Predictability of the Call Triage Protocol to Detect if Dispatchers Should Activate Community First Responders

AbstractIntroductionShortening response time to an emergency call leads to the success of resuscitation by chest compression and defibrillation. However, response by ambulance or fire truck is not fast enough for resuscitation in Japan. In rural areas, response times can be more than 10 minutes. One possible way to shorten the response time is to establish a system of first responders (eg, police officers or firefighters) who are trained appropriately to perform resuscitation. Another possible way is to use a system of Community First Responders (CFRs) who are trained neighbors. At present, there are no call triage protocols to decide if dispatchers should activate CFRs.ObjectiveThe aim of this study was to determine the predictability to detect if dispatchers should activate CFRs.MethodsTwo CFR call triage protocols (CFR protocol Ver.0 and Ver.1) were established. The predictability of CFR protocols was examined by comparing the paramedic field reports. From the results of sensitivity of CFR protocol, the numbers of annual CFR activations were calculated. All data were collected, prospectively, for four months from October 1, 2012 through January 31, 2013.ResultsThe ROC-AUC values appear slightly higher in CFR protocol Ver.1 (0.857; 95% CI, 79.8-91.7) than in CFR protocol Ver.0 (0.847; 95% CI, 79.0-90.3). The number of annual CFR activations is higher in CFR protocol Ver.0 (7.47) than in CFR protocol Ver.1 (5.45).ConclusionTwo call triage protocols have almost the same predictability as the Medical Priority Dispatch System (MPDS). The study indicates that CFR protocol Ver.1 is better than CFR protocol Ver.0 because of the higher predictability and low number of activations. Also, it indicates that CFRs who are not medical professionals can respond to a patient with cardiac arrest.NarikawaK, SakamotoT, KubotaK, SuzukawaM, YonekawaC, YamashitaK, ToyokuniY, YasudaY, KobayashiA, IijimaK. Predictability of the call triage protocol to detect if dispatchers should activate Community First Responders. Prehosp Disaster Med. 2014;29(5):1-5.

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Impact of dual dispatch system implementation on response times and survival outcomes in out-of-hospital cardiac arrest in rural areas

10.22514/sv.2021.134 ◽

2022 ◽

Keyword(s):

Logistic Regression ◽

Cardiac Arrest ◽

Rural Areas ◽

Response Times ◽

Cerebral Performance Category ◽

Intervention Group ◽

First Responders ◽

Survival Outcomes ◽

Historical Group ◽

Hospital Cardiac Arrest

Objectives: Dual dispatch early defibrillation in out-of-hospital cardiac arrest (OHCA) victims provided by firefighters in addition to Emergency medical services (EMS) has proven to increase rate of return of spontaneous circulation (ROSC) and thus survival in the metropolitan or suburban areas whereas the data in rural areas are scarce. Methods: This was a retrospective observational cohort study of EMS resuscitated OHCA victims in regions with dual dispatch of volunteer firefighters as first responders (intervention group). Historical group was based on all OHCAs occurring in these regions before the implementation of first responders (EMS response only). Multivariate logistic regression with following variables: intervention, age, gender, witnessed status, bystander cardiopulmonary resuscitation (CPR), first rhythm and etiology were used to control for confounding factors affecting ROSC. Results: A total of 312 OHCAs were included in the study (historical group, n = 115 and intervention group, n = 197). Median time to arrival of first help shortened significantly for all patients, patients with ROSC and patients with Cerebral Performance Category 1/2 (CPC 1/2) in intervention vs historical group (8 vs 12 min, p < 0.001; 7.5 vs 11 min, p = 0.002; 7 vs 10 min, p = 0.011; respectively). The proportion of patients with ROSC, 30-day survival and CPC 1/2 at hospital discharge remained unchanged in intervention vs historical group (21% vs 23%, p = 0.808; 7% vs 6%, p = 0.914; 6% vs 3%, p = 0.442; respectively). The logistic regression model of adjustment confirms the absence of improvement in the ROSC rate after the implementation of first responders. Conclusions: Introduction of a dual dispatch of local first responders in addition to EMS in cases of OHCA significantly shortened response times. However, reduced response times were not associated with better survival outcomes.

