RT for high urgent medical cases was 16.1 min, while it was 15.2 min for high urgent trauma cases. Around 62.3% of emergency cases in urban and 56.5% in rural areas were responded to within 20.00 min. Women utilized EMS less frequently. The RT was increased in urban areas compared to previous studies. The RT in the central region of SA has been identified as equal, or less than 20.00 min in 62.4% of all emergency cases. To further improve adherence to the 20′ target, reorganizing the lowest urgent cases in the rural areas seems necessary.

scholarly journals Emergency Medical Services (EMS) Transportation of Trauma Patients by Geographic Locations and In-Hospital Outcomes: Experience from Qatar

2021 ◽  
Vol 18 (8) ◽  
pp. 4016
Author(s):  
Hassan Al-Thani ◽  
Ahammed Mekkodathil ◽  
Attila J. Hertelendy ◽  
Ian Howland ◽  
Tim Frazier ◽  
...  
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Prehospital Care ◽  
Hospital Length Of Stay ◽  
Medical Services ◽  
Trauma Patients ◽  
Hospital Outcomes ◽  
Emergency Medical ◽  
Urban And Rural Areas

Background: Prehospital care provided by emergency medical services (EMS) plays an important role in improving patient outcomes. Globally, prehospital care varies across countries and even within the same country by the geographic location and access to medical services. We aimed to explore the prehospital trauma care and in-hospital outcomes within the urban and rural areas in the state of Qatar. Methods: A retrospective analysis was conducted utilizing data from the Qatar National Trauma Registry for trauma patients who were transported by EMS to a level 1 trauma center between 2017 and 2018. Data were analyzed and compared between urban and rural areas and among the different municipalities in which the incidents occurred. Results: Across the study duration, 1761 patients were transported by EMS. Of that, 59% were transported from an urban area and 41% from rural areas. There were significant differences in the on-scene time and total prehospital time as a function of urban and rural areas and municipalities; however, the response time across the study groups was comparable. There were no significant differences in blood transfusion, intubation, hospital length of stay, and mortality. Conclusion: Within different areas in Qatar, the EMS response time and in-hospital outcomes were comparable. This indicates that the provision of prehospital care across the country is similar. The prehospital and acute in-hospital care are accessible for everyone in the country at no cost. Understanding the differences in EMS utilization and prehospital times contributes to the policy development in terms of equitable distribution of healthcare resources.

scholarly journals Organisational factors affecting emergency medical services’ performance in rural and urban areas of Saudi Arabia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Ramdan M Alanazy ◽  
John Fraser ◽  
Stuart Wark
Keyword(s):  
Saudi Arabia ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Services ◽  
Time Service ◽  
Rural And Urban Areas ◽  
Emergency Medical ◽  
Rural And Urban ◽  
Organisational Factors

Abstract Background There is a disparity in outcomes between rural and urban emergency medical services (EMS) around the world. However, there is a scarcity of research that directly asks EMS staff in both rural and urban areas how service delivery could be improved. The aim of the present study is to gain insights from frontline workers regarding organisational factors that may underpin discrepancies between rural and urban EMS performance. Subject and methods The study was undertaken in the Riyadh region of Saudi Arabia. Potential participants were currently employed by Saudi Red Crescent EMS as either a technician, paramedic or an EMS station manager, and had a minimum of five years experience with the EMS. Semi-structured interviews were undertaken between October 2019 and July 2020 with first respondents to a call for participants, and continued until data saturation was reached. All interviews were conducted in Arabic and transcribed verbatim. The Arabic transcript was shared with each participant, and they were asked to confirm their agreement with the transcription. The transcribed interviews were then translated into English; the English versions were shared with bi-lingual participants for validation, while independent certification of the translations were performed for data from participants not fluent in English. A thematic analysis methodological approach was used to examine the data. Results The final sample involved 20 participants (10 rural, 10 urban) from Saudi Red Crescent EMS. Data analyses identified key organisational factors that resulted in barriers and impediments for EMS staff. Differences and similarities were observed between rural and urban respondents, with identified issues including response and transportation time, service coordination, reason for call-out, as well as human and physical resourcing. Conclusion The findings identified key issues impacting on EMS performance across both rural and urban areas. In order to address these problems, three changes are recommended. These recommendations include a comprehensive review of rural EMS vehicles, with a particular focus on the age; incentives to improve the numbers of paramedics in rural areas and more localised specialist training opportunities for rurally-based personnel; and the implementation of national public education program focusing on the role of the EMS.

