Planning for emergency ambulance service systems

Emergency Ambulance Utilization in Harlem, New York (July 1985)

Emergency ambulance service in Harlem, New York was studied to determine the degree to which misuse exists. Data was collected prospectively from a paramedic (ALS) ambulance and a basic life support (BLS) ambulance dispatched from Harlem Hospital. The results show that only 29.5% of the 136 calls dispatched to the ALS unit had congruent dispatch and actual priorities (r = 0.05), and only 59.6% of the 255 calls handled by both units were recommended for the unit with the proper level of the skill. 69.9% of calls assigned to the ALS unit were found not to need emergency transport (ET), the most common reason being the "unfounded" call, which represented 35.3% of the sample. ALS intervention was needed on only 20.6% of calls dispatched to the ALS unit. Paramedics were able to correctly access the need for ET 95.6% of the time, but were only willing to refuse transport 35.2% of times in which they felt it was unnecessary. Within the population studied, there exists a significant subset of non-emergency calls which could be more efficiently triaged, both at the level of dispatch and by EMS personnel on the scene.

Resource allocation in multifacility emergency medical service systems

As instruments of public policy, Emergency Medical Service Systems must not only make effective use of the available resources but also ensure that those resources are shared equitably by the systems' facilities. This paper develops a multifacility EMS system resource allocation model that enables its user to evaluate the equitability of resource allocation schemes. Recognizing and objectively defining the relationships between the consumption of system resources and the provision of EMS System services, this model is appropriate for use in both prospective and retrospective EMS System resource allocation analyses.

Cellular telephone communication between hospitals and ambulances

Cellular telephones provide a new means of wireless telephone communication. In an experimental design study comparing the clarity of receiving and transmitting communications with cellular telephones versus conventional emergency medical radio/microwave equipment, cellular telephones proved to be superior in all aspects of clarity and ease. Cellular telephones have numerous cost and equipment advantages over radio equipment and should replace conventional radio/microwave equipment for emergency medical communication in areas where reliable cellular telephone networks are available. This will improve an important facet of prehospital emergency care.