Emergency Medical Services Response to Motor Vehicle Crashes in Rural Areas (2013) / Chapter Skim
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Pages 7-26
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7 CHAPTER TWO LITERATURE REVIEW (VMT) on public roads occurs in urban areas (1.7 VMT in trillions)
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8 55% of persons killed in rural crashes were unrestrained compared with 50% of those killed in urban crashes. Furthermore, nearly 70% of rural pick-up truck occupants killed in crashes were not wearing seat belts, making it the highest percentage of any passenger vehicle occupants killed among both rural and urban areas (NHTSA 2009)
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9 areas used here. For larger documents, a summary of contents is included as opposed to providing detailed information.
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10 obstructions or system malfunctions, can affect performance and should be considered when deploying GPS guidance. TABLE 3 OVERALL MEAN EMS RESPONSE TIME GROUPED BY MILES TRAVELED With GPS Without GPS EMS Miles Traveled to Scene No.
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11 Many states have similar documents, although they differ in process, capabilities, and operational rules. The South Dakota study identified Arkansas, Idaho, Iowa, Kentucky, Minnesota, Nebraska, New Hampshire, South Carolina, Vermont, and Wyoming as having communications interoperability plans or systems in place for emergency responders (South Dakota Public Safety Communication Council 2007)
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12 TABLE 5 COMPARISON OF SHSPS SHSP EMS Related Descriptions SHSP Described Efforts and Demonstrations Minnesota Focus: Creation of a statewide system to reduce crash response times by improving patient to trauma ward routing practices Improvement on ACN and 911 routing communications and development of rural intersection decision support technologies Alabama Focus: Reducing the time from crash to care by ensuring that trauma patients are transported to an appropriate facility with resources to care for patient injuries Provide crash location through advanced GPS technologies; make efforts toward statewide EMS quality and services coordination and increase consumer education on traffic safety. Improve electronic data and voice Maryland Focus: Improving EMS across a range of technology, process, and program improvement Improve electronic data and voice communications for emergency response and improve resource deployment for EMS response California Focus: Reduce crash-related fatalities by at least 5% from 2004 levels through improvements in EMS system communications, response and safety education Advance technologies for locating crash sites, improving EMS access routes, dispatching, decreasing response times and increasing overall EMS system resources and effectiveness Utah Focus: Review of current systems in order to increase opportunities for crash data use Plans to advance development of technologies to analyze, and distribute crash data in a timely manner across multiple agencies with goals of increasing quality assurance standards Washington Focus: Continued efforts in developing Washington's EMS and Trauma Care System (EMSTC)
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13 other devices, and the ability to enable hospital referrals. Additional challenges to be addressed include EMS picture-taking protocols, flexibility for new features, and paramedic versus emergency department expectations.
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14 records from the initial crash reporting though patient discharge following care. The report The REACT Project: Rural Enhancement on Access and Care for Trauma (Garrison et al.
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15 Combix Corp. created a system that used GPS positioning and vehicle sensors to detect and relay crash data.
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16 minute of a crash are technologically possible and economically feasible, potentially reducing response times by up to an average of 5.8 minutes. In March 1997, NHTSA funded development of the URGENCY 1.0 software package.
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17 mortality during the same time in the control region, and 7% before the discontinuation. • The mortality rate did not change in the control region between the two time periods.
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18 them with 7,854 ambulance records to determine response times categorized by distance of transport. The authors conclude that for distances of greater than 10 miles from scene to care facility, simultaneous dispatched helicopters result in lower overall transport times.
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19 with the range previously established in other studies, the authors reviewed research to compare their values with other estimates for additional lives saved per 100 flights. Table 9 (Table 1 in the original document)
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20 in the review highlighted the importance of HEMS. Several key notes regarding HEMS are -- • Trauma surgeons support that HEMS response to trauma scenes provides life-saving care during the "golden hour" that is over and above care rendered by an Advanced Life Support (ALS)
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21 On-scene time for the en route insertion is statistically less (P < 0.001) , and successful insertion percentage for en route insertion is statistically more (P < 0.05)
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22 Trauma Triage Protocol and the National Unified Goal for Traffic Incident Management. Patient Transportation Paradigms summarizes Engineering and Design Standards for Ambulances, Helicopter EMS Utilization Criteria, and Ground Ambulance Access to Intelligent Transportation Systems (ITS)
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23 sored by FHWA, AASHTO, and NCHRP. The scanning tour focused on Traffic Incident Management (TIM)
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24 safety, and hospital discharge to help communities develop injury prevention programs. • Institutional-level changes.
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25 Statistics regarding injuries and trauma centers across the United States show -- • Approximately 30 million injuries were serious enough to warrant visit to a hospital emergency department. • Of these injured patients, 5.4 million (18%)
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26 • Integrate services to enhance emergency medical capabilities • Provide or improve management and decision-making tools • Provide better education opportunities for rural EMS • Reduce time from injury to appropriate definitive care. These objectives were then supported by 24 individual strategies, categorized as tried (implemented, but not fully evaluated)
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