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.

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 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.

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 148: A Machine Learning-based Dispatch Rule for Drone-delivered Defibrillators

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Jamal Chu ◽  
K.H. Benjamin Leung ◽  
Sheldon Cheskes ◽  
Paul Snobelen ◽  
Gordon Nevils ◽  
...  
Keyword(s):  
Machine Learning ◽  
Response Time ◽  
Response Times ◽  
Time Of Day ◽  
Sign Test ◽  
Type I ◽  
Similar Response ◽  
Median Response ◽  
Optimal Dispatch ◽  
Median Response Time

Introduction: Drone-delivered defibrillators may reduce response time for out-of-hospital cardiac arrest (OHCA). However, an optimal dispatch rule is not yet known. Methods: We identified all suspected OHCAs in Peel Region, Ontario, Canada from Jan. 2014 to Dec. 2019. We trained a neural network model to predict emergency medical services (EMS) response times using OHCA location, distance from responding ambulance, day of week and time of day. Instead of least-squares loss, our model optimized a loss function that penalized weighted errors in the dispatch decision (type I/II error). Assuming drones were deployed from three bases in the region, we calculated drone response time to each suspected OHCA using real drone specifications. Our dispatch rule dispatched a drone when its calculated response time was shorter than the predicted EMS response time. Response time was calculated as the minimum of the drone and EMS response times. The performance of our dispatch rule was compared on out-of-sample OHCAs using 5-fold cross validation to the baseline cases of (1) no drones, and (2) drone dispatch to every suspected OHCA. Statistical analysis on the median response times was performed using a right-tailed sign test. Results: We identified 4774 suspected OHCAs with a median historical EMS response time of 6.0 minutes. Using our dispatch rule, median response time was significantly shorter at 3.9 minutes (P<0.001). Drones were dispatched to 3803 cases (79.7%) and of those, drone response was faster than EMS in 3076 cases (80.9%). When the drone was not dispatched, it would have been slower than EMS in 856 cases (88.1%). Sending a drone to every suspected OHCA resulted in an identical median response time of 3.9 minutes (P<0.001), with drones arriving before EMS in 3191 cases (66.8%). Conclusion: A machine learning-based dispatch rule can achieve similar response times as a policy that dispatches a drone to all suspected OHCAs, while dispatching drones less frequently.

scholarly journals A study to assess the awareness and practice regarding utilization of sanitary toilet in the rural villages of Kalaburagi district

2020 ◽  
Vol 7 (3) ◽  
pp. 1184
Author(s):  
Sunil Deshmukh ◽  
Shreeshail Ghooli ◽  
Ravi S. Kurle
Keyword(s):  
Rural Areas ◽  
Millennium Development Goals ◽  
Standard Of Living ◽  
Important Goal ◽  
Rural Villages ◽  
Attitude And Practice ◽  
Development Goals ◽  
The One ◽  
Latrine Use ◽  
Knowledge Attitude And Practice

Background: As there is some improvement in sanitary latrine use and safe disposal of child faeces which is the one of the important goal of millennium development goals, awareness, practice and lack of community and household sanitary latrines is still a major problem. The objective was to study awareness and practice about use of sanitary latrine in villages.Methods: The study was undertaken to assess the knowledge, attitude and practice in rural villages of Kalaburagi District, Karnataka, India. The study sample consist a total of 500 participants.Results: The prevalence of usage of sanitary latrines was 40%. The prevalence of open air defecation in the study was 97.4%. There was significant association between belief, low standard of living and open air defecation.Conclusions: To overcome the underutilization problem of sanitary latrines in rural areas is to provide quality household and community sanitary latrines along with the provision for creating awareness among the population regarding the benefit of using sanitary latrine.

scholarly journals Why is hitting A&E time targets so hard?: using Nudge theory and modelling to improve response times

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S223-S223
Author(s):  
Kaj Svedberg
Keyword(s):  
Response Time ◽  
Statistical Difference ◽  
Distribution Curve ◽  
Response Times ◽  
University Hospital ◽  
Time Data ◽  
Performance Targets ◽  
Significant Statistical Difference ◽  
Large Display ◽  
The One

AimsTo improve the one hour response times to referrals made to psychiatric Liaison in A&E without adding or changing available resources.MethodResponse time data of referrals made to the Homerton University Hospital psychiatric liaison service was collected dating back from August 2016 to October 2019 (n = 10225).A nudge was introduced in the form of a large display showing referrals arriving in real time in the staff office.Data was then collected over a period of 5 weeks (n = 436) to measure if any change had occurred in response times.ResultResponse times appear to follow a Poisson like distribution curve. The average referral was responded to within 6 minutes (n = 1577) prior to the nudge, and 6 minutes (n = 88) after. Prior to the nudge the 95% referral envelope fell within 134 minutes (n = 9728) and was 122 minutes (n = 414) after the intervention. Significant statistical difference is observed upon considering response in the first 240 minutes.ConclusionNudge interventions could be a useful resource-sparing method to improve services. The average referral to the HUH liaison team was quickly responded to within 6 minutes and yet hitting the 1 hour 95% target appears ever-elusive. Hitting targets of 95% responses within 1 hour may prove very difficult if we are not considering natural distributions, such as Poisson, occuring in the backgroung which ultimately may require a change in approaches to how we set performance targets.

scholarly journals Can Encrypted DNS Be Fast?

