Emergency Response Time Research Articles

Emergency Response Times and Crash Risk: An Analysis Framework for Costa Rica

Emergency Response Times and Crash Risk: An Analysis Framework for Costa Rica

Development of agent based model for predicting emergency response time

Summary Determining the time to reach any incident location by an emergency service is a very important aspect for emergency management. In most of the developing countries road network is considered as a main infrastructure for transporting emergency services. Therefore in order to predict the response time consideration must be given to the characteristics of road segments and driving behaviour of emergency vehicle drivers. In this paper real time driving data by Fire emergency service of Allahabad city is collected using GPS logger HOLUX M1000C. The spatial trajectories collected from GPS logger are analysed in GIS along with road network, population density and landuse data to determine the driver's route deciding behaviour. Based on the integrated analysis the Fire Emergency Vehicle Agent is designed. The Agent based model is simulated to determine the response time which is subsequently compared with the real response time.

Fire Department Turnout Times: A Contextual Analysis

Abstract Fire departments nationwide seek to decrease their turnout times to emergencies. Turnout time is the time from which a dispatcher alerts a fire unit of an emergency to when the unit leaves the fire station. As such, it is an integral component of emergency response time. The National Fire Protection Association has set a 60 second standard for effective turnout. We examine how station design of dormitory location and the time of day of the emergency affect turnout times. Previous research indicates that the location of a station’s dormitory is major component of turnout time. Moving beyond descriptive statistics, we present a causal model and interactive hypothesis. Contrary to previous research, we hypothesize that the effect of station design is conditional upon the time of emergency – that above-the-garage dormitories have longer turnout times during the graveyard shift. We find that station design, per se, does not affect turnout time. We find that the effect of station design on turnout time is conditional upon the time of day of the emergency. Above-the-garage dormitories experience 10.7% longer turnout times, but during the graveyard shift. Across all station designs, the graveyard shift increases turnout times between 50.8% and 58.9%.

一体化急救模式对内科急危重症患者救治效果的研究

Objective: To investigate the treatment effect of new pattern of integrated emergency nursing in general acute and critically ill patients. Methods: Select 100 cases of acute critically ill patients from hospital emergency department during 2012 Jan．-2014 Jan．as experimental group, and applicant integration and ambulance new mode were conducted. Select 100 cases of acute and critically ill patients from hospital emergency department in 2009 Jan.-2011 Jan as control group, and ordinary first aid care mode were conducted. The effective rescue time length and effect were retrospectively analyzed among the two groups. Results: The effective treatment time and emergency response time of the experimental group is shorter than those of control group, and it was statistically significant ( P <0.05).The total efficiency of treatment group was significantly higher than the control group ( P <0.05). The total score on family satisfaction in the experimental group is（7.7±0.3）points,（5.8±0.3）points in the control group, and the difference was statistically significant ( P <0.05). Conclusion: Application of integrated emergency in acute and critically ill patients can shorten the treatment time, improve treatment effect, ensure the clinical patients with severe trauma work smoothly, and is of a higher value in clinical practice.

Dial 911 for Murder: The Impact of Emergency Response Time on Homicides

Several theories have been offered to explain the recent declines in violent crime rates in the United States. We hypothesize that technological innovations, which improved information transmission and shortened the response time between an aggravated assault incident and treatment, reduced the cost of saving lives and caused much of the decline in homicide rates in recent decades. Using difference-in-differences and event studies, we show that improvements in emergency services (9-1-1) caused significant decreases in homicide rates. Various falsification tests support these findings.

Evaluation of the effects of standardization process of severe trauma treatment in China

Objective: This study aims to evaluate the effects of standardization processes in improving severe trauma treatments in China. Methods: This study was conducted in 12 hospitals located in 12 geographically and industrially different cities in China. A standard process on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating pre-hospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and one year after the implementation of standardization processes. Results: The outcomes of a total of 74,615 and 12051 cases of severe trauma were collected from 12 hospitals before the implementation of standardization processes. Implementation of the standardization processes led to efficient cooperation and information sharing of different treatmen services. The emergency response time, pre-hospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24±4.32、45.69±3.89、6.38±1.05、17.53±0.72 minutes, and 33.82±3.87%, n=441,respectively before the Implementation of the standardization and significantly reduced to 10.11±3.21、22.39±4.32、3.26±0.89、3.45±0.45 minutes, and20.49±3.11 %, seperatly, n=495, (P&lt;0.05) after that. Conclusion: Staff training and standardization processes can significantly improve the treatment efficiency of severe trauma based on current personnel and organizations of severe trauma treatments in China.

