Related Experiment Video
Updated: Oct 2, 2025
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Effect of Designating Emergency Medical Centers for Critical Care on Emergency Medical Service Systems during the
Hang A Park1, Sola Kim1, Sang Ook Ha2
1Department of Emergency Medicine, Dongtan Sacred Heart Hospital, Hwaseong-si 18450, Korea.
Insights
Designating emergency medical centers for critical care during COVID-19 reduced ambulance diversion rates. However, this intervention also significantly increased prehospital times for critically ill patients.
Area of Science:
- Emergency Medicine
- Public Health Policy
- Health Systems Research
Background:
- The COVID-19 pandemic significantly disrupted prehospital care, leading to delays for critically ill patients.
- Timely hospital arrival is crucial for effective treatment of emergent conditions.
- The Korean government implemented designated emergency medical centers for critical care (EMC-CC) in March 2020 to mitigate pandemic-related delays.
Purpose of the Study:
- To evaluate the effectiveness of designated EMC-CC in reducing ambulance diversion (AD) and prehospital times.
- To analyze the impact of the EMC-CC intervention on patient transport distances and overall prehospital durations.
Main Methods:
- Retrospective analysis of emergency medical service records for 219,763 non-traumatic patients (≥18 years) in Gyeonggi Province, South Korea (January 1-December 31, 2020).
- Interrupted time series analysis to assess changes in daily AD rates and prehospital times before and after the EMC-CC designation.
- Comparison of patient transport distances pre- and post-intervention.
Main Results:
- The proportion of patients transported longer distances (30-35 km and ≥50 km) increased post-intervention.
- While the overall change in AD rate was not significant, the daily AD rate significantly decreased following the EMC-CC designation.
- Prehospital times significantly increased for all patients (p < 0.001) and across most disease groups, with the exception of scene time for cardiac arrest patients.
Conclusions:
- The EMC-CC designation led to a significant reduction in daily ambulance diversion rates but paradoxically increased prehospital times.
- Increased transport distances suggest a potential redistribution of patient flow, impacting overall time to treatment.
- Regional distribution of EMC-CC and prioritizing care for less severe conditions may be necessary to optimize treatment times during healthcare system strain, such as pandemics.
Abstract:
During the coronavirus disease 2019 (COVID-19) pandemic, prehospital times were delayed for patients who needed to arrive at the hospital in a timely manner to receive treatment. To address this, in March 2020, the Korean government designated emergency medical centers for critical care (EMC-CC). This study retrospectively analyzed whether this intervention effectively reduced ambulance diversion (AD) and shortened prehospital times using emergency medical service records from 219,763 patients from the Gyeonggi Province, collected between 1 January and 31 December 2020. We included non-traumatic patients aged 18 years or older. We used interrupted time series analysis to investigate the intervention effects on the daily AD rate