title: Eight minutes or less: does the ambulance response time guideline impact trauma patient outcome?
abstract: Emergency Medical Services (EMS) agencies are increasingly being held to an ambulance response time (RT) criterion of responding to a medical emergency within 8 min for at least 90% of calls. This recommendation resulted from one study of outcome after nontraumatic cardiac arrest and has never been studied for any other emergency. This retrospective study evaluates the effect of exceeding the 8 min RT guideline on patient survival for victims of traumatic injury treated by an urban paramedic ambulance EMS system and transported to a single Level I trauma center. Of 3576 patients identified by the hospital trauma registry, 3490 (97.6%) had complete records available. Patients were grouped according to ambulance RT: < or = 8 min (n = 2450) or > 8 min (n = 1040). After controlling for other significant predictors, there was no difference in survival after traumatic injury when the 8 min ambulance RT criteria was exceeded (mortality odds ratio 0.81, 95% CI 0.43-1.52). There was also no significant difference in survival when patients were stratified by injury severity score group. Exceeding the ambulance industry response time criterion of 8 min does not affect patient survival after traumatic injury.
authors.affiliation: Department of Emergency Medicine and Denver Paramedic Division, Denver Health Medical Center, Colorado, USA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Pons
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Markovchick
mesh_terms: D000328:Adult; D000552:Ambulances / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003120:Colorado; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D016896:Treatment Outcome