The Relationship between Emergency Response Time and Out-Of-Hospital Cardiac Arrest Prognosis: A Meta-Analysis

Objective To assess the relationship between emergency response time and prognosis of patients with out-of-hospital cardiac arrest. Design Systematic review. Methods Relevant observational studies were identified by a search of PubMed and ISI databases to 30 January 2014. Primary outcome was survival to discharge. The weighted mean differences (WMD) for response time were calculated for those survivals to discharge and death in hospital. We also carried out a dose response meta-analysis for assessing summary odds ratio (OR) of survival by response time. Results A total of 13 studies with 804,998 patients included in the meta-analysis. The WMD of response time between survivals to discharge group and death in hospital group was 1.976 (95% confidence interval [CI] = 1.161-2.792; p&lt;0.001). Sensitivity analyses by only included prospective cohorts showed the WMD of response time between two groups was 1.115 (95% CI=0.508-1.723; p&lt;0.001). Dose-response relationship between response time and survival to discharge risk was observed statistically significant (χ2=39.86, p&lt;0.001). In linear model, the summary OR was 0.914 (95% CI=0.889-0.940) for every 1 minutes delay in response time. In spline model, the survival OR decreased along with the response time, especially when response time less than 7 minutes. Conclusions Emergency response time is an important risk factor for prognosis after OHCA in adults. The EMS team must arrive as soon as possible to the site of the event. (Hong Kong j.emerg.med. 2015;22:345-351)

Out-of-hospital cardiac arrest in the elderly: A large-scale population-based study

BackgroundThere is little information on elderly people who suffer from out-of-hospital cardiac arrest (OHCA). AimTo determine 30-day mortality and neurological outcome in elderly patients with OHCA. MethodsOHCA patients ≥70 years of age who were registered in the Swedish Cardiopulmonary Resuscitation Register between 1990 and 2013 were included and divided into three age categories (70–79, 80–89, and ≥90 years). Multiple logistic regression analyses were performed to identify independent predictors of 30-day survival. ResultsAltogether, 36,605 cases were included in the study. Thirty-day survival was 6.7% in patients aged 70–79 years, 4.4% in patients aged 80–89 years, and 2.4% in those over 90 years. For patients with witnessed OHCA of cardiac aetiology found in a shockable rhythm, survival was higher: 20%, 15%, and 11%, respectively. In 30-day survivors, the distribution according to the cerebral performance categories (CPC) score at discharge from hospital was similar in the three age groups. In multivariate analysis, in patients over 70 years of age, the following factors were associated with increased chance of 30-day survival: younger age, OHCA outside the home, witnessed OHCA, CPR before arrival of EMS, shockable first-recorded rhythm, and short emergency response time. ConclusionsAdvanced age is an independent predictor of mortality in OHCA patients over 70 years of age. However, even in patients above 90 years of age, defined subsets with a survival rate of more than 10% exist. In survivors, the neurological outcome remains similar regardless of age.

Evaluation of the effects of standard rescue procedure on severe trauma treatment in china.

Background:This study aimed to evaluate the effects of standard rescue procedure (SRP) in improving severe trauma treatments in China.Methods:This study was conducted in 12 hospitals located in geographically and industrially different cities in China. A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating prehospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and 1 year after the implementation of the SRP.Results:The outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP. Implementation of the SRP led to efficient cooperation and information sharing of different treatment services. The emergency response time, prehospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24 ± 4.32 min, 45.69 ± 3.89 min, 6.38 ± 1.05 min, 17.53 ± 0.72 min, and 33.82% ± 3.87% (n = 441), respectively, before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min, 22.39 ± 4.32 min, 3.26 ± 0.89 min, 3.45 ± 0.45 min, and 20.49% ± 3.11%, separately (n = 495, P < 0.05) after that.Conclusions:Staff training and SRP can significantly improve the efficiency of severe trauma treatments in China.

