Impact of crowding in local ambulance demand on call-to-ambulance scene arrival in out-of-hospital cardiac arrest.
Am J Emerg Med
; 52: 105-109, 2022 Feb.
Article
in En
| MEDLINE
| ID: mdl-34920390
ABSTRACT
BACKGROUND:
Rapid emergency medical service (EMS) response is an important prognostic factor in out-of-hospital cardiac arrest (OHCA). This study aims to evaluate the association between local hourly EMS demand and ambulance response in OHCA.METHODS:
OHCA occurring in 24 districts of Seoul from 2013 to 2018 was analyzed. Hourly ambulance demand per ambulance in each local district of patient location at the hour of cardiac arrest was calculated as the crowding index. The crowding index was categorized according to quartiles (1Q ≤0.43, 2Q 0.44-0.67, 3Q 0.68-0.99, 4Q ≥1.0 calls/h\r/ambulance). The primary outcome was ambulance dispatched within 1 km of the OHCA scene. Multivariable logistic regression analysis was performed to test the association between the local hourly ambulance demand and outcomes.RESULTS:
A total of 26,479 patients were analyzed. The rate of ambulance dispatched within 1 km decreased according to the crowding quartile (1Q 31.3%, 2Q 30.0%, 3Q 28.8%, and 4Q 26.6%). Compared to 1Q, adjusted odds ratios (95% CIs) of dispatch distance within 1 km in 2Q, 3Q, and 4Q were 0.92 (0.86-0.99), 0.86 (0.80-0.94), and 0.77 (0.71-0.84), respectively.CONCLUSION:
Crowding in local ambulance demand was associated with less ambulance dispatched within 1 km and delayed response to the scene in OHCA. Strategies to mitigate and adjust to ambulance demand crowding may be considered for better EMS response performance.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ambulances
/
Out-of-Hospital Cardiac Arrest
/
Emergency Medical Dispatch
Type of study:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
Am J Emerg Med
Year:
2022
Document type:
Article
Affiliation country:
South Korea