Prospective validation of a new model for evaluating emergency medical services systems by in-field observation of specific time intervals in prehospital care

Annals of Emergency Medicine
D W SpaiteP Hinsberg

Abstract

To develop and validate a new time interval model for evaluating operational and patient care issues in emergency medical service (EMS) systems. DESIGN/SETTING/TYPE OF PARTICIPANT: Prospective analysis of 300 EMS responses among 20 advanced life support agencies throughout an entire state by direct, in-field observation. Mean times (minutes) were response, 6.8; patient access, 1.0; initial assessment, 3.3; scene treatment, 4.4; patient removal, 5.5; transport, 11.7; delivery, 3.5; and recovery, 22.9. The largest component of the on-scene interval was patient removal. Scene treatment accounted for only 31.0% of the on-scene interval, whereas accessing and removing patients took nearly half of the on-scene interval (45.8%). Operational problems (eg, communications, equipment, uncooperative patient) increased patient removal (6.4 versus 4.5; P = .004), recovery (25.4 versus 20.2; P = .03), and out-of-service (43.0 versus 30.1; P = .007) intervals. Rural agencies had longer response (9.9 versus 6.4; P = .014), transport (21.9 versus 10.3; P < .0005), and recovery (29.8 versus 22.1; P = .049) interval than nonrural. The total on-scene interval was longer if an IV line was attempted at the scene (17.2 versus 12.2; P < .0001). This re...Continue Reading

References

Nov 1, 1978·JACEP·C G CaytenS Walsh
Feb 1, 1977·JACEP·N J DiamondJ W Elliott
Apr 1, 1991·Annals of Emergency Medicine·L B BeckerG T Kondos
Jul 1, 1991·The American Journal of Emergency Medicine·D A Propp, C A Rosenberg
Oct 1, 1990·The Journal of Trauma·S M KaweskiR W Virgilio
Nov 1, 1990·The American Journal of Emergency Medicine·G StarkR Norton
Feb 1, 1990·Annals of Emergency Medicine·B HonigmanPeter T Pons
May 1, 1990·Annals of Emergency Medicine·O BraunJ Fazackerley
Jul 1, 1990·The American Journal of Emergency Medicine·Corey M SlovisR J Guthmann
Feb 1, 1989·Annals of Emergency Medicine·M Shuster, J Chong
Oct 1, 1989·Annals of Emergency Medicine·J E Pointer, M A Osur
Jan 1, 1989·The Journal of Trauma·M O'GormanD B Pilcher
Mar 1, 1989·Annals of Emergency Medicine·S E JonesE Alcouloumre
Oct 1, 1988·Annals of Emergency Medicine·N C DeanP J Hawker
Jul 1, 1987·Annals of Emergency Medicine·C R Gold
Apr 1, 1988·The Journal of Trauma·F W ClevengerH D Reines
Jun 1, 1988·Annals of Emergency Medicine·D PotterM Selig
Sep 1, 1988·The American Journal of Emergency Medicine·Jerris R HedgesD W Haver
Aug 1, 1987·The Journal of Trauma·G J JurkovichA Luterman
Nov 1, 1987·Annals of Emergency Medicine·H A WermanP Gandy
Jun 1, 1986·Annals of Emergency Medicine·H A StuevenJ C Darin
Apr 1, 1987·Annals of Emergency Medicine·A A CwinnN Dinerman
Jan 1, 1985·The Journal of Trauma·J P SmithC F Frey
Jan 25, 1985·JAMA : the Journal of the American Medical Association·J P Smith, B I Bodai
Jun 1, 1985·Annals of Emergency Medicine·C C AprahamianJ F Tucker
Aug 1, 1985·Annals of Emergency Medicine·B M ThompsonJ C Darin
Aug 1, 1983·Journal of Pediatric Surgery·M RamenofskyM A Talley
Jan 1, 1984·The Journal of Trauma·D D Trunkey
Jun 1, 1982·The Journal of Trauma·A S Gervin, R P Fischer
Nov 1, 1982·The Journal of Trauma·K L Mattox, D V Feliciano
Dec 1, 1982·The Journal of Trauma·Jerris R HedgesH R Champion
Jul 3, 1981·JAMA : the Journal of the American Medical Association·M EisenbergL Bergner
Jul 1, 1980·Annals of Emergency Medicine·G R McSwainC P Artz

