Using firefighters as medical first responders to shorten response time in rural areas in Sweden

2020 ◽  
Vol 28 (1) ◽  
pp. 6-14 ◽  
Author(s):  
Anders Svensson ◽  
Carina Elmqvist ◽  
Bengt Fridlund ◽  
Mikael Rask ◽  
Richard Andersson ◽  
...  
Keyword(s):  
Response Time ◽  
Rural Areas ◽  
First Responders

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

2014 ◽  
Vol 29 (5) ◽  
pp. 484-488 ◽  
Author(s):  
Kenji Narikawa ◽  
Tetsuya Sakamoto ◽  
Katsuaki Kubota ◽  
Masayuki Suzukawa ◽  
Chikara Yonekawa ◽  
...  
Keyword(s):  
Response Time ◽  
Police Officers ◽  
Rural Areas ◽  
Response Times ◽  
First Responders ◽  
Medical Professionals ◽  
Publication Type ◽  
Triage Protocol ◽  
Dispatch System ◽  
Better Than

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.

Abstract 138: A Before and After Study of Active Compression Decompression Cardiopulmonary Resuscitation With the Impedance Threshold Device in a Large Urban Pre-Hospital System

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Johanna C Moore ◽  
Michael Grahl ◽  
Tracy Marko ◽  
Ariel Blythe-Reske ◽  
Amber Lage ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Response Time ◽  
First Responders ◽  
The United States ◽  
Threshold Device ◽  
Before And After ◽  
Mechanical Cpr ◽  
Impedance Threshold Device ◽  
Before And After Study

Introduction: Active Compression Decompression cardiopulmonary resuscitation with an impedance threshold device (ACD+ITD CPR) is available for use in the United States. However, little is known regarding integration of this CPR system into a large urban prehospital system with short response times, routine use of mechanical CPR and ITD, and transport of patients to cardiac arrest centers. This is an ongoing before and after study of the implementation of ACD+ITD CPR in non-traumatic cardiac arrest cases 6 months pre and post protocol change. Hypothesis: Neurologically intact rates of survival, defined by Cerebral Performance Category (CPC) score of 1 or 2, would be higher post protocol. Methods: Basic life support first responders (n = 420) and paramedics (n = 207) underwent training including didactic and hands-on sessions to learn ACD+ITD CPR. The protocol included ACD+ITD CPR initially, with the option to transition to mechanical CPR at 15 minutes. Demographics, response time, CPR duration, initial rhythm, signs of perfusion during CPR, and return of spontaneous circulation (ROSC) were recorded prospectively by first responders. Chart review was performed to determine survival to hospital admission and CPC score at discharge. Results: Training occurred October 2016 to March 2017, with protocol change on May 1, 2017. Cases from November 2016-April 2017 (n = 136) and May 2017-November 2017 (n= 103) were reviewed. Complete data were available for 128 subjects pre-protocol change (94%) and 96 subjects (94%) post. Age, gender, response time, rhythm, total CPR time, and rates of bystander CPR and witnessed arrest were similar between groups. Post protocol change, 87% (89/102) received ACD+ITD CPR with median ACD+ITD CPR time of 15 minutes (range 2-300). Pre-protocol, 6/128 (4.7%) subjects survived with CPC score 1 or 2, versus 8/96 (13.5%) subjects post (difference 8.8%, 95% CI 1%-17%). ROSC rates were similar (pre: 54/127, 42.5% post: 44/93, 47%, difference 4.8%, 95% CI -8% - 18%) Conclusions: The change in protocol was straightforward with a high rate of adherence of the system for the recommended duration of therapy. Results are suggestive of a higher rate of neurological survival with the routine use of ACD+ITD CPR in a small cardiac arrest patient population.