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Lost in transition: The effects of transitioning between firearms and electronic control devices (ECDs) on perception-response times (PRTs)

The Police Journal Theory Practice and Principles ◽

10.1177/0032258x211044135 ◽

2021 ◽

pp. 0032258X2110441

Author(s):

Paul L Taylor ◽

Paul Sipe ◽

Lon Bartel

Keyword(s):

Response Time ◽

Visual Stimulus ◽

Police Officers ◽

Response Times ◽

Use Of Force ◽

Policy Research ◽

Police Training ◽

Laboratory Setting ◽

Training Simulator ◽

Temporal Space

The research described in this article tested the perception-response times for experienced police officers to transition from a firearm to a TASER and from a TASER to a firearm. The theoretical models and police training on use of force have largely ignored the temporal space between force modalities. Escalating through force modalities has by default been treated as equivalent, in task and timing, to deescalating through force modalities. This study employed a randomized controlled experiment using a police firearms training simulator and 139 active law enforcement officers. The average perception-response time for transition from a TASER to a firearm was 2.49 seconds for experienced police officers in response to an anticipated visual stimulus in a laboratory setting. The average perception-response time for transition from a firearm to a TASER was 4.7 seconds for experienced police officers in a response to an anticipated visual stimulus in a laboratory setting. 70% of the officers that participated in the study had never participated in department training that required them to transition between a firearm and a TASER. The findings demonstrate that moving from TASER to firearm and from firearm to TASER are not equivalent tasks. In the case of firearms and TASERs, it is significantly faster to move up the force continuum—from TASER to firearm—than it is to move down the force continuum. This research has implications for police training, tactics, policy, research, and post hoc investigations involving the use or potential use of force.

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A Method to Reduce Rural EMS Response Times

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00028260 ◽

1991 ◽

Vol 6 (2) ◽

pp. 143-147 ◽

Cited By ~ 2

Author(s):

David R. Johnson ◽

W. Ann Maggiore ◽

David Ralph Davis

Keyword(s):

Response Time ◽

Rural Areas ◽

Response Times ◽

Patient Assessment ◽

Mean Response Time ◽

Response System ◽

Significant Difference ◽

The Mean ◽

Privately Owned ◽

Made In

AbstractProlonged EMS response times are a significant problem in rural areas. In this study, VHF radios and personal medical kits were placed in the private vehicles of rescue squad members. By coordinating the responses using radios, higher level EMTs were sent directly to the scene to initiate patient assessment and other procedures while others proceeded to an unstaffed station to pick up the rescue truck.Using this response system, EMTs arrived at the scene prior to the rescue vehicle on 30 of 35 calls (85.7%). In 25 of 35 calls (71.4%), the first person at the scene was at an advanced EMT level even though the majority of responses (56%) were made by Basic EMTs (p<0.001). The mean response time for EMTs using privately owned vehicles was 9±4 minutes (means±SD) compared with 16±9 minutes for the rescue truck (p<0.01). There also was a significant difference in response times between the privately owned vehicles and the rescue truck when the time between the receipt of the call and the initial acknowledgement of response was measured (1±1 minutes vs. 7±3 minutes; p<0.01).An effective EMS response can be made in rural areas by sending EMTs directly to a scene in private vehicles. Providing EMTs with VHF radios and personal medical kits enhances this response.

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Medical first response models in rural villages and towns: A simulation study of response times

Australasian Journal of Paramedicine ◽

10.33151/ajp.18.815 ◽

2021 ◽

Vol 18 ◽

Author(s):

Jukka Pappinen ◽

Anna Olkinuora ◽

Päivi Laukkanen-Nevala

Keyword(s):

Response Time ◽

Rural Areas ◽

Response Times ◽

Fire Department ◽

Median Response ◽

Rural Villages ◽

First Response ◽

Geographic Datasets ◽

The Difference ◽

The One

Introduction Medical first responders (MFR) shorten the response times and improve outcomes in, for example, out-of-hospital cardiac arrests. This study demonstrates the usability of open geographic data for analysing MFR service performance by comparing simulated response times of different MFR models in rural town and village settings in Finland. Methods Community first response (CFR) models with one to three responders obeying the speed limit were compared to a volunteer/retained fire department (FD) model where three responders first gather at a fire station and then drive to the scene with lights and siren. Five villages/towns, each with a volunteer/retained FD but no ambulance base within a 10 km radius, were selected to test the models. A total of 50,000 MFR responses with randomly selected buildings as potential responder and patient locations were simulated. Results In central areas, the simulated median response time for the one-responder model was 1.6 minutes, outperforming the FD model’s simulated response time median by 4.5 minutes. In surrounding rural areas, the median response times of one- and two-responder CFR models were still shorter (15.0 and 15.9 minutes, respectively) than in the FD model (16.4 minutes), but the FD model outperformed the three-responder CFR model (16.8 minutes). Conclusion Open geographic datasets were useful in performing logistic simulations of MFR. Based on the simulations, CFR without emergency vehicles may reach patients faster than FD-based MFR in central areas, whereas in surrounding rural areas the difference is less pronounced.

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

Australasian Journal of Paramedicine ◽

10.33151/ajp.17.805 ◽

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.

