Prehosp Emerg Care. 2019 Nov-Dec;23(6):802-810. doi: 10.1080/10903127.2019.1593563. Epub 2019 Apr 5.
Fluctuations in emergency medical services (EMS) responses can have a substantial impact on the ability of agencies to meet resource needs within an EMS system. We aimed to identify weather characteristics as potentially predictable factors associated with EMS responses. We reviewed hourly counts of scene responses documented by 24 EMS agencies in Western Pennsylvania from January 1, 2014 to December 31, 2017 and compared rates of responses to weather characteristics. Responses to counties nonadjacent to the studied weather reporting station and interfacility/scheduled transports were excluded. We identified the mean temperature, meters visibility, dew point, wind speed, total millimeters of precipitation, and presence of rain or snow in 6-hour windows prior to dispatch, in addition to temporal factors of time of day and weekend vs. weekday. Analysis was performed using multivariable linear regression of a negative binomial distribution, reporting incidence rate ratios (IRR) with 95% confidence intervals (CI). Secondary analyses were performed for transports to the hospital and cases involving transports for traumatic complaints and pediatric patients (age <18 years). We included 529,058 responses (54.8% female, mean age 57.2 ± SD 24.7 years). In our multivariable model, responses were associated with (IRR, 95% CI) rain (1.10, 1.08-1.11) snow (1.07, 1.05-1.09), and both rain and snow (1.15, 1.11-1.19). A lower incidence of responses occurred on weekends (0.84, 0.83-0.85) and at night (0.62, 0.61-0.62). Increasing temperature in 5 °C increments was associated with an increase in responses across seasons with an effect that varied between 1.16 (1.15-1.17) in winter to 1.31 (1.28-1.33) in summer. Windy weather was associated with increased responses from light breeze (1.10, 1.09-1.11) to fresh breeze or greater (1.23, 1.16-1.30). Transports occurred in a similar pattern to responses. Trauma transports ( = 64,235) occurred more during weekends (1.04, 1.02-1.06). Pediatric transports ( = 21,880) were not significantly associated with precipitation or season. EMS responses increased with rising temperature and following rain and snow. These findings may assist in planning by EMS agencies and emergency departments to identify periods of greatest resource utilization.
急救医疗服务(EMS)响应的波动会对机构在 EMS 系统内满足资源需求的能力产生重大影响。我们旨在确定天气特征作为与 EMS 响应相关的潜在可预测因素。我们回顾了 2014 年 1 月 1 日至 2017 年 12 月 31 日期间宾夕法尼亚州西部 24 个 EMS 机构记录的每小时现场响应计数,并比较了对天气特征的响应率。排除了与研究中的天气报告站不相邻的县和机构间/预定转运的响应。我们确定了派遣前 6 小时窗口内的平均温度、能见度、露点、风速、总降水量毫米数以及降雨或降雪的存在,以及白天和周末与工作日的时间因素。使用负二项式分布的多变量线性回归进行分析,报告发病率比(IRR)及其 95%置信区间(CI)。对转运至医院的患者和涉及转运创伤投诉和儿科患者(年龄 <18 岁)的病例进行了二次分析。我们纳入了 529,058 次响应(54.8%为女性,平均年龄 57.2 ± 24.7 岁)。在我们的多变量模型中,响应与(IRR,95%CI)雨(1.10,1.08-1.11)雪(1.07,1.05-1.09)以及雨和雪(1.15,1.11-1.19)相关。周末(0.84,0.83-0.85)和夜间(0.62,0.61-0.62)的响应发生率较低。温度每升高 5°C,与各季节的响应增加相关,冬季效应为 1.16(1.15-1.17),夏季效应为 1.31(1.28-1.33)。大风天气与微风(1.10,1.09-1.11)至清风或更大(1.23,1.16-1.30)的响应增加有关。转运的发生模式与响应相似。创伤转运( = 64,235)在周末更常见(1.04,1.02-1.06)。儿科转运( = 21,880)与降水或季节无显著相关性。随着温度升高和降雨及降雪后,EMS 响应增加。这些发现可能有助于 EMS 机构和急诊科进行规划,以确定资源利用率最高的时期。