scholarly journals An analysis of emergency response times within the public sector emergency medical services in KwaZulu-Natal

2017 ◽  
Author(s):  
◽  
Melissa Joy Finlayson
Keyword(s):  
Focus Group ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Response Times ◽  
The Public ◽  
Emergency Medical ◽  
National Norms

Introduction: Response times are considered to be one of the oldest and most popular indicators which are used to measure the efficiency of Emergency Medical Services (EMS), particularly to cases in which the patient’s condition is deemed to be life threatening. Purpose: To analyse emergency response times within the public sector Emergency Medical Services in KwaZulu-Natal and to compare these to the national norms. Methods: Using a mixed method approach, the study was conducted in two phases. The first phase involved collecting quantitative data for all the cases logged in the Umgungundlovu Health District Communications Centre over a period of one week (seven days). Phase Two involved the collection of qualitative data from focus group discussions which were conducted with three groups which had been identified. These groups included the communications centre staff, operational staff and supervisory staff. The aim of these focus group discussions was to identify factors that influenced response times as well as to propose strategies which would improve these response times. Content analysis was utilised to interpret the qualitative data which had been collected. Results: Quantitative data was collected from a total of 1 503 cases of which 680 were categorised as priority 1 (P1), 270 as priority 2 (P2) and 553 as inter facility transfer (IFT). The majority of the cases (895) had occurred in urban areas. A total of 406 cases were exempted as no patient was transported. The number of these cases was greater on days when the total case load was higher as compared to days with a lower total case load. The mean response time to cases in rural areas was 129 minutes and 110 minutes to cases in urban areas. All the time intervals were found to be longer for cases in rural areas as compared to those for cases in urban areas but with the exception of the EMD response interval. P1 cases had the shortest mean response times for both urban area cases (33 minutes) and rural area cases (95 minutes) as compared to the other case categories. Nevertheless, the national norm of 15 minutes in urban areas and 40 minutes in rural areas was not achieved in the majority of the cases. The mean Emergency Medical Dispatch (EMD) response interval was 41 minutes for P1 cases, 56 minutes for P2 cases and 96 minutes for IFT cases. The qualitative data revealed factors that impacted on the response times and helped to explain and account for the quantitative data results. Challenges regarding the availability of resources, including vehicles, staff and equipment, as well as the way in which such resources are managed, were highlighted. The high demand for services compared to the available resources was raised by the focus group participants with this high demand resulting in extended EMD response intervals. This was exacerbated by the overwhelming demand for IFT cases which are serviced by the same resources as emergency cases and which have a much longer mission time, thus delaying response times continuously. Exempt cases were also found to impact negatively on response times as, although operational vehicles are committed to these cases, services are not required. Inconsistencies with regards to case prioritisation and dispatch triage also emerged. External factors, including poor road infrastructure, lack of road names and house numbers, weather conditions and long distances between EMS bases, the patient or incident location and health care facilities were also identified as factors that resulted in extended response times. Strategies to improve the situation were explored. These strategies included the effective management of resources in order to ensure optimal availability, the introduction of a formal, computer aided, dispatch system, the adoption of demand pattern analysis and dynamic location/relocation models, standardised processes and procedures to guide all areas of EMS operations and the education of both the public and staff. Conclusion: South African EMS response time national norms for both rural and urban areas are unachievable under the majority of circumstances and, thus, they may be said to be unrealistic. Until these national norms, against which the efficiency of EMS in South Africa is measured, are revised, the service will be deemed to be incompetent.

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 < .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.

scholarly journals Standard Precautions Among Emergency Medical Services in Urban and Rural Areas

2019 ◽  
Vol 68 (2) ◽  
pp. 73-80
Author(s):  
Riyadh A. Alhazmi ◽  
R. David Parker ◽  
Sijin Wen
Keyword(s):  
West Virginia ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Standard Precautions ◽  
Cross Sectional ◽  
Emergency Medical ◽  
Rural And Urban

Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers ( p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.

