{"title":"Time savings associated with lights and siren use by ambulances: a scoping review","authors":"Aditya C. Shekhar, Jeffrey Clement","doi":"10.1108/ijes-01-2022-0003","DOIUrl":"https://doi.org/10.1108/ijes-01-2022-0003","url":null,"abstract":"PurposeMany studies have suggested the use of lights and siren by ambulances has the potential to save time, which can be clinically beneficial for certain patients. However, other studies suggest lights and siren use increases an emergency vehicle’s crash risk. In the absence of a comprehensive multi-center trial, a meta-analysis of prior studies can offer insight into this topic. Thus, we conducted a meta-analysis to evaluate the extent to which the use of lights and siren decreases response and transport times nationally.Design/methodology/approachWe searched PUBMED, EBSCO Academic Search Ultimate, Google Scholar and the premier EMS journals for potential articles identifying time savings associated with lights and siren use and augmented the search results with other relevant studies. Studies were included if they compared time involved with driving a given route using lights and siren with the time required to drive the same route without lights and siren.FindingsNine studies were included. Across these studies, lights and siren use was associated with a weighted average time savings of 159 s or 2.7 min (95% CI: 100–219 s, p < 0.0001).Originality/valueOur analysis of the previously-published literature reveals that lights and siren use is associated with time savings across geographies; however, the precise difference may only be beneficial to certain patients. Most studies are small and relatively dated, so individual EMS systems ought to study their specific geography to inform policies that maximize the beneficial impact of lights and siren use and minimize unnecessary risk.","PeriodicalId":502507,"journal":{"name":"International Journal of Emergency Services","volume":"115 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mike Brady, M. C. Fivaz, Peter Noblett, Greg Scott, C. Olola
{"title":"999 telephone triage: a comparison of UK ambulance nurse and paramedic case mix, outcomes and audit compliance","authors":"Mike Brady, M. C. Fivaz, Peter Noblett, Greg Scott, C. Olola","doi":"10.1108/ijes-08-2023-0033","DOIUrl":"https://doi.org/10.1108/ijes-08-2023-0033","url":null,"abstract":"PurposeMost UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.Design/methodology/approachThe retrospective descriptive study analysed data collected at Welsh Ambulance Services University NHS Trust (WAST) from prioritisation, triage, and audit tools between the 17th May 2022 to 8th November 2022. A total of 21,076 cases and 728 audits were included for review.FindingsThere was little difference in the type and frequency of the presenting complaints assessed, and clinical outcomes reached in percentage terms. Whilst paramedics had more highly compliant call audits and fewer non-compliant call audits, there was, again, little difference in percentage terms between the two, indicating positive levels of safety across the two professional groups.Research limitations/implicationsThere continues to be a substantial difference between UK paramedics to those in the Middle East, the United States, and some African nations, which may limit the applicability of findings. This study also looked at a six-month window from only one UK service using one type of prioritisation and triage tool. Future research could explore longer periods from multiple services using various tools. It is important to note that this study did not link outcome data with primary, secondary or tertiary care settings. Thus, it is impossible to determine if the level of care aligned closely with the final diagnosis.Practical implicationsThe practical implications of this work include better workforce planning for agencies who have perhaps only employed one type of clinician or a reaffirmation to those who have employed both. The authors suggest that the training and education of both sets of clinicians could remain general in nature, with no overt requirement for specificity based on professional registration alone. Commissioners and stakeholders in the wider health economy should consider ensuring equitable access to alternative pathways for patients assessed by both nurses and paramedics.Social implicationsIt has been posited that UK nurses and paramedics are, by virtue of their consistency in education, skill set, licensure, and general experience, both able to achieve safe and effective remote outcomes in 999 settings. This study provides evidence to support that hypothesis. These results say more about the two professions' ability to work together rather than just the professions themselves. The multidisciplinary team approach is well-established in acute care settings, and is broadly considered to improve communication, coordination decision making, adherence to up-to-date treatment recommendations, and be positive for shared learning and development for younger colleagues.Originality/valueMost UK servi","PeriodicalId":502507,"journal":{"name":"International Journal of Emergency Services","volume":"20 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Taylor, Hulya Francis, John Fielding, Emma Dean
{"title":"A catastrophe theory view of accidental dwelling fire injuries","authors":"M. Taylor, Hulya Francis, John Fielding, Emma Dean","doi":"10.1108/ijes-09-2022-0049","DOIUrl":"https://doi.org/10.1108/ijes-09-2022-0049","url":null,"abstract":"PurposeThe study aims to apply catastrophe theory to the analysis of accidental dwelling fire injuries in terms of age band, gender and contributory factors in order to inform fire prevention activities.Design/methodology/approachThe study employed a case study in a UK Fire and Rescue service concerning analysis of the circumstances of accidental dwelling fire injuries, and the characteristics and behaviours associated with utilising frequency analysis, percentages, ratios and catastrophe theory modelling.FindingsOverall, males were more likely to be injured in an accidental dwelling fire compared to females by a ratio of 1.68 to 1, and those in the age band 50–64 appeared to be at maximum risk. A total of 15.4% of the accidental dwelling fire injuries involved consumption of alcohol or drugs, and 5.9% involved falling asleep.Research limitations/implicationsThe circumstances of accidental dwelling fire injury can be analysed to identify patterns concerning when a catastrophic change relating to ordinary use of domestic objects results in an accidental dwelling fire injury.Practical implicationsA catastrophe theory view can aid the understanding of how ordinary use of domestic objects results in an accidental dwelling fire injury.Social implicationsSince fire injuries have both a social and economic cost, understanding how such fire injuries occur can aid fire prevention through appropriately targeted fire prevention activities.Originality/valueThe study made use of a catastrophe theory view to analyse the circumstances under which accidental dwelling fire injuries occurred using fire injury data from a UK fire and rescue service.","PeriodicalId":502507,"journal":{"name":"International Journal of Emergency Services","volume":"59 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Working principle of agile capabilities for emergency response during cyclones and floods","authors":"Joshin John, Neetha J. Eappen","doi":"10.1108/ijes-01-2023-0002","DOIUrl":"https://doi.org/10.1108/ijes-01-2023-0002","url":null,"abstract":"PurposeThis paper investigates how agile capabilities in humanitarian settings work in combination, and its effects on performance outcome. The study was conducted in the frame of reference of response operations during cyclones and floods, which is considered most complex and with the most widespread impact.Design/methodology/approachA survey-based method was used to collect empirical data on response operations from 131 field officers who were involved in disaster response during cyclones or floods. A partial least square based structural equation model was used to study the path model of interaction of agile capabilities, and their effect on performance outcomes.FindingsThe results show that integration of agile capabilities is important for enhancing effectiveness of humanitarian response. The results indicated a serial mediation effect involving visibility, responsiveness and flexibility capability on the effectiveness of emergency response.Research limitations/implicationsThis research has implications for response units of humanitarian organisations. This includes capacity building for key agile capabilities, integration, supply chain re-configuration and differential positioning of response phase as against preparedness and recovery phases.Originality/valueThis study is unique for the chosen humanitarian setting, which is considered most difficult. The authors demonstrate from empirical evidence the interaction effects of agile capabilities during response phase for cyclones and floods, and their impact. The research insights will help practitioners to configure and position supply chains for better effectiveness during response operations, which have markedly different objectives vis-à-vis other phases or types of humanitarian settings.","PeriodicalId":502507,"journal":{"name":"International Journal of Emergency Services","volume":"25 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139155994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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