2021 ◽  
pp. 444-459
Author(s):  
Austin Hounsel ◽  
Paul Schmitt ◽  
Kevin Borgolte ◽  
Nick Feamster
Keyword(s):  
United States ◽  
Response Time ◽  
Significant Variation ◽  
Response Times ◽  
The United States ◽  
Web Browsers ◽  
Home Networks ◽  
Median Response

AbstractIn this paper, we study the performance of encrypted DNS protocols and conventional DNS from thousands of home networks in the United States, over one month in 2020. We perform these measurements from the homes of 2,693 participating panelists in the Federal Communications Commission’s (FCC) Measuring Broadband America program. We found that clients do not have to trade DNS performance for privacy. For certain resolvers, DoT was able to perform faster than DNS in median response times, even as latency increased. We also found significant variation in DoH performance across recursive resolvers. Based on these results, we recommend that DNS clients (e.g., web browsers) should periodically conduct simple latency and response time measurements to determine which protocol and resolver a client should use. No single DNS protocol nor resolver performed the best for all clients.

Visual Search in Complex Fields: Size Differences between Target Disc and Surrounding Discs

1972 ◽  
Vol 14 (2) ◽  
pp. 139-148 ◽  
Author(s):  
John R. Bloomfield
Keyword(s):  
Visual Search ◽  
Response Time ◽  
Response Times ◽  
Time Factors ◽  
Theoretical Work ◽  
Single Target ◽  
Solid Disc ◽  
The Difference ◽  
The Times ◽  
Time Required

An adaptable technique for performing search experiments, enabling extensive studies to be undertaken with well-practiced observers, is described. In each trial a single target disc was presented. Cumulative distributions of the times taken to locate 6 solid disc targets of varying size in a display containing 99 larger standard discs arranged in a regular fashion, and 3 disc targets in a display of 107 larger discs arranged irregularly, are presented. Three practiced observers were used with each display. Sixty readings per observer, per target, per display were obtained. It is suggested that for the targets most different in size from the background discs, the distributions of times to locate are largely dependent on response time factors; and for the targets closest in size the distributions are largely dependent on search factors. Some support is lent to theoretical work that suggests search times are exponentially distributed. The shortest time required to locate a particular target is used as an estimate of response time. Response times are found to be inversely proportional to both the difference between the log of the target and nontarget disc diameters, and to the difference between the diameters. An amendment, taking response time into account, is suggested for exponential search equations.

On the Difference Between Monkeys' and Humans' Response Times: Could It Be the Experimental Procedure?

2012 ◽  
Author(s):  
Guy E. Hawkins ◽  
Birte U. Forstmann ◽  
Eric-Jan Wagenmakers ◽  
Scott D. Brown
Keyword(s):  
Response Times ◽  
Experimental Procedure ◽  
The Difference

Use of a Lyophilized Reference Plasma to Compare Coagulation Test Procedures

1975 ◽  
Vol 34 (02) ◽  
pp. 426-444 ◽  
Author(s):  
J Kahan ◽  
I Nohén
Keyword(s):  
Oral Anticoagulant Therapy ◽  
Repeated Measurements ◽  
Test Procedures ◽  
Coagulation Activity ◽  
Close Relationship ◽  
Measured Activity ◽  
Test Materials ◽  
The Difference ◽  
The Stability ◽  
The One

SummaryIn 4 collaborative trials, involving a varying number of hospital laboratories in the Stockholm area, the coagulation activity of different test materials was estimated with the one-stage prothrombin tests routinely used in the laboratories, viz. Normotest, Simplastin-A and Thrombotest. The test materials included different batches of a lyophilized reference plasma, deep-frozen specimens of diluted and undiluted normal plasmas, and fresh and deep-frozen specimens from patients on long-term oral anticoagulant therapy.Although a close relationship was found between different methods, Simplastin-A gave consistently lower values than Normotest, the difference being proportional to the estimated activity. The discrepancy was of about the same magnitude on all the test materials, and was probably due to a divergence between the manufacturers’ procedures used to set “normal percentage activity”, as well as to a varying ratio of measured activity to plasma concentration. The extent of discrepancy may vary with the batch-to-batch variation of thromboplastin reagents.The close agreement between results obtained on different test materials suggests that the investigated reference plasma could be used to calibrate the examined thromboplastin reagents, and to compare the degree of hypocoagulability estimated by the examined PIVKA-insensitive thromboplastin reagents.The assigned coagulation activity of different batches of the reference plasma agreed closely with experimentally obtained values. The stability of supplied batches was satisfactory as judged from the reproducibility of repeated measurements. The variability of test procedures was approximately the same on different test materials.

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