scholarly journals Development of Emergency Medical Services Amid 5 Years’ Experience at a Medical School in Thailand

2021 ◽  
Vol 9 (E) ◽  
pp. 378-381
Author(s):  
Korakot Apiratwarakul ◽  
Phongphat Ruamsuk ◽  
Takaaki Suzuki ◽  
Ismet Celebi ◽  
Somsak Tiamkao ◽  
...  
Keyword(s):  
Response Time ◽  
Medical School ◽  
Emergency Medical Services ◽  
Response Times ◽  
Medical Services ◽  
Emergency Medical ◽  
The Mean ◽  
Work Model ◽  
Two Phases

BACKGROUND: The development of emergency medical services (EMSs) in Thailand is divided into two phases following the enactment of the Emergency Medical Act in 2007 aimed at making the work model more systematic. However, the amount of EMS operations has not been well studied. AIM: The aim of this study was to describe the pattern of EMS operations throughout a 5-year period. METHODS: A retrospective, single-centered study at a medical school hospital in Thailand. Data were gathered from the EMS database at Srinagarind Hospital throughout the years 2016–2020. RESULTS: A total of 10,384 EMS operations were examined over a 5-year period (2016–2020). The mean age of patients in 2016 was 40.2 ± 3.5 years, and 55.3% (n = 1178) were male. Operations were most commonly performed during the afternoon shift (4.00 p.m.–0.00 a.m.) 41.0%, 38.6%, 39.5%, 39.2%, and 50.8%, respectively. The amount of EMS members had a tendency to increase in number throughout the 5 years of study (p = 0.022). The average times from 1669 center call receipt to arrival on scene (response time) for 2016 and 2020 were 8.52 ± 2.20 min and 5.52 ± 3.02 min, respectively (p < 0.001). CONCLUSION: The development of EMS at Srinagarind Hospital took place with an increase in the age of patients, number of operations in the afternoon shift, and EMS members, yet with a decrease in response times.

Why the Closest Ambulance Cannot be Dispatched in an Urban Emergency Medical Services System

2008 ◽  
Vol 23 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Stephen F. Dean
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Response Times ◽  
Peak Load ◽  
Medical Services ◽  
Structured Interviews ◽  
Time Performance ◽  
Emergency Medical ◽  
Dynamic Deployment ◽  
Computer Aided

AbstractIntroduction:Response time performance is related to increased survival for a relatively small group of patients with critical emergencies. Effectively utilizing current resources is a challenge for all emergency medical services (EMS) systems for reasons of cost-effectiveness and safety.Problem:The objective of this study was to identify opportunities for improving ambulance response-time performance in an urban EMS system using fixed deployment.Methods:This was a qualitative and quantitative case study which consisted of structured interviews with policy makers, managers, and workers in a fire department EMS division, as well as analysis of dispatch data and observation of dispatch operations.Results:The current computer-aided dispatch (CAD) system does not identify the closest ambulance to the emergency, and therefore, dispatchers must guess which unit is closer when units are not within their stations or “first due” areas. There is no means to track how often dispatchers guess correctly or how often the closest ambulance actually is dispatched to the emergency.Temporal and geographic patterns were identified. Opportunities also were identified to improve response time performance through the use of dynamic deployment and peak-load staffing.Conclusions:The results suggest that there were opportunities for improving ambulance response times by implementing strategies such as peak-load staffing and dynamic deployment. However, the most important improvement would be the implementation of a policy to send the closest ambulance to the emergency. More research is needed to identify how prevalent the failure to send the closest ambulance is within EMS systems that use fixeddeployment response strategies and computer-aided dispatch systems that are incapable of tracking unit locations outside of their stations.