Citations

Feb 5, 2003·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Michael J SchullDonald A Redelmeier
Oct 29, 2013·Best Practice & Research. Clinical Gastroenterology·Isabel PedrotoJosé Manuel Romãozinho
Sep 3, 2003·Injury·Thomas H BlackwellMichael Thomason
Dec 13, 2002·Emergency Medicine Clinics of North America·Theodore R Delbridge
Sep 10, 2002·The Journal of Emergency Medicine·Peter T Pons, Vincent J Markovchick
Jan 1, 1997·Journal of Advanced Nursing·B O Suserud, H Haljamäe
Jan 5, 2002·Accident and Emergency Nursing·B O Suserud
Apr 21, 2001·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·K H Altintaş, N Bilir
Jan 28, 2005·The Journal of Trauma·Marco A DiazHerbert G Bivins
Nov 24, 1999·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·E Brooke LernerR M Moscati
Sep 18, 1999·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·David C ConeT A Brabson
Oct 8, 1997·Journal of Accident & Emergency Medicine·S W GoodacreA McGowan
Oct 5, 2012·International Journal of Health Geographics·Alka B PatelWilliam A Ghali
Apr 3, 2002·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Thomas H Blackwell, Jay S Kaufman
Jan 1, 2014·The Journal of Emergency Medicine·Alix J E CarterDavid C Cone
Sep 29, 2009·Annals of Emergency Medicine·Craig D NewgardResuscitation Outcomes Consortium Investigators
Oct 27, 2011·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Ian E BlanchardGrant D Innes
Feb 11, 2012·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Craig D NewgardMohamud Daya
Dec 11, 2013·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·David C Cone, Adam B Landman
Oct 9, 2012·Emergency Medicine Australasia : EMA·David C ConeSadaf Marashi Pour
Dec 3, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·David C ConeD W Spaite
Feb 24, 1998·Annals of Emergency Medicine·David C ConeQ Nguyen
Dec 1, 1995·Annals of Emergency Medicine·J P CampbellW A Watson
Aug 1, 1993·Annals of Emergency Medicine·Vincent Mosesso
Feb 5, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Govind J Oliver, Darren P Walter
Aug 13, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·D W SpaiteKurt R Denninghoff
Mar 3, 2005·Air Medical Journal·John R WishResearch Committee of Association of Air Medical Services
Jul 20, 2013·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Ross J FleischmanCraig Warden
Feb 7, 2015·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Patrick C DraynaE Brooke Lerner
Dec 24, 2011·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Mazen El SayedJonathan S Olshaker
Aug 30, 2011·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Derek R CooneyHarry J Wallus
May 1, 1994·Annals of Emergency Medicine·W H CordellA W Nyhuis
Jun 27, 2015·PloS One·Yu Jin LeeWon Chul Cha
Mar 15, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Donald S MacMillan, David C Cone
Sep 9, 2005·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Marc EcksteinU.S. Metropolitan Municipalities' EMS Medical Directors Consortium
Nov 18, 2017·Stroke; a Journal of Cerebral Circulation·Daniel WeiJohanna T Fifi
Dec 11, 2017·Prehospital and Disaster Medicine·Ian HowardVeronica Lindstrom
Mar 15, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Brendan G CarrCharles C Branas
Jun 28, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Eli SegalMarc Afilalo
Apr 10, 2010·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Matthew GrattonJason Shearer
Feb 16, 2012·Current Opinion in Critical Care·Bentley J BobrowCleo Subido
Dec 26, 2003·Prehospital and Disaster Medicine·Wolfgang F Dick
Sep 5, 1994·Prehospital and Disaster Medicine·J P CampbellW A Watson
Feb 24, 2001·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·P A SilkaJ Y Kim
Apr 13, 2011·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Steve VandeventerTom Blackwell
Jun 16, 2017·Turkish Journal of Emergency Medicine·Gorkem SariyerZeynep Sofuoglu
Aug 21, 2020·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Ludovic MaudetPierre-Nicolas Carron
Jun 7, 1995·Prehospital and Disaster Medicine·D M WolfbergR D Flinn
Jun 7, 1994·Prehospital and Disaster Medicine·J S SampalisJ I Williams
Apr 19, 2002·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Samuel A McLeanHerbert G Garrison
Oct 17, 2008·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Zachary F MeiselJon Vernick
Sep 5, 1993·Prehospital and Disaster Medicine·D W SpaiteH W Meislin
Apr 19, 2002·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·E Brooke LernerChristopher Zak
Oct 2, 2007·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Alix J E Carter, Robert Grierson
Jul 10, 2018·Health Care Management Science·Mengyu LiAlix J E Carter
Nov 28, 2020·International Journal of Health Geographics·Weicong LuoXiaoxiang Zhang

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