Simulation and optimization models for emergency medical systems planning

2016 ◽  
Vol 12 (4) ◽  
pp. 287 ◽  
Author(s):  
Andrea Bettinelli, PhD ◽  
Roberto Cordone, PhD ◽  
Federico Ficarelli, MSc ◽  
Giovanni Righini, PhD
Keyword(s):  
Queuing Theory ◽  
Discrete Event ◽  
Minimum Cost ◽  
Real Data ◽  
Analytical Models ◽  
Medical Systems ◽  
Simulation And Optimization ◽  
Emergency Medical ◽  
Optimal Mix ◽  
Emergency Medical Systems

The authors address strategic planning problems for emergency medical systems (EMS). In particular, the three following critical decisions are considered: i) how many ambulances to deploy in a given territory at any given point in time, to meet the forecasted demand, yielding an appropriate response time; ii) when ambulances should be used for serving nonurgent requests and when they should better be kept idle for possible incoming urgent requests; iii) how to define an optimal mix of contracts for renting ambulances from private associations to meet the forecasted demand at minimum cost. In particular, analytical models for decision support, based on queuing theory, discrete-event simulation, and integer linear programming were presented. Computational experiments have been done on real data from the city of Milan, Italy.

A simulation-optimization algorithm for return strategies in emergency medical systems

SIMULATION ◽  
2021 ◽  
pp. 003754972110061
Author(s):  
Hamed Golabian ◽  
Jamal Arkat ◽  
Hiwa Farughi ◽  
Reza Tavakkoli-Moghaddam
Keyword(s):  
Simulated Annealing Algorithm ◽  
Simulation Optimization ◽  
Discrete Event ◽  
Real Data ◽  
Optimization Approach ◽  
Medical Systems ◽  
Queuing Model ◽  
Emergency Medical ◽  
Demand Rate ◽  
Hypercube Model

In an emergency medical system, the locations of ambulance stations has a direct impact on response time. In this paper, two location models are presented in combination with the hypercube queuing model to maximize coverage probability. In the first model, the locations of free and busy ambulances are considered in the system states, and the hypercube model can be analyzed accurately. The model contains a large number of states, and cannot be used for large-sized problems. For this reason, the second model is presented with the same assumptions as in the first model, except that the locations of busy ambulances are not included in the system state, but approximated based on the arrival rates. Both models are offline and dynamic, in which an ambulance does not necessarily return to the station from which it has been dispatched. Two strategies are defined for returning ambulances to the stations from the customer’s location. In the first strategy, the ambulance is returned to the nearest station after completion of its mission, and in the second strategy, it returns to the empty station that covers the highest demand rate. For evaluation of the performance of the proposed models, small-sized examples are solved for both return strategies using the GAMS software. A simulation-optimization approach combined with a simulated annealing algorithm and a discrete-event simulation are used for solving large-sized problems. Moreover, real data from a case study are used to demonstrate the performance of the models in the real world.

A Call to Action: The Institute of Medicine Report on Emergency Medical Services for Children

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 173-174
Author(s):  
Jane F. Knapp
Keyword(s):  
Emergency Medical Services ◽  
Pediatric Emergency ◽  
Medical Services ◽  
Institute Of Medicine ◽  
Medical Systems ◽  
Call To Action ◽  
Emergency Medical ◽  
Grant Program ◽  
Public Responsibility ◽  
Emergency Medical Systems

