A non-linear multi-criteria programming approach for determining county emergency medical service ambulance allocations.

In this paper an integer, non-linear mathematical programming model is developed to allocate emergency medical service (EMS) ambulances to sectors within a county in order to meet a government-mandated response-time criterion. However, in addition to the response-time criterion, the model also reflects criteria for budget and work-load, and, since ambulance response is best described within the context of a queueing system, several of the model system constraints are based on queueing formulations adapted to a mathematical programming format. The model is developed and demonstrated within the context of an example of a county encompassing rural, urban and mixed sectors which exhibit different demand and geographic characteristics. The example model is solved using an integer, non-linear goal-programming technique. The solution results provide ambulance allocations to sectors within the county, the probability of an ambulance exceeding a prespecified response time, and the utilization factor for ambulances per sector.

Critical assessment of jacket plethysmographs for use in young children.

In infants and very young children changes in thoracic gas volume (Vtg) during tidal breathing and during intermittent positive-pressure lung inflations have been estimated from pressure changes within double-layered rubber jackets covering the thorax and abdomen. In vitro and in vivo assessments demonstrated the linearity of these jackets over the range of volume changes found in these young subjects during respiratory function tests, and the small intrajacket background pressure (2.5 cmH2O) had minimal effects on resting lung volume and lung mechanics. These jackets can be used to monitor tidal volume in quiet subjects, and if an intermittent positive-pressure inflation technique is used static compliance can be accurately measured. The hysteresis of natural rubber and the direct contact of the recording system with the subject renders it unsuitable for the measurement of lung mechanics during tidal breathing and for the estimation of Vtg during airway occlusions.