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Paramedic response time: does it affect patient survival?

Peter T Pons1, Jason S Haukoos, Whitney Bludworth

  • 1Department of Emergency Medicine, Denver Health Medical Center, CO 80204, USA. peter.pons@dhha.org <peter.pons@dhha.org>

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|July 5, 2005
PubMed
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An 8-minute emergency medical services response time did not improve survival for most patients. However, a 4-minute response time showed a survival benefit for high-risk individuals.

Area of Science:

  • Emergency Medicine
  • Public Health
  • Health Services Research

Background:

  • The 8-minute response time guideline for emergency medical services (EMS) is a marker of care quality.
  • This guideline was established based on cardiac arrest patients and its applicability to unselected patients is not well-studied.

Purpose of the Study:

  • To evaluate the impact of paramedic response time on survival to hospital discharge in a diverse patient population.
  • To control for confounders such as illness severity, age, and gender in the analysis.

Main Methods:

  • Retrospective cohort study of patients transported by paramedics in an urban EMS system.
  • Data included demographics, response/scene/transport times, medical complaint, and survival status.
  • Multivariable logistic regression was used to analyze the relationship between response time and survival.

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Main Results:

  • A survival benefit was observed for response times of 4 minutes or less (OR, 0.70; 95% CI = 0.52 to 0.95).
  • No survival benefit was found for response times within 8 minutes or when modeled continuously.
  • This benefit was specifically noted in patients with intermediate or high mortality risk.

Conclusions:

  • The standard 8-minute EMS response time guideline is not supported by these findings for unselected patients.
  • Faster response times, specifically within 4 minutes, are associated with improved survival for critically ill patients.
  • These results suggest a need to re-evaluate current EMS response time benchmarks.