Emergency Medical Services for Chi (EMS-C) must be recognized as a public responsibility; the "market" cannot be relied on to produce the kind of planning and cooperation required to make services available to all who need them.1 The Institute of Medicine (IOM) Report on Emergency Medical Services For Children. Each year millions of American chi become seriously ill or injured. If you have ever encountered a child who did not receive the medical care they needed or deserved under these circumstances you understand what EMS-C is all about. The familiar adage, "Children are not small adults," emphasizes that their care must be an integral part of a system not an afterthought once the adults have been addressed. The achievement of the desired level of competence for EMS-C in the larger system is hampered by many factors. These include lack of organization, equipment, training, and a tack of understanding of the child's unique problems and needs. In response to these needs, Congress approved a demonstration grant program in 1984. The purpose of the program was threefold: to expand access to EMS-C, to improve the quality available through existing Emergency Medical Systems (EMS), and to generate knowledge and experience that would be of use to all states and localities seeking to improve their system. Continuing interest prompted the formation of the Committee on Pediatric Emergency Medical Services by the IOM. This 19-member committee Chaired by Dr Donald N. Medearis, Jr released their report in the summer of 1993. The IOM report entitled Emergency Medical Services for Chi is available in both a soft cover 25-page summary and the full text (see Appendix).

scholarly journals Prospective, Multicentre Trial of Methoxyflurane for Acute Trauma-Related Pain in Helicopter Emergency Medical Systems and Hostile Environments: METEORA Protocol

2018 ◽  
Vol 35 (11) ◽  
pp. 2081-2092 ◽  
Author(s):  
Franco Marinangeli ◽  
◽  
Giorgio Reggiardo ◽  
Antonella Sblendido ◽  
Amedeo Soldi ◽  
...  
Keyword(s):  
Multicentre Trial ◽  
Medical Systems ◽  
Acute Trauma ◽  
Emergency Medical ◽  
Hostile Environments ◽  
Emergency Medical Systems

Emergency Medical Services and the Pediatric Patient: Are the Needs Being Met?

PEDIATRICS ◽  
1984 ◽  
Vol 73 (6) ◽  
pp. 769-772
Author(s):  
James S. Seidel ◽  
Mark Hornbein ◽  
Kathy Yoshiyama ◽  
Dorothy Kuznets ◽  
Jerry Z. Finklestein ◽  
...  
Keyword(s):  
Los Angeles ◽  
Death Rate ◽  
The United States ◽  
Base Station ◽  
Medical Systems ◽  
Medical Problems ◽  
Emergency Medical ◽  
Mobile Intensive Care Unit ◽  
Critically Ill Child ◽  
Emergency Medical Systems

Emergency medical systems are being developed throughout the United States primarily to deal with myocardial infarction and trauma. These programs often fail to recognize the special needs of the critically ill child. Data collected in Los Angeles County from the LA County Trauma Surveys, Mobile Intensive Care Unit Rescue Reports, and Base Station Hospitals demonstrate that children represent approximately 10% of the paramedic calls. The calls are for medical problems as well as trauma. These data suggest that children have a higher death rate in the field than adults, and deaths occur more commonly in areas where there are no pediatric centers. Children are often secondarily transferred from emergency departments to other centers for definitive care. This study suggests that the needs of children in the prehospital setting are not being met.

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

2013 ◽  
pp. 783-799
Author(s):  
Joel A. Fein ◽  
William T. Zempsky ◽  
Joseph P. Cravero
Keyword(s):  
Pediatric Patients ◽  
Medical Systems ◽  
Emergency Medical ◽  
Emergency Medical Systems

International development of emergency medical systems

1998 ◽  
Vol 5 (1) ◽  
pp. 23???28 ◽  
Author(s):  
J. A. HOJNOSKI ◽  
G. R. CIOTTONE ◽  
R. V. AGHABABIAN
Keyword(s):  
International Development ◽  
Medical Systems ◽  
Emergency Medical ◽  
Emergency Medical Systems

Arterial line in prehospital emergency settings – A feasibility study in four physician-staffed emergency medical systems

Resuscitation ◽  
2011 ◽  
Vol 82 (9) ◽  
pp. 1198-1201 ◽  
Author(s):  
Gernot Wildner ◽  
Nina Pauker ◽  
Sylvia Archan ◽  
Geza Gemes ◽  
Marcel Rigaud ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Arterial Line ◽  
Medical Systems ◽  
Emergency Medical ◽  
Prehospital Emergency ◽  
Emergency Medical Systems
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