Research on the support model of large equipment emergency spare parts under fuzzy demand

Purpose: Aim at making a scheme for emergency spare parts the support problem when large equipment spare parts supply network faced with large-scale emergency events. Design/methodology/approach : In order to analyze the model, we establish the spare parts security model under network supply conditions to respond emergency in case of fuzzy demand. And in end of the paper, we adopt an improved genetic algorithms to solve the problem. Findings : Considering emergency spare parts support problem from three aspects including satisfaction of time, satisfaction of demand and emergency cost constraints, which makes decision-making process more accord with reality condition, we can get a more realistic solution for the decision makers. Originality/value: Considering the occurrence of emergency and adopting information entropy theory to order the weight of emergency maintenance station in priority sequence, this paper presented emergency response time and demand satisfaction function, which uses the time, demand satisfaction and the cost restrictor as main objective, we have constructed the spare parts support model under fuzzy demand to solve emergency events, having expanded the scope of solution.

Enhancing Emergency Response Management using Emergency Description Information Technology (EDIT)

This paper presents a novel approach toward facilitating the effective collection and communication of information during an emergency. Initially, this research examines current emergency response information workflows and emergency responder dispatch criteria. A process for the optimization of these workflows and criteria, along with a suggested method to improve data collection accuracy and emergency response time using a mobile device application, are suggested. Specifically, a design-science approach incorporating the development of an expert system designed to facilitate efficient and effective sharing of emergency information is applied. The resulting benefits could improve emergency communications during large-scale international gatherings, such as sporting events or festivals, as well as the sharing of industry-specific safety incidents. A process model for conducting analyses of additional emergency response processes is also presented. Finally, future research directions are discussed.

Simulated Training System for Undersea Oil Spill Emergency Response

This paper describes a simulated training system supported by Virtual Environment in real time for undersea oil spill emergency response, which provides all the functionalities to train emergency workers. This system aims to establish a highly immersed sense of 3D oil spill interactive environment based on “The semi physical simulation system of undersea emergency maintenance”. The research in this paper provides a new solution for undersea oil spill accident treatment. At present the system has been completed the designs of system architecture, hardware structure, software platform and interface.

Effect of integrated emergency nursing on the first-aid of patients with stroke

Objective To explore the clinical effect of integrated emergency nursing on the first-aid of patients with stroke. Methods We implemented the integrated emergency nursing since January 2013, the clinical data of patients were collected before and after the implementation. Fourty patients with routine nursing from January 2012 to December 2012 were divided into control group, fourty patients with integrated emergency nursing from January 2013 to December 2013 were divided into observation group. Quality of nursing and accident rate in transfer were compared between two groups. Results The pre-hospital emergency response time was (11.2±2.7)min and treatment time of emergency department was (17.2±8.1)min in observation group, shorter than those of control group (14.1±4.5), (22.8±12.5)min, the differences were statistical significance (t=3.495, 2.378, respectively; P<0.05). The survival rate and the accident rate of transfer declined of observation group were 82.5% and 7.5%, higher than control group (χ2=4.013, 4.501, respectively; P<0.05). Conclusions The integrated emergency nursing significantly shortens the first-aid time of patients with stroke, and promotes the effect of treatment. Key words: Stroke; Integrated emergency nursing; Nursing quality

Emergency facilities location optimisation for hazardous materials transportation under the background of counterterrorism

Hazardous materials transportation vehicles may become one of the main attack goals under the background of terrorist attacks. This article gives an optimisation method of emergency service facility location for a specific counterterrorism area. Firstly, the multi-objective optimisation model of emergency service facility location is proposed through maximising cover risks, minimising emergency response time, emergency facilities fixed costs and transportation costs. Secondly, the model is solved with an improved genetic algorithm, which use 0-1 encoding method to code chromosome, use roulette with the optimal preservation strategy to conduct choose operation and use adaptive weighted distribution method to assign weight. Finally, a case study with 12 nodes and 21 roads is given to indicate that the optimisation model and algorithm are feasible.