scholarly journals Development of unmanned aerial vehicle (UAV) networks delivering early defibrillation for out-of-hospital cardiac arrests (OHCA) in areas lacking timely access to emergency medical services (EMS) in Germany: a comparative economic study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043791
Author(s):  
Jan Bauer ◽  
Dieter Moormann ◽  
Reinhard Strametz ◽  
David A Groneberg
Keyword(s):  
Cost Effectiveness ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Medical Services ◽  
Secondary Outcome ◽  
Annual Average ◽  
Emergency Medical ◽  
Life Years ◽  
Timely Access ◽  
The Cost

ObjectivesThis study wants to assess the cost-effectiveness of unmanned aerial vehicles (UAV) equipped with automated external defibrillators (AED) in out-of-hospital cardiac arrests (OHCA). Especially in rural areas with longer response times of emergency medical services (EMS) early lay defibrillation could lead to a significant higher survival in OHCA.Participants3296 emergency medical stations in Germany.SettingRural areas in Germany.Primary and secondary outcome measuresThree UAV networks providing 80%, 90% or 100% coverage for rural areas lacking timely access to EMS (ie, time-to-defibrillation: >10 min) were developed using a location allocation analysis. For each UAV network, primary outcome was the cost-effectiveness using the incremental cost-effectiveness ratio (ICER) calculated by the ratio of financial costs to additional life years gained compared with current EMS.ResultsCurrent EMS with 3926 emergency stations was able to gain 1224 life years on annual average in the study area. The UAV network providing 100% coverage consisted of 1933 UAV with average annual costs of €43.5 million and 1845 additional life years gained on annual average (ICER: €23 568). The UAV network providing 90% coverage consisted of 1074 UAV with average annual costs of €24.2 million and 1661 additional life years gained on annual average (ICER: €14 548). The UAV network providing 80% coverage consisted of 798 UAV with average annual costs of €18.0 million and 1477 additional life years gained on annual average (ICER: €12 158).ConclusionThese results reveal the relevant life-saving potential of all modelled UAV networks. Furthermore, all analysed UAV networks could be deemed cost-effective. However, real-life applications are needed to validate the findings.

Resuscitation Potentials in Mass Disasters

1986 ◽  
Vol 2 (1-4) ◽  
pp. 34-47 ◽  
Author(s):  
Peter Safar
Keyword(s):  
Infectious Diseases ◽  
Emergency Medical Services ◽  
Medical System ◽  
Medical Services ◽  
Nuclear Accidents ◽  
Industrial Accidents ◽  
Emergency Medical ◽  
Mass Disasters ◽  
Political Economic ◽  
National Disaster

Mass disastersare events which overwhelm, damage or destroy local Emergency Medical Services (EMS) systems, and therefore need the response of a State or National Disaster Medical System (NDMS). Natural mass disasters include major earthquakes, floods, hurricanes and fires. Manmade mass disasters include major fires, industrial accidents, wars, and nuclear accidents. Mass disasters must be distinguished from “multicasualty incidents” (MCI), such as major transportation accidents, which the local EMS system should be able to handle, if necessary, with the assistance of surrounding (regional) EMS systems. Endemic-epidemic disasters (e.g., droughts, famines, infectious diseases, and refugee problems) are catastrophes which deserve separate considerations, as they require ongoing political-economic solutions.

Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 681-690 ◽  
Author(s):  
James S. Seidel ◽  
Deborah Parkman Henderson ◽  
Patrick Ward ◽  
Barbara Wray Wayland ◽  
Beverly Ness
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Pediatric Patients ◽  
Life Support ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P &lt; .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

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