An age‐integrated approach to improve measurement of potential spatial accessibility to emergency medical services for urban areas

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.

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Standard Precautions Among Emergency Medical Services in Urban and Rural Areas

Workplace Health & Safety ◽

10.1177/2165079919864118 ◽

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.

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Impact of traffic on the spatiotemporal variations of spatial accessibility of emergency medical services in inner-city Shanghai

Environment and Planning B Urban Analytics and City Science ◽

10.1177/2399808318809711 ◽

2018 ◽

Vol 47 (5) ◽

pp. 841-854 ◽

Cited By ~ 2

Author(s):

Wenyan Hu ◽

Jinkai Tan ◽

Mengya Li ◽

Jun Wang ◽

Fahui Wang

Keyword(s):

Response Time ◽

Inner City ◽

Emergency Medical Services ◽

Traffic Congestion ◽

Spatial Accessibility ◽

Medical Services ◽

Policy Makers ◽

Large Cities ◽

Emergency Medical ◽

Transportation Simulation

Variability in spatial accessibility of emergency medical services has become a major concern in evaluating the quality of emergency medical services in China. Unlike some other public services, response time is critical in the provision of emergency medical services. Traffic congestion may significantly affect response time, especially in large cities. This study uses a transportation simulation model to estimate the travel time under free-flow and congested road conditions and measure the corresponding spatial accessibility of emergency medical services for various hours of a day in inner-city Shanghai. When traffic congestion is considered, the overall spatial accessibility is significantly reduced, and the effect is further magnified in certain congested areas. The results help policy makers in planning the emergency medical services resource that is sensitive to the spatiotemporal variation of its accessibility.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217944 ◽

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.

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A Survey of Emergency Medical Services Systems on College and University Campuses

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00043107 ◽

1996 ◽

Vol 11 (4) ◽

pp. 265-269 ◽

Cited By ~ 2

Author(s):

Brent R. King ◽

Brian S. Zachariah ◽

David C. Cone ◽

Peter Clark

Keyword(s):

Emergency Medical Services ◽

Urban Areas ◽

The United States ◽

Emergency Medical Technician ◽

Medical Services ◽

Campus Police ◽

University Campuses ◽

College And University ◽

Emergency Medical ◽

Level Of Training

AbstractIntroduction:Many colleges and universities appear to exist in relative isolation from community-based emergency medical services (EMS) systems. In response, some have developed their own EMS systems.Objective:To determine the extent of this phenomenon and to delineate the characteristics of these systems.Design/Methods:Questionnaires were mailed to 1,503 colleges/universities in the United States and Canada. The questionnaire asked whether the institution had an EMS system and included 19 questions about the characteristics of the system.Results:A total of 919 (61 %) responses were received. Of the institutions responding, 234 (25%) had an EMS system and 31 (3.4%) were considering starting a system. Characteristics of the systems were as follows: 1) Types of patients—the two most common call types were medical and trauma/surgical; 134 (57%) reported one-fourth of calls to be medical and 91 (39%) reported one-fourth of calls to be trauma/surgical. 2) Type of service—133 (57%) services transport patients; 195 (83%) respond only to the campus or other university property; the remainder also respond to the community; and 135 (58%) function all year. 3) Dispatch—178 (76%) are dispatched by the campus police, although most services are dispatched by several sources; 46 (20%) use 9-1-1. 4) Personnel—two systems (0.85%) exclusively employ paramedic; 141 systems (60%) have at least one emergency medical technician; the remainder use emergency care attendants and first-aid providers; 118 (50%) have medical directors, of these 76 (64 %) are student health physicians and 21 (18%) are community physicians. 5) Demographic Information—The majority of the campus-based EMS systems exist on small campuses in urban areas.Conclusions:A significant number of colleges/universities have EMS systems and one-half transport patients. However, the level of training of the personnel and medical direction may be below the standard for the EMS systems in the communities in which these campus-based systems exist.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312305 ◽

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.

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Impact of Vehicular Networks on Emergency Medical Services in Urban Areas

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph111111348 ◽

2014 ◽

Vol 11 (11) ◽

pp. 11348-11370 ◽

Cited By ~ 4

Author(s):

Chun-Liang Lee ◽

Chung-Yuan Huang ◽

Tzu-Chien Hsiao ◽

Chun-Yen Wu ◽

Yaw-Chung Chen ◽

...