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 Suspected Miscarriage in the Experience of Emergency Medical Services Teams—Preliminary Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12305
Author(s):  
Ewa Rzońca ◽  
Agnieszka Bień ◽  
Grażyna Bączek ◽  
Patryk Rzońca ◽  
Michał Filip ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Health Care Professionals ◽  
Rural Areas ◽  
Urban Areas ◽  
Vaginal Bleeding ◽  
Medical Services ◽  
Medical Procedure ◽  
Emergency Medical ◽  
Gestational Week ◽  
Team Interventions

Vaginal bleeding and abdominal pain are symptoms indicative of a threat to pregnancy that prompt women to seek assistance from health care professionals. The purpose of the study was to present the characteristics of Emergency Medical Services (EMS) team interventions in cases of suspected miscarriage. The study involved a retrospective analysis of EMS team interventions in cases of suspected miscarriage carried out between January 2018 and December 2019 in Poland. Data obtained from Poland’s National Monitoring Center of Emergency Medical Services included emergency medical procedure records and EMS team dispatch records in electronic format. The mean patient age was 30.53 years. Most were primiparous (48.90%) and up to the 13th gestational week (76.65%). The most commonly reported symptom was vaginal bleeding (80.71%). EMS teams were most commonly dispatched in the winter (27.03%), between 7 A.M. and 6:59 P.M. (51.87%), in urban areas (69.23%), with urgency code 2 (55.60%), and in most cases, they transferred the patient to a hospital (97.53%). The present study addresses very important issues concerning the characteristics of Polish suspected miscarriage cases handled by different EMS team types, in different locations (urban vs. rural areas), and concerning patients in a different obstetric situation (gestational week, gravidity, parity). Our findings suggest a need for further studies in this field and for gestational health promotion activities to be implemented, specifically including actions to reduce the risk of vaginal bleeding during pregnancy.

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 Factors Impacting Patient Outcomes Associated with Use of Emergency Medical Services Operating in Urban Versus Rural Areas: A Systematic Review

2019 ◽  
Vol 16 (10) ◽  
pp. 1728 ◽  
Author(s):  
Ahmed Ramdan M. Alanazy ◽  
Stuart Wark ◽  
John Fraser ◽  
Amanda Nagle
Keyword(s):  
Systematic Review ◽  
Emergency Medical Services ◽  
Patient Outcomes ◽  
Rural Areas ◽  
Urban Areas ◽  
Survival Rates ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Urban Versus

The goal of this systematic review was to examine the existing literature base regarding the factors impacting patient outcomes associated with use of emergency medical services (EMS) operating in urban versus rural areas. A specific subfocus on low and lower-middle-income countries was planned but acknowledged in advance as being potentially limited by a lack of available data. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during the preparation of this systematic review. A comprehensive literature search of PubMed, EBSCO (Elton B. Stephens Company) host, Web of Science, ProQuest, Embase, and Scopus was conducted through May 2018. To appraise the quality of the included papers, the Critical Appraisal Skills Programme Checklists (CASP) were used. Thirty-one relevant and appropriate studies were identified; however, only one study from a low or lower-middle-income country was located. The research indicated that EMS in urban areas are more likely to have shorter prehospital times, response times, on-scene times, and transport times when compared to EMS operating in rural areas. Additionally, urban patients with out-of-hospital cardiac arrest or trauma were found to have higher survival rates than rural patients. EMS in urban areas were generally associated with improved performance measures in key areas and associated higher survival rates than those in rural areas. These findings indicate that reducing key differences between rural and urban settings is a key factor in improving trauma patient survival rates. More research in rural areas is required to better understand the factors which can predict these differences and underpin improvements. The lack of research in this area is particularly evident in low- and lower-middle-income countries.

scholarly journals Traditional Omani Crafts Approaches To Identity

2020 ◽  
Vol 10 ◽  
pp. 566-578
Author(s):  
Badar Mohammed Almamari ◽  
Fakhriya Al-Yahayai ◽  
Mohammed Alamri
Keyword(s):  
Data Collection ◽  
Rural Areas ◽  
Urban Areas ◽  
Qualitative Data ◽  
Collection Method ◽  
The Public ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban And Rural Areas ◽  
Qualitative Data Collection

The purpose of this study is to identify how landscapes, places, and geographical forms of land influenced craft making identity by addressing Omani crafts enterprises in urban and rural areas. This has been done by interviewing local craftspeople and analysing their responses as a qualitative data collection method using open-ended questions to seek reliability and credibility in the study. The interviews in this research were mostly conducted with participants belonging to ten enterprises under the management of the Public Authority for Crafts Industries (PACI), Department of Art Education and the Handcrafts Centre. Consequently, this study highlights the importance of studying the influence of landscapes, places, and geographical forms in shaping local people's crafts identity by investigating their craft industries in rural and urban areas.

