Thompson Valley EMS

The most costly product in EMS is the delivery of response time performance. Units have to be staffed in order to respond quickly—even if no calls occur.  The “Cost of readiness”.

Response time performance has been used as an indicator of ambulance service quality for many years. The standards are usually applied to all calls regardless of clinical urgency. However, the rationale for using response time as a performance standard is based in research evidence on the relationship between time and patient outcome for very specific clinical conditions, predominately out of hospital cardiac arrest. Many of these research studies were conducted before the advent of BLS automated defibrillators (AEDs) when defibrillation was an ALS procedure.

Contemporary studies in the US found overall, rapid response in terms of an 8 minute target makes no discernible difference to survival to discharge. Nevertheless, we also know there are benefits – for the survival of a small number of out-of-hospital cardiac arrests, and in the short term in reducing levels of anxiety, pain and distress. Thus for a given level of resources, response times clearly need to be minimized.

TVEMS also uses dispatch call prioritization according to the urgency and seriousness of the patient’s condition on the assumption that a faster response to life-threatening emergencies could lead to an increase in the number of lives saved.

Armed with this new information, “prioritized” response times are gaining acceptance and could be defined in a manner below:

• Category 1 - Life-threatening emergencies of which 90% should be responded to within 9 minutes
• Category 2 - Serious conditions which should be responded to within 15 minutes
• Category 3 - An unspecified but appropriate response for calls with no immediate clinical need