Emergency Response in Rural Areas

2013 ◽  
Vol 5 (2) ◽  
pp. 19-31 ◽  
Author(s):  
Sofie Pilemalm ◽  
Rebecca Stenberg ◽  
Tobias Andersson Granberg
Keyword(s):  
Social Capital ◽  
Emergency Management ◽  
Emergency Response ◽  
Rural Areas ◽  
Mobile Applications ◽  
Large Scale ◽  
First Responders ◽  
Local Resources ◽  
Technical Solutions

In this study, security and safety in rural parts of Sweden are investigated. New ways of organizing for efficient response can be found in the extended collaboration between societal sectors and in the utilization of local social capital. New categories of first responders and their requirements are identified and technical and non-technical solutions as support are proposed. The solutions include e.g. mobile applications and a technical infrastructure making it possible for volunteers to obtain information about events requiring emergency response. Emergency management in rural areas shows several similarities to large-scale crises, e.g. in terms of insufficient infrastructure available and the need to use local resources in the immediate aftermath of the event. Therefore, the results of the study can be transferable to large-scale crises.

Disaster Triage by Advanced Emergency Medical Technicians

1987 ◽  
Vol 3 (2) ◽  
pp. 6-8
Author(s):  
Constance J. Doyle ◽  
Richard E. Birney
Keyword(s):  
Medical Care ◽  
Rural Areas ◽  
First Responders ◽  
Environmental Hazards ◽  
Field Conditions ◽  
Emergency Medical Technicians ◽  
Trauma Patients ◽  
Paramedical Personnel ◽  
Emergency Medical

Many disaster plans are based on the presence of a physician at the scene to perform triage. This requirement originated when there were no trained paramedical personnel in the field and may actually delay care in rural areas where a physician may not be readily available or may be the only physician at the hospital.It is our hypothesis that properly trained Advanced Emergency Medical Technicians (AEMT's) may serve as triage officers for rural disasters with little difference, and perhaps improvement, in the outcomes of medical care. AEMT's are among the first responders to arrive at scenes of accidents and often triage from three to five trauma patients in multiple victim accidents on the highway. They are on duty, available and strategically located both day and night. The AEMT's are familiar with working under field conditions, i.e. at night by headlight, in rain, snow, and darkness, and know extrication procedures. They are aware of environmental hazards. They have radio and telemetry communication with a physician when needed.

Organizational Description and Emergency Preparedness of Nationally Registered First Responders

2008 ◽  
Vol 23 (3) ◽  
pp. 250-255 ◽  
Author(s):  
Jonathan R. Studnek ◽  
Antonio R. Fernandez
Keyword(s):  
Rural Communities ◽  
Emergency Preparedness ◽  
Rural Areas ◽  
Disaster Preparedness ◽  
Urban Areas ◽  
First Responders ◽  
Fire Departments ◽  
Community Size ◽  
Service Type ◽  
In Fire

AbstractIntroduction: This study intended to describe the types of organizations and communities in which Nationally Registered First Responders (NRFR) perform their duties. Also, it aimed to estimate the number of NRFR who received disaster preparedness training. It was hypothesized that NRFR participation in disaster preparedness training was related to the types of organizations and communities in which they performed their duties.Methods: The NRFR re-registering in 2006 were asked to report the organization type and community size in which they work. They also were asked to report the amount and content of preparedness training received during the last 24 months. Multivariable logistic regression modeling was utilized to describe the relationship between NRFR organizational characteristics and the receipt of disaster preparedness training.Results: The analysis included 872 (59%) individuals who completed the survey and reported working for one or more emergency medical services (EMS) organizations. The majority of NRFR performed work in rural areas (75%) and more NRFR reported working for fire departments (61%) than for any other organization type. In all categories of service type, participants who reported working in urban areas had higher odds of receiving disaster preparedness training than those working in rural areas. Additionally, regardless of community size, individuals working in fire departments were more likely to receive disaster preparedness training.Conclusions: This study indicated that the majority of NRFR perform EMS duties for fire departments and work in rural communities. In this sample of NRFR, more than one-quarter did not receive disaster preparedness training within a 24-month period. Finally, a statistical model was constructed that indicated a relationship between service type, community size, and the participation in disaster preparedness training.

First responders' response area and response time analysis with/without grade crossing monitoring system

2016 ◽  
Vol 79 ◽  
pp. 100-110 ◽  
Author(s):  
Peter Y. Park ◽  
Wook Rak Jung ◽  
Godfred Yeboah ◽  
Garreth Rempel ◽  
Dan Paulsen ◽  
...  
Keyword(s):  
Response Time ◽  
Monitoring System ◽  
First Responders ◽  
Response Time Analysis ◽  
Time Analysis ◽  
Grade Crossing ◽  
Response Area

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

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.

