Riddle Terry J, Lane Melinda, Fair Robert, Bryant Raylon, Bertrand Skipper, Northeim Justin, Northeim Kari
Emergency Medical Services (EMS), Parker County Hospital District, Weatherford, USA.
Medical Direction, Emergency Medicine, Beacon Emergency Services Team Emergency Medical Services (BEST EMS), Grapevine, USA.
Cureus. 2024 Sep 26;16(9):e70257. doi: 10.7759/cureus.70257. eCollection 2024 Sep.
Objective Activation of emergency medical services (EMS) through radio dispatching in the United States of America is the established first component in the link of the Chain of Survival. However, little is known about how auditory dispatch alerts operationally aid in the recognition and physical response of priority dispatch communications. This research aims to determine if a modification in radio alerting procedures will elicit a reduction in chute times for first responders. Methods This study uses a retrospective pre-post design evaluating the impact on reaction times to cardiac arrest priority p-tones in a semi-urban/rural area. Data were collected by comparing a period of six months before and 10 months after the implementation of a system that replaced p-tones with digitized human speech notifications. The analysis of continuous data to determine statistical significance in response times (global positioning system (GPS)-measured) was conducted using the Student's t-test. For data normalization, Box-Cox transformations were utilized. The interpretation of control charts was used to assess process stability and evaluate the outcomes. Results Of the 16 months of continuous data and 137 case response times for priority alarms, the average response time (GPS-measured) was 29.3 seconds (M = 29.375, SD = 19.69), well below the system target time of 60 seconds. Results of the paired sample t-test show that the mean time did not differ before treatment (M = 27.86, SD = 27.213) and after treatment (M = 30.88, SD = 27.872) at the 0.05 level of significance, t(65) =.802, n = 65, p<.425. 95% CI for the mean difference: -5.384 - 12.617, r =.032. Process control charts indicated a slight reduction in the process efficiency. A secondary finding indicated that radio utilization time was reduced by five seconds due to the intervention. Conclusion Response times for EMS, including the characteristics of the priority p-tone and speech influence, are understudied. This case study introduced a methodology for designing chute time process improvement interventions. Process stability charts bring increased opportunities to measure and manage response times in EMS.
目的 通过美国无线电调度激活紧急医疗服务（EMS）是生存链环节中既定的首要组成部分。然而，关于听觉调度警报在操作上如何协助识别优先调度通信并做出身体反应，人们知之甚少。本研究旨在确定无线电警报程序的修改是否会使急救人员的降落时间缩短。方法 本研究采用回顾性前后设计，评估对半城市/农村地区心脏骤停优先音调的反应时间的影响。通过比较实施将音调替换为数字化语音通知系统之前的六个月和之后的十个月来收集数据。使用学生t检验对连续数据进行分析，以确定反应时间（通过全球定位系统（GPS）测量）的统计显著性。为了进行数据归一化，采用了Box-Cox变换。使用控制图的解释来评估过程稳定性并评估结果。结果 在16个月的连续数据和137例优先警报的病例反应时间中，平均反应时间（通过GPS测量）为29.3秒（M = 29.375，SD = 19.69），远低于系统目标时间60秒。配对样本t检验的结果表明，在0.05的显著性水平下，治疗前（M = 27.86，SD = 27.213）和治疗后（M = 30.88，SD = 27.872）的平均时间没有差异，t（65）= 0.802，n = 65，p < 0.425。平均差异的95%置信区间：-5.384 - 12.617，r = 0.032。过程控制图表明过程效率略有降低。一个次要发现表明，由于干预，无线电使用时间减少了5秒。结论 对EMS的反应时间，包括优先音调的特征和语音影响，研究不足。本案例研究介绍了一种设计降落时间过程改进干预措施的方法。过程稳定性图为测量和管理EMS中的反应时间带来了更多机会。