Abstract 17127: Sports-Related Sudden Cardiac Arrest: Comparison of Survival Outcomes in Europe versus the United States

Background: Sports-related sudden cardiac arrest (sport SCA) has always attracted attention and the United States and European Union have developed divergent strategies for prevention over the last decade; notably regarding screening of younger athletes but also for SCA prevention in middle-aged and senior individuals. In this context, the extent to which outcomes of sports SCA differ between Europe and the USA have not been characterized. Methods: SCA cases aged 15-75 years were identified in two large prospective, population-based SCA programs, one in the Paris region (Paris-SDEC) and the other in a Northwestern US metro region (Oregon-SUDS) between 2002 and 2012. Cases of SCA, occurring during sports activity were compared between the two regions. Results: Of the 7,357 cases studied, 290 (4%) occurred during sports, with very similar proportions in both regions: 86 out of 1,894 (4.5%) in Oregon and 204 out of 5,463 (3.8%) in Paris. Subjects’ characteristics of cases in both programs were very similar (Paris vs. Oregon, respectively, for all results following), regarding age (50.7±14 vs. 50.4±13 years, P=0.55), male proportion (94%vs. 92%, P=0.53), past medical history of ≥2 cardiovascular risk factors (16% vs. 23%, P=0.16) and/or heart disease (10% vs. 8%, P=0.55). There was a high proportion of witnessed events in both populations (89% vs. 90%, P=0.94). However, we observed significant differences with more bystander cardiopulmonary resuscitation in Paris (63% vs. 48%, P=0.02), faster response time in Oregon (8.3±6 vs. 6.9±4 min, P=0.05), and more initially shockable rhythms in Oregon (52% vs. 70%, P=0.006). Overall, resuscitation outcomes were very similar for return of spontaneous circulation (26% vs. 33%, P=0.21) and survival to hospital discharge (27% vs. 26%, P=0.80). Conclusions: On either side of the Atlantic, burden and characteristics of sports-related SCA are very similar. Survival rates are approximately one in four cases. Optimizing bystander cardiopulmonary resuscitation rates and emergency response times could further improve outcomes. Deployment of uniform, effective strategies for screening and prevention are likely to make the greatest impact on sports SCA.

Particle Swarm Optimization Algorithm for Emergency Resources Dispatch Scheduling

This paper presents a meta-heuristics algorithm of particle swarm optimization for solving the emergency resources distribution in disaster relief operations. An optimization mathematical model is established to achieve the objectives of the earliest emergency response time, and the lowest dispatch costs, considering the actual application environment in which the relief resources are consumed by the affected areas continuously and all available selected depots are called upon to transport commodities to the demand point at almost the same time. Furthermore, this proposed model highlights the real meaning of continuous consumption by adding the assumption that subsequent supplement is not allowed. The results of a numerical example indicate that the improved solution based on PSO algorithm is reasonable and feasible. The purpose of this study is to provide an effective approach by addressing recent patents and scholarly articles on the subject of engineering design and modeling. Keywords: Continuous consumption, demand point, dispatch scheduling, emergency logistics, particle swarm optimization, subsequent supplement.

Modeling operators' emergency response time for chemical processing operations.

Operators have a crucial role during emergencies at a variety of facilities such as chemical processing plants. When an abnormality occurs in the production process, the operator often has limited time to either take corrective actions or evacuate before the situation becomes deadly. It is crucial that system designers and safety professionals can estimate the time required for a response before procedures and facilities are designed and operations are initiated. There are existing industrial engineering techniques to establish time standards for tasks performed at a normal working pace. However, it is reasonable to expect the time required to take action in emergency situations will be different than working at a normal production pace. It is possible that in an emergency, operators will act faster compared to a normal pace. It would be useful for system designers to be able to establish a time range for operators' response times for emergency situations. This article develops a modeling approach to estimate the time standard range for operators taking corrective actions or following evacuation procedures in emergency situations. This will aid engineers and managers in establishing time requirements for operators in emergency situations. The methodology used for this study combines a well-established industrial engineering technique for determining time requirements (predetermined time standard system) and adjustment coefficients for emergency situations developed by the authors. Numerous videos of workers performing well-established tasks at a maximum pace were studied. As an example, one of the tasks analyzed was pit crew workers changing tires as quickly as they could during a race. The operations in these videos were decomposed into basic, fundamental motions (such as walking, reaching for a tool, and bending over) by studying the videos frame by frame. A comparison analysis was then performed between the emergency pace and the normal working pace operations to determine performance coefficients. These coefficients represent the decrease in time required for various basic motions in emergency situations and were used to model an emergency response. This approach will make hazardous operations requiring operator response, alarm management, and evacuation processes easier to design and predict. An application of this methodology is included in the article. The time required for an emergency response was roughly a one-third faster than for a normal response time.

