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APHA Scientific Session and Event Listing
4232.0: Tuesday, November 06, 2007 - 3:30 PM

Abstract #158966

An outcome based approach to enhancing EMS systems transport safety

Nadine Levick, MD, MPH, Division of Research, EMS Safety Foundation, 137 Central Park North, New York, NY 10026, 917.4932001, nlevick@attglobal.net and John Russell, MD, Cape County Private Ambulance Service, 1458 North Kingshighway, Cape Girardeau, MO 63701.

Use of lights and sirens (L/S) has been shown to increase hazards for EMS transport.

Objective: To determine response outcome of changing ‘to scene' Emergency ‘L/S' responses to Immediate ‘no L/S' modality for a defined cohort of runs.

Methodology: Pilot study conducted in a 911 provider regional EMS system serving 100,000 people, using Medical Priority Dispatch System, a validated dispatch system, classifying runs by increasing severity: Alpha, Bravo, Charlie, Delta, Echo. Alpha trips were run ‘no L/S' since 1992. The intervention, to change Bravo responses from ‘L/S' to ‘no L/S' responses, commenced in March 2005. Data was collected the last 6 months of 2004 and the last 6 months of 2005. A comparison of response category, run data and ‘L/S' use was performed.

Results: During the study periods call distribution, weather, and demand factors were similar. In the 2004 period 2495 runs, and 2005 period 2780 runs, Bravo responses were 28% and 25% respectively. Changing Bravo ‘to scene' responses to Immediate ‘no L/S' resulted in the expected 25% decrease in ‘L/S' responses and there was no increase in total ‘from scene' ‘L/S' transports. There was an 8% decrease in Emergency ‘L/S' responses where there was no patient found or no transport.

Conclusion: A policy replacing potentially hazardous use of ‘to scene' Emergency L/S responses in this cohort with Immediate ‘no L/S' responses resulted in a substantial decrease in potential transport hazards. Generalizability would require a larger sample size. Defining response modalities is where prioritization of dispatch can pay safety dividends.

Learning Objectives:

Keywords: EMS/Trauma, Quality Improvement

Related Web page: www.objectivesafety.net

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Emergency Services and Emergency Department Practices

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA