title: Fuel use in a large, dynamically deployed emergency medical services system.
abstract: BACKGROUND
  Emergency medical services (EMS) systems are a central component of the healthcare system, particularly for older patients. As currently configured, EMS transport is fundamentally petroleum dependent. Petroleum scarcity is an emerging public health concern, particularly for patient transport. Little is known regarding EMS fuel use, potential impacts of scarcity on operations, or strategies to minimize these impacts.
  
  
  OBJECTIVE
  The objective of this study was to characterize the fuel use of a large, urban, hospital-based, dynamically-deployed EMS system, and to identify broad optimization categories to minimize EMS's petroleum dependence.
  
  
  METHODS
  Fuel use was reviewed retrospectively using fuel purchasing and maintenance data from January 2007 through September 2008. Data on unit-hours, call volume, and patient transports also were collected. Data were processed using descriptive statistics.
  
  
  RESULTS
  During the study period, a fleet of 35 diesel ambulances operated for 277,849 unit-hours and traveled 1,902,710 miles. Detailed mileage data were available for 66,527 unit-hours, 23.9% of the sample. Overall, vehicles averaged 6.6.89 (6.71, 7.08) miles per gallon (mpg), 11.5 (10.4, 12.6) miles were travelled per call, and 16.2 (14.8, 17.6) miles per transport; 2.7 (2.4, 2.9) gallons of fuel were used per transport.
  
  
  CONCLUSIONS
  In this EMS system, operations are fundamentally dependent on petroleum. Mileage estimates can serve as a baseline to evaluate interventions for reducing petroleum dependence and in contingency planning. As cost pressures increase and these interventions become more common, systematic evaluations will be important.
authors.affiliation: Department of Emergency Medicine, Emory University, Atlanta, GA, USA. jhess@emory.edu
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Hess
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Greenberg
mesh_terms: D000368:Aged; D000552:Ambulances; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data*; D005742:Gasoline / Q000706:statistics & numerical data; D005845:Georgia; D006299:Health Services for the Aged; D006801:Humans; D012189:Retrospective Studies
chemical_list: D005742:Gasoline