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.

Analysis of Fatal Traffic Crash-Reporting and Reporting-Arrival Time Intervals of Emergency Medical Services

2018 ◽  
Vol 2672 (32) ◽  
pp. 61-71 ◽  
Author(s):  
Jaeyoung Lee ◽  
Mohamed Abdel-Aty ◽  
Qing Cai ◽  
Ling Wang
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Services ◽  
Economic Factors ◽  
Functional Classification ◽  
Arrival Times ◽  
Emergency Medical ◽  
Time Required ◽  
Socio Economic Factors

Emergency Medical Services (EMS) play a vital role in the postcrash effort to reduce fatalities by providing first aid and transportation to medical facilities. This study aims to analyze the time required for crash reporting and EMS arrival in fatal traffic crashes and to identify relevant crash, roadway, environmental and zonal socio-economic factors. The time required for EMS reporting and arrivals were calculated by location type (urban or rural) and roadway functional classification using Florida data. Subsequently, a variety of duration models were estimated to reveal the contributing factors for crash-reporting and reporting-arrival intervals. Although about 90% of fatal crashes are reported to EMS within ten minutes in both urban and rural settings, EMS average reporting time in rural areas (4.5 min) is greater than that in urban areas (3 min). Moreover, freeways require longer time for EMS arrival (8.3 min) compared with conventional roadways (6.8 min). It was shown that the log-logistic and gamma models performed the best for crash-reporting and reporting-arrival intervals, respectively. The modeling results revealed that both EMS reporting and arrival times are related to the crash, roadway, environmental, and socio-economic factors. The key findings indicate that EMS reporting and arrival times differ significantly according to the urban or rural designation and road functional classification, and that they have statistically significant relationship with various factors. It is expected that the findings from this study can be used to develop effective and practical strategic plans to minimize EMS reporting and arrival times and, therefore, decrease the likelihood of fatalities.

scholarly journals Analysis of Emergency Medical Vulnerability and Survival Rates Following Real-Time Traffic Information

2020 ◽  
Vol 10 (18) ◽  
pp. 6492
Author(s):  
Jeongbae Jeon ◽  
Solhee Kim ◽  
Gu Hyun Kang ◽  
Kyo Suh
Keyword(s):  
Survival Rate ◽  
Real Time ◽  
Rural Areas ◽  
Urban Areas ◽  
Road Traffic ◽  
Survival Rates ◽  
Emergency Patients ◽  
The Public ◽  
Emergency Medical ◽  
Medical Facilities

Providing rapid access to emergency medical services (EMS) within the “golden time” for survival is important to improve the survival rate of emergency patients. This study analyzes the accessibility of EMS based on driving speed changes following real-time road traffic conditions by time to estimate vulnerable areas for EMS and survival rates of emergency patients. The key results of the network analysis based on real-time road speed and this evaluation of vulnerable areas by village level across South Korea reveal the different characteristics of urban and rural areas to access emergency medical facilities. In urban areas, road traffic congestion during rush hour delays the patients’ access time to EMS. In contrast, in rural areas, the long geographical distance to an emergency medical facility is a hurdle for receiving care from an EMS during the “golden time” because emergency medical facilities are mostly located in urban areas. The existing standard to assess vulnerable areas of EMS accessibility is based on the speed limit of roads, but the time may be underestimated because the speed limit alone does not reflect the real road conditions. The study results show that an effective way to increase the survival rate is receiving immediate first aid treatment, which means that the government should continuously train the public to perform cardiopulmonary resuscitation (CPR) as well as install automated external defibrillators (AEDs) in populated places, and train the public to use them. Reducing assess time to emergency medical centers in urban areas and providing additional manpower to help with first aid in rural areas are reasonable ways to improve the survival rate of emergency patients.

Sign in / Sign up

Export Citation Format

Share Document