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Prehospital Response Time Delays for Emergency Patients in Events of Concurrent Mass Casualty Incidents

Published online by Cambridge University Press:  19 September 2017

Jungeun Kim
Affiliation:
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
Chu Hyun Kim*
Affiliation:
Department of Emergency Medicine, Inje University College of Medicine and Seoul Paik Hospital, Seoul, Korea
Sang Do Shin
Affiliation:
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
Ju Ok Park
Affiliation:
Department of Emergency Medicine, Hallym University College of Medicine and Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi, Korea
*
Correspondence and reprint requests to Chu Hyun Kim, MD, PhD, Department of Emergency Medicine, Inje University College of Medicine and Seoul Paik Hospital, 85, 2-Ga, Jeo-dong, Jung-Gu, Seoul 100-032, Korea (e-mail: juliannnn@hanmail.net).

Abstract

Objective

We investigated the extent of delays in the response time of emergency medical services (EMS) as an impact of mass casualty incidences (MCIs) in the same area.

Methods

We defined an MCI case as an event that resulted in 6 or more patients being transported by EMS, and prehospital response time as the time from the call to arrival at the scene. We matched patients before and after MCIs by dividing them into categories of 3 hours before, 0-1 hour after, 1-2 hours after, and 2-3 hours after the MCIs. We compared prehospital response times using multiple linear regression.

Results

A total of 33,276 EMS-treated patients were matched. The prehospital response time for the category of 3 hours before the MCIs was 8.8 minutes (SD: 8.2), treated as the reference, whereas that for the category of 0-1 hour after the MCI was 11.3 minutes (P<0.01). The multiple linear regression analysis revealed that prehospital response time increased by 2.5 minutes (95% CI: 2.3-2.8) during the first hour and by 0.3 minutes (95% CI: 0.1-0.6) during the second hour after MCIs.

Conclusion

There were significant delays in the prehospital response time for emergency patients after MCIs, and it lasted for 2 hours as the spillover effect. (Disaster Med Public Health Preparedness. 2018;12:94–100)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

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References

REFERENCES

1. World Health Organization. Mass Casualty Management System: Strategies and Guidelines for Building Health Sector Capacity. Geneva: WHO Press, 2007.Google Scholar
2. Kuisma, M, Hiltunen, T, Maatta, T, et al. Analysis of multiple casualty incidents – a prospective cohort study. Acta Anaesthesiol Scand. 2005;49(10):1527-1533.Google Scholar
3. Yanagida, T, Fujimoto, S, Inoue, T, Suzuki, S. Prehospital delay and stroke-related symptoms. Int Med. 2015;54(2):171-177.Google Scholar
4. De Luca, G, Suryapranata, H, Ottervanger, JP, Antman, EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. Circulation. 2004;109(10):1223-1225.Google Scholar
5. Eisenberg, MS, Bergner, L, Hallstrom, A. Cardiac resuscitation in the community. Importance of rapid provision and implications for program planning. JAMA. 1979;241(18):1905-1907.Google Scholar
6. Park, JO, Shin, SD, Song, KJ, Hong, KJ, Kim, J. Epidemiology of emergency medical services-assessed mass casualty incidents according to causes. J Korean Med Sci. 2016;31(3):449-456.Google Scholar
7. Pretto, EA, Angus, DC, Abrams, JI, et al. An analysis of prehospital mortality in an earthquake. Disaster Reanimatology Study Group. Prehosp Disaster Med. 1994;9(2):107-117.CrossRefGoogle Scholar
8. Nagata, T, Rosborough, SN, VanRooyen, MJ, Kozawa, S, Ukai, T, Nakayama, S. Express railway disaster in Amagasaki: a review of urban disaster response capacity in Japan. Prehosp Disaster Med. 2006;21(5):345-352.Google Scholar
9. Martin, AJ, Lohse, CM, Sztajnkrycer, MD. A descriptive analysis of prehospital response to hazardous materials events. Prehosp Disaster Med. 2015;30(5):466-471. http://dx.doi.org/10.1017/S1049023X1500504X.Google Scholar
10. Schenk, E, Wijetunge, G, Mann, NC, Lerner, EB, Longthorne, A, Dawson, D. Epidemiology of mass casualty incidents in the United States. Prehosp Emerg Care. 2014;18(3):408-416.CrossRefGoogle ScholarPubMed
11. Abir, M, Choi, H, Cooke, CR, Wang, SC, Davis, MM. Effect of a mass casualty incident: clinical outcomes and hospital charges for casualty patients versus concurrent inpatients. Acad Emerg Med. 2012;19(3):280-286.Google Scholar
12. Ministry of Land, Infrastructure, and Transport Korea. The Annual Report of Land Register, 2013.Google Scholar
13. Ro, YS, Shin, SD, Song, KJ, et al. A trend in epidemiology and outcomes of out-of-hospital cardiac arrest by urbanization level: a nationwide observational study from 2006 to 2010 in South Korea. Resuscitation. 2013;84(5):547-557.Google Scholar
14. Kim, SJ, Kim, CH, Shin, SD, Lee, SC, Park, JO, Sung, J. Incidence and mortality rates of disasters and mass casualty incidents in Korea: a population-based cross-sectional study, 2000-2009. J Korean Med Sci. 2013;28(5):658-666.CrossRefGoogle ScholarPubMed
15. Ahn, KO, Shin, SD, Suh, GJ, et al. Epidemiology and outcomes from non-traumatic out-of-hospital cardiac arrest in Korea: a nationwide observational study. Resuscitation. 2010;81(8):974-981.Google Scholar
16. Lee, G. Analysis of EMS appropriateness survey in Korea. National Emergency Management Agency, 2013.Google Scholar
17. Kim, CH, Park, JO, Park, CB, Kim, SC, Kim, SJ, Hong, KJ. Scientific framework for research on disaster and mass casualty incident in Korea: building consensus using Delphi method. J Korean Med Sci. 2014;29(1):122-128.Google Scholar