Keyword(s):

Emergency Medical Services ◽

Urban Areas ◽

Vehicular Networks ◽

Medical Services ◽

Emergency Medical

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Heat-Related Illnesses Transported by United States Emergency Medical Services

Medicina ◽

10.3390/medicina56100543 ◽

2020 ◽

Vol 56 (10) ◽

pp. 543 ◽

Cited By ~ 1

Author(s):

Susan Yeargin ◽

Rebecca Hirschhorn ◽

Andrew Grundstein

Keyword(s):

Emergency Medical Services ◽

Urban Areas ◽

Public Awareness ◽

South Atlantic ◽

Medical Services ◽

Age Group ◽

Census Division ◽

South Central ◽

Emergency Medical ◽

Us Census

Background and objectives: Heat-related illness (HRI) can have significant morbidity and mortality consequences. Research has predominately focused on HRI in the emergency department, yet health care leading up to hospital arrival can impact patient outcomes. Therefore, the purpose of this study was to describe HRI in the prehospital setting. Materials and Methods: A descriptive epidemiological design was utilized using data from the National Emergency Medical Services (EMS) Information System for the 2017–2018 calendar years. Variables of interest in this study were: patient demographics (age, gender, race), US census division, urbanicity, dispatch timestamp, incident disposition, primary provider impression, and regional temperatures. Results: There were 34,814 HRIs reported. The majority of patients were white (n = 10,878, 55.6%), males (n = 21,818, 62.7%), and in the 25 to 64 age group (n = 18,489, 53.1%). Most HRIs occurred in the South Atlantic US census division (n = 11,732, 33.7%), during the summer (n = 23,873, 68.6%), and in urban areas (n = 27,541, 83.5%). The hottest regions were East South Central, West South Central, and South Atlantic, with peak summer temperatures in excess of 30.0 °C. In the spring and summer, most regions had near normal temperatures within 0.5 °C of the long-term mean. EMS dispatch was called for an HRI predominately between the hours of 11:00 a.m.–6:59 p.m. (n = 26,344, 75.7%), with the majority (27,601, 79.3%) of HRIs considered heat exhaustion and requiring the patient to be treated and transported (n = 24,531, 70.5%). Conclusions: All age groups experienced HRI but particularly those 25 to 64 years old. Targeted education to increase public awareness of HRI in this age group may be needed. Region temperature most likely explains why certain divisions of the US have higher HRI frequency. Afternoons in the summer are when EMS agencies should be prepared for HRI activations. EMS units in high HRI frequency US divisions may need to carry additional treatment interventions for all HRI types.

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

BMC Health Services Research ◽

10.1186/s12913-021-06565-3 ◽

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.

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The Impact of Heat Waves on Transport Volumes in an Urban Emergency Medical Services System: A Retrospective Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x13008960 ◽

2013 ◽

Vol 28 (6) ◽

pp. 610-615 ◽

Cited By ~ 9

Author(s):

Ricky C. Kue ◽

K. Sophia Dyer

Keyword(s):

Emergency Medical Services ◽

Heat Wave ◽

Retrospective Review ◽

Urban Areas ◽

Heat Waves ◽

Medical Emergency ◽

Medical Services ◽

Emergency Medical ◽

The Impact ◽

Call Volume

AbstractIntroductionHeat waves pose a serious public health risk to particular patient populations, especially in urban areas. Emergency Medical Services (EMS) in many urban areas constitute the first line of regional preparation and response to major heat wave events; however, little is known on heat wave operational impact to the EMS system, such as call volume or demand.ObjectiveTo examine the effect of heat wave periods on overall urban EMS system call volume and transport volume as well as the nature of the call types.MethodsRetrospective review of all emergency medical calls to an urban, two-tiered EMS system performed over a 5-year period from 2006–2010. Heat wave days (HWD) defined as two or more consecutive days of hot weather >32.2°C (90°F) were compared with similar non-heat wave days (nHWD) of the previous year to also include two calendar days prior to and after the heat wave. National Weather Service (NWS) temperature data, daily EMS call volume data, and call type codes were collected and underwent descriptive analysis.ResultsThirty-one HWD were identified and compared with 93 nHWD. The mean maximum temperature for HWD was 34°C (93.2°F) compared with 25.3°C (77.6°F) for nHWD (P< .001). Average daily medical emergency calls (318.4 vs 296.3,P< .001) and actual patients transported per day (247.5 vs 198.3,P< .001) were significantly higher during HWD. There was no difference in daily medical emergency call volume or EMS transports between weekdays or weekend days. No significant differences on various call types were observed between HWD and nHWD except for “heat” related calls (7.7 vs 0.5,P< .001).ConclusionEmergency Medical Services call volumes were significantly increased during heat waves, however there was minimal change in the types of calls received.KueRC,DyerKS.The impact of heat waves on transport volumes in an urban Emergency Medical Services system: a retrospective review.Prehosp Disaster Med.2013;28(6):1-6.

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