A hidden cost of war: the impact of mobilizing reserve troops on emergency response times

This paper analyzes a hidden cost of war: the effect of the mass mobilization of reserve troops on the response times of domestic emergency services to accidents. We provide a statistical examination of this linkage following the US invasion of Iraq in 2003 and find that mobilization significantly increases response times to accidents in the United States. These mobilization-related costs are exacerbated by both legal restrictions and issues of replacing highly specialized human capital.

Trends in survival among elderly patients with out-of-hospital cardiac arrest: a prospective, population-based observation from 1999 to 2011 in Osaka

BackgroundLittle is known about the improvement in out-of-hospital cardiac arrest (OHCA) survival among elderly patients. The aim of this study was to evaluate the trends in the survival after bystander-witnessed OHCA of cardiac origin in this age group. MethodsThis prospective, population-based, observation of the whole population of Osaka, Japan included consecutive OHCA patients aged ≥65 years with emergency responder resuscitation attempts from January 1999 to December 2011. The primary outcome measure was one-month survival with neurologically favorable outcome, and the trends in the outcome from OHCA were evaluated by location. Multiple logistic regression analysis was used to assess factors that were potentially associated with neurologically favorable outcome. ResultsDuring the study period, a total of 10,876 bystander-witnessed OHCA of cardiac origin were eligible for our analyses. In whole arrests, the proportion of one-month survival with neurologically favorable outcome improved from 1.4% in 1999 to 4.8% in 2011 (P for trend <0.001). The proportion of neurologically favorable outcome in homes and public places improved from 0.7% in 1999 to 3.2% in 2011 (P for trend <0.001) and from 4.2% in 1999 to 20.9% in 2011 (P for trend <0.001), respectively, whereas, in nursing homes, the proportion of neurologically favorable outcome did not improve. In a multivariate analysis, bystander-initiated cardiopulmonary resuscitation and emergency response time were significant predictors for neurologically favorable outcome. ConclusionsIn this population, survival from OHCA among elderly patients significantly improved during the study period, but the trends differed by the OHCA location.

A Survey of the Residents of Zhejiang, China on the Knowledge and Awareness of Community Cardiopulmonary Resuscitation and Expectation of the Emergency Medical Service

Objectives To investigate the opinions and expectations of residents from Zhejiang Province on the prehospital emergency medical services (EMS). To evaluate the differences among main urban areas, county-level areas and rural areas in Zhejiang Province. To provide objective data for relevant departments to make further improvement and promote balanced development of the pre-hospital EMS cause. Methods The study was conducted from 1st April 2011 to 30th December 2011. It was carried out in 11 cities and 1,650 residents were included by stratified random sampling method. The survey mainly focused on residents' expectations of EMS and residents' knowledge of emergency skills, the emergency response time, the actions of EMS dispatchers, the fees charged for EMS. Pearson's Chi-Square Test was also used to compare the differences of the current status and residents' expectations of EMS among main urban areas, county-level areas and rural areas. Results The survey showed that the top four emergency skills most needed by residents are cardiopulmonary resuscitation (CPR), bandaging to stop bleeding, first aids for heatstroke and drowning. Trauma patients account for 37.5% (95% CI: 35.08-39.92%) of all those who received EMS service, ranking the first place. While the percentage receiving “wound care” was rated as the most needed emergency skill. There were statistically significant differences in the rate of knowing CPR, independently conducting CPR and emergency response time less than 5 minutes among main urban areas, county-level areas and rural areas in Zhejiang Province. Conclusions Residents of Zhejiang Province lack knowledge and awareness of emergency skills. Their mastery and expectation of emergency skills vary greatly from rural areas to urban areas. Trauma patients have become the main receiver of EMS in these three different regions. The emergency response time, as well as the services provided by EMS dispatchers, is far below the expectation of residents. In addition, the majority of respondents expect EMS to send patients to the nearest hospital and most of the trained paramedics are qualified for the pre-hospital care. (Hong Kong j.emerg.med. 2014;21:237-248)