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Elder Abuse and Neglect: Training First Responders in Rural Arkansas to Recognize, Respond, and Report

Innovation in Aging ◽

10.1093/geroni/igaa057.151 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 46-47

Author(s):

Robin McAtee ◽

Valerie Claar ◽

Laura Spradley ◽

Whitney Thomasson

Keyword(s):

Older Adults ◽

Police Officers ◽

Rural Areas ◽

Elder Abuse ◽

First Responders ◽

Elder Abuse And Neglect ◽

Abuse And Neglect ◽

Potential Abuse ◽

On Line ◽

Type Of Abuse

Abstract As the incidence of elder abuse and neglect continue to rise and plague our country’s older adults, it is imperative that their plight is recognized, reported and elicits an appropriate response. At least 1 out of 10 older adults suffer from at least one type of abuse each year (DOJ, 2020) and only 1 in 24 cases of elder abuse is ever reported to authorities (National Center on Elder Abuse, 2019). Since 41% of Arkansas’ population live in rural areas, reaching and educating first responders who work in these areas is a priority, yet has been a challenge. It has been ascertained that virtually no elder abuse or neglect related training for first responders occurs in Arkansas. In 2015, the Arkansas Geriatric Education Collaborative (a HRSA Geriatric Workforce Enhancement Program) developed an education program and mobilized it to multiple first responder groups including the AR State Police, multiple city and county paramedics’ organizations, EMTs, local police officers and fire fighters. The program was further enhance late in 2019 when the training was made available on-line in conjunction with dementia training. The content and methods of training and test results revealing knowledge gained will be reviewed. Follow-up stories from first responders who have put their training into action in the field will be told as they reveal how they have used their training to identify potential abuse, neglect and self-neglect cases and how they have recognized, reported and addressed specific cases.

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Female Strength and Neuromuscular Response Time: A Review

Women in Sport and Physical Activity Journal ◽

10.1123/wspaj.3.1.47 ◽

1994 ◽

Vol 3 (1) ◽

pp. 47-72

Author(s):

Nancy C. Rich

Keyword(s):

Response Time ◽

Motor Skills ◽

Police Officers ◽

Response Times ◽

Front Line ◽

Genetic Characteristics ◽

The Past ◽

Neuromuscular Response ◽

Line Work ◽

And Performance

There are an abundant number of published studies in which the authors state that post-pubertal men are stronger, faster and more powerful and therefore more proficient than women in many motor skills. The topics of strength and neuromuscular response time are phenomena that have been used in the past as bases for the rationalization that women do not have the physical characteristics that are essential requirements for front-line work as soldiers, firepersons, police officers and construction workers, and also that they are not as proficient as men in other occupations. This paper is a review of physiological and performance data that have contributed to our knowledge base in the areas of strength and neuromuscular response times of women. In addition, data regarding the deterioration of these parameters that occur with aging and the potential determent of this deterioration as a consequence of a lifetime of activity will be considered. Finally, a suggestion will be made that female and male data should be analyzed and reported in ways that eliminate genetic characteristics which bias the data.

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Influence of Wearing Ballistic Vests on Physical Performance of Danish Police Officers: A Cross-Over Study

Sensors ◽

10.3390/s21051795 ◽

2021 ◽

Vol 21 (5) ◽

pp. 1795

Author(s):

Henrik Koblauch ◽

Mette K. Zebis ◽

Mikkel H. Jacobsen ◽

Bjarki T. Haraldsson ◽

Klaus P. Klinge ◽

...

Keyword(s):

Response Time ◽

Physical Performance ◽

Police Officers ◽

Response Times ◽

Muscle Endurance ◽

Abdominal Muscles ◽

Entry And Exit ◽

Significant Difference ◽

Lumbar Muscle ◽

Police Cars

Purpose: We aimed to investigate the influence of wearing a ballistic vest on physical performance in police officers. Methods: We performed a cross-over study to investigate the influence of wearing a ballistic vest on reaction and response time, lumbar muscle endurance and police vehicle entry and exit times. Reaction and response time was based on a perturbation setup where the officers’ pelvises were fixed and EMG of lumbar and abdominal muscles was recorded. We used a modified Biering–Sørensen test to assess the lumbar muscle endurance and measured duration of entry and exit maneuvers in a variety of standard-issue police cars. Results: There was a significant difference of 24% in the lumbar muscle endurance test (no vest: 151 s vs. vest: 117 s), and the police officers experienced higher physical fatigue after the test when wearing a vest. Furthermore, officers took longer to both enter and exit police cars when wearing a vest (range: 0.24–0.56 s) depending on the model of the vehicle. There were no significant differences in reaction and response times between the test conditions (with/without vest). Discussion and Conclusion: Wearing of a ballistic vest significantly influenced the speed of movement in entry and exit of police cars and lumbar muscle endurance, although it does not seem to affect reaction or response times. The ballistic vest seems to impair performance of tasks that require maximal effort, which calls for better designs of such vests.

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