title: Factors related to prolonged on-scene time during ambulance transportation for critical emergency patients in a big city in Japan: a population-based observational study.
abstract: OBJECTIVE
  We aimed to investigate the factors related to prolonged on-scene times, which were defined as being over 30 min, during ambulance transportation for critical emergency patients in the context of a large Japanese city.
  
  
  METHODS
  A population-based observational study.
  
  
  METHODS
  Kawasaki City, Japan's eighth largest city.
  
  
  METHODS
  The participants in this study were all critical patients (age ≥ 15 years) who were transported by ambulance between April 2010 and March 2013 (N=11,585).
  
  
  METHODS
  On-scene time during ambulance transportation for critical emergency patients.
  
  
  RESULTS
  The median on-scene time for all patients was 17 min (IQR 13-23). There was a strong correlation between on-scene time and the number of phone calls to hospitals from emergency medical service (EMS) personnel (p<0.001). In multivariable logistic regression, the number of phone calls to hospitals from EMS personnel, intoxication, minor disease and geographical area were associated with on-scene times over 30 min. Age, gender, day of the week and time of the day were not associated with on-scene times over 30 min.
  
  
  CONCLUSIONS
  To make on-scene time shorter, it is vital to redesign our emergency system and important to develop a system that accommodates critical patients with intoxication and minor disease, and furthermore to reduce the number of phone calls to hospitals from EMS personnel.
authors.affiliation: Graduate School of Comprehensive Human Sciences, Majors of Medical Sciences, University of Tsukuba, Tsukuba, Japan Department of Critical Care Medicine, Yokohama City Minato Red Cross Hospital, Yokohama, Japan Graduate School of Public Health, Teikyo University, Tokyo, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Nagata
authors.affiliation: Department of Emergency and Critical Care Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Abe
authors.affiliation: Graduate School of Public Health, Teikyo University, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nakata
authors.affiliation: Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Nanako
authors.initials: N
authors.lastname: Tamiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D002947:Cities; D003422:Critical Care / Q000592:standards*; D016638:Critical Illness / Q000628:therapy*; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult
keywords: ACCIDENT & EMERGENCY MEDICINE; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PUBLIC HEALTH