A Method to Reduce Rural EMS Response Times

1991 ◽  
Vol 6 (2) ◽  
pp. 143-147 ◽  
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.

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

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.

scholarly journals Serviço de atendimento móvel de urgência do Rio Grande do Sul

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Magda Regina Dorr ◽  
Gabriella Barbosa Nadas ◽  
Celia Sapin Duarte ◽  
Cristiane Damiani Tomasi ◽  
Lisiane Tuon
Keyword(s):  
Response Time ◽  
Rural Areas ◽  
Rio Grande ◽  
User Profile ◽  
State Regulation ◽  
Rio Grande Do Sul ◽  
Total Response ◽  
Health Services Administration ◽  
Total Response Time ◽  
Day Of The Week

Objetivo: analisar os atendimentos realizados na Central de Regulação de Urgência/SAMU do Estado do Rio Grande do Sul no período de 2016 e 2017. Metodologia: estudo observacional, descritivo e retrospectivo com abordagem quantitativa. Foram coletados os dados sobre perfil do usuário, dia da semana, classificação de risco, tipo do agravo, tempo médio de atendimento às solicitações, quantitativo de desistência da solicitação e número de chamados não regulados por falta de equipes ou veículos. Resultados: o número de solicitações por motivos clínicos foi 53.8%, destes 51,6% foram média gravidade. A prevalência foi do sexo masculino e idade entre 18 e 29 anos. Em 84,7% dos chamados solicitou-se suporte básico. O tempo resposta total foi entre 30 minutos e 1 hora, maior que o recomendado de acordo com a média nacional, seja nas as zonas urbanas ou rurais. Conclusão: este serviço necessita reduzir o tempo resposta de atendimento das solicitações.Palavras-chave: SAMU; Indicadores; Central de Regulação Estadual; Serviços Médicos de Emergência; Administração de Serviços de Saúde. Objective: to analyze the attendances performed at the Emergency Regulation Center / SAMU of the State of Rio Grande do Sul in 2016 and 2017, focusing in response time. Methodology: observational, descriptive and retrospective study with quantitative approach. Data were collected on user profile, day of the week, risk classification, type of grievance, average time to respond to requests, amount of withdrawal and number of calls not regulated due to lack of teams or vehicles. Results: The number of requests for clinical reasons was 53.8%, of these 51.6% were medium severity. The prevalence was male and aged between 18 and 29 years. In 84.7% of the calls, basic support was requested. The total response time was between 30 minutes and 1 hour, longer than recommended according to the national average, whether in urban or rural areas. Conclusion: After analyzing the calls, it is clear that the worst problem with the calls is the response time, and it is necessary to decrease the same of the requests.Key-words: SAMU; Indicators; Central of State Regulation; Emergency Medical Services; Health Services Administration.   Objetivo: analizar las asistencias realizadas en el Centro de Regulación de Emergencias / SAMU del Estado de Rio Grande do Sul en 2016 y 2017, centrándose en el tiempo de respuesta. Metodología: estudio observacional, descriptivo y retrospectivo con enfoque cuantitativo. Se recopilaron datos sobre el perfil del usuario, el día de la semana, la clasificación de riesgos, el tipo de queja, el tiempo promedio para responder a las solicitudes, la cantidad de retiros y la cantidad de llamadas no reguladas debido a la falta de equipos o vehículos. Resultados: El número de solicitudes por razones clínicas fue del 53.8%, de estas 51.6% fueron de gravedad media. La prevalencia fue masculina y de edades comprendidas entre 18 y 29 años. En el 84.7% de las llamadas, se solicitó soporte básico. El tiempo de respuesta total fue de entre 30 minutos y 1 hora, más de lo recomendado según el promedio nacional, ya sea en áreas urbanas o rurales. Conclusión: Después de analizar las llamadas, está claro que el peor problema con las llamadas es el tiempo de respuesta, y es necesario disminuir las mismas solicitudes.Palabras clave: SAMU; Indicadores; Central de Regulación Estatal; Servicios Médicos de Urgencia; Administración de los Servicios de Salud. 

Sign in / Sign up

Export Citation Format

Share Document