Response Times of Emergency Medical Services in Ankara over the Last Five Years

Year 2022, Volume: 5 Issue: 1, 1 - 6, 09.03.2022

Burak Bekgöz , Mustafa Akkaya , Merve Bozer Serhat Akçaalan İshak Şan

https://doi.org/10.54996/anatolianjem.1008029

Abstract

Aim: Emergency medical services (EMS) must be delivered continuously and quickly in order to treat patients as soon as possible. The purpose of this study was to assess the activities and response times of the EMS in Ankara over the last five years.

Material and Methods: Database of the Ministry of Health, Emergency Health Automation System (ASOS), was used to obtain data for the past five years (01.01.2015 - 31.12.2019). Reasons and outcomes of the calls, response times, and the number of EMS personnel and ambulances were evaluated in the study.

Results: This study showed that the total number of people who received treatment from EMS in Ankara over the past five years is 2,036,734. The number of cases was 359,686 (mean response time = 7 minutes and 20 seconds) in 2015, 391,057 (mean response time = 6 minutes and 34 seconds) in 2016, 417,155 (mean response time = 6 minutes and 41 seconds) in 2017, 421,452 (mean response time = 6 minutes and 9 seconds) in 2018, and 447,384 (mean response time = 6 minutes and 12 seconds) in 2019. Emergency calls were mostly for medical reasons, followed by health measures, whereas the least common reason of emergency calls was the need for transfer to the morgue.

Conclusion: In the provision of EMS, early intervention can save lives. EMS has a proper coordination system and a continuously increasing number of ambulances and personnel, which provides short EMS response times despite the expanding population and increasing number of cases over the years.

Keywords

Emergency medical services, response time, ambulance

Ankara 112 İl Ambulans ve Çağrı Servisi ’nin Son Beş Yıl İçindeki Vaka Tepki Sürelerinin İncelenmesi

Abstract

Amaç: Acil sağlık hizmetlerinin kesintisiz ve hızlı bir şekilde sunulması hastaların ilk müdahalelerinin en kısa sürede yapılabilmesi için hayati önem taşımaktadır. Bu çalışmada Ankara 112 İl Ambulans Servisi’nin son beş yıl içindeki faaliyetleri ve olaya müdahale sürelerini ayrıca 112 çağrı merkezine yapılan başvuruların incelenmesi amaçlanmıştır.

Gereç ve Yöntemler: Bilgiler Ankara İl Sağlık Müdürlüğü acil sağlık otomasyon sistemi (ASOS) üzerinden geçmişe dönük son beş yıl (01.01.2015 - 31.12.2019) olarak taranmıştır. Çalışmada taranan veriler; acil sağlık hizmetindeki çağrı nedenleri ve sonuçları, ambulans hizmetlerinin vakalara ortalama ulaşım süreleri, acil yardım personeli ve ambulans sayıları olarak belirlenmiştir.

Bulgular: Çalışmamızda; Ankara ilinde son 5 yılda acil sağlık hizmeti sunulan toplam 2.036.734 hasta olduğu görüldü. Veriler incelendiğinde yıllara (2015 – 2019) göre vaka kabul sayıları ve vakalara ortalama ulaşım süreleri sırası ile; 2015: 359.686 vaka ortalama 7 dakika (dk) 20 saniye (sn), 2016: 391.057 vaka ortalama 6 dk 34 sn, 2017: 417.155 vaka 6 dk 41 sn, 2018: 421.452 vaka 6 dk 9 sn, 2019: 447.384 vaka 6 dk 12 sn olduğu görülmüştür. Aramaların nedenlerine bakıldığında ise tarama yılından bağımsız olarak birinci sırada “medikal” ikinci sırada ise “sağlık tedbirleri” gelmekteydi. En son sırada gelen çağrı nedeni ise yine tarama yılından bağımsız olarak sırası ile “ex-morga nakil” olarak belirlenmiştir.

Sonuç: ASH sunumunda vakalara yapılacak erken müdahaleler hayat kurtarıcı olmaktadır. Yıllar içinde artan popülasyon ve vaka sayısına rağmen acil çağrı merkezlerine yapılan yardım çağrıları sonrası benzer sayıda acil yardım ambulansı ve personeli ile uygun bir koordinasyon sistemi sayesinde kısa tepki süreleri içinde vakalara müdahale gerçekleştirebilmektedir.

Keywords

Acil sağlık hizmeti, tepki süresi, ambulans

References

• Terzi O, Sisman A, Canbaz S, Dündar C, Peksen Y. A geographic information system-based analysis of ambulance station coverage area in Samsun, Turkey. Singapore Medical Journal. 2013;54(11).
• Singer M, Donoso P. Assessing an ambulance service with queuing theory. Computers & Operations Research. 2008;35(8):2549-60.
• Burnett RE, Blumenthal JA, Mark DB, Leimberger JD, Califf RM. Distinguishing between early and late responders to symptoms of acute myocardial infarction. The American Journal of Cardiology. 1995;75(15):1019-22.
• Grunau B, Kawano T, Scheuermeyer F, Tallon J, Reynolds J, Besserer F, et al. Early advanced life support attendance is associated with improved survival and neurologic outcomes after non-traumatic out-of-hospital cardiac arrest in a tiered prehospital response system. Resuscitation. 2019;135:137-44.
• Dean D, Wetzel B, White N, Kuppermann N, Wang NE, Haukoos JS, et al. From 9-1-1 call to death. Journal of Trauma and Acute Care Surgery. 2014;76(3):846-53.
• Chen JC, Bullard MJ, Liaw SJ. Ambulance use, misuse, and unmet needs in a developing emergency medical services system. European Journal of Emergency Medicine. 1996;3(2):73-8.
• Hanaki N, Yamashita K, Kunisawa S, Imanaka Y. Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan. BMJ Open. 2016;6(12).
• Blanchard IE, Doig CJ, Hagel BE, Anton AR, Zygun DA, Kortbeek JB, et al. Emergency Medical Services Response Time and Mortality in an Urban Setting. Prehospital Emergency Care. 2012;16(1):142-51.
• Venkatraman C, Odusola AO, Malolan C, Kola-Korolo O, Olaomi O, Idris J, et al. Lagos state ambulance service: a performance evaluation. European Journal of Trauma and Emergency Surgery. 2021;47(5): 1591–98.
• Peleg K, Pliskin JS. A geographic information system simulation model of EMS: reducing ambulance response time. The American Journal of Emergency Medicine. 2004;22(3):164-70.
• Pons PT, Markovchick VJ. Eight minutes or less: does the ambulance response time guideline impact trauma patient outcome? The Journal of Emergency Medicine. 2002;23(1):43-8.
• Byrne JP, Mann NC, Dai M, Mason SA, Karanicolas P, Rizoli S, et al. Association Between Emergency Medical Service Response Time and Motor Vehicle Crash Mortality in the United States. JAMA Surgery. 2019;154(4).
• Monsomboon A, Chantawatsharakorn P, Suksuriyayothin S, Keorochana K, Mukda A, Prapruetkit N, et al. Prevalence of emergency medical service utilisation in patients with out-of-hospital cardiac arrest in Thailand. Emergency Medicine Journal. 2016;33(3):213-7.
• Chen J, Bellomo R, Flabouris A, Hillman K, Assareh H, Ou L. Delayed Emergency Team Calls and Associated Hospital Mortality. Critical Care Medicine. 2015;43(10):2059-65.
• Bingham G, Fossum M, Barratt M, Bucknall T. Clinical review criteria and medical emergency teams: evaluating a two-tier rapid response system. Crit Care Resusc. 2015;17(3):167-73.
• Altintas KH, Bilir N. Ambulance times of Ankara emergency aid and rescue services' ambulance system. Eur J Emerg Med. 2001;8(1):43-50.
• Epidemiology of avoidable delay in the treatment of acute myocardial infarct: study conducted by "GISSI" (Italian Group for the Study of Survival after Myocardial Infarct)]. G Ital Cardiol. 1996;26(7):807-20.
• Cui ER, Beja-Glasser A, Fernandez AR, Grover JM, Mann NC, Patel MD. Emergency Medical Services Time Intervals for Acute Chest Pain in the United States, 2015-2016. Prehosp Emerg Care. 2020;24(4):557-65.
• Henry JA, Reingold AL. Prehospital trauma systems reduce mortality in developing countries: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2012;73(1):261-8.
• Campbell JP, Gridley TS, Muelleman RL. Measuring response intervals in a system with a 911 primary and an emergency medical services secondary public safety answering point. Ann Emerg Med. 1997;29(4):492-6.
• Haddadi M, Sarvar M, Soori H, Ainy E. The Pattern of Pre-hospital Medical Service Delivery in Iran; a Cross Sectional Study. Emerg (Tehran). 2017;5(1):e57.
• Cabral E, Castro WRS, Florentino DRM, Viana DA, Costa Junior JFD, Souza RP, et al. Response time in the emergency services. Systematic review. Acta Cir Bras. 2018;33(12):1110-21.
• Nogueira LC, Jr., Pinto LR, Silva PM. Reducing Emergency Medical Service response time via the reallocation of ambulance bases. Health Care Manag Sci. 2016;19(1):31-42.
• Peacock PJ, Peacock JL, Victor CR, Chazot C. Changes in the emergency workload of the London Ambulance Service between 1989 and 1999. Emerg Med J. 2005;22(1):56-9.
• Kutty S, Jones PG, Karels Q, Joseph N, Spertus JA, Chan PS. Association of Pediatric Medical Emergency Teams With Hospital Mortality. Circulation. 2018;137(1):38-46.
• Silva R, Saraiva M, Cardoso T, Aragao IC. Medical Emergency Team: How do we play when we stay? Characterization of MET actions at the scene. Scand J Trauma Resusc Emerg Med. 2016;24:33.
• Khanizade A, Khorasani-Zavareh D, Khodakarim S, Palesh M. Comparison of pre-hospital emergency services time intervals in patients with heart attack in Arak, Iran. J Inj Violence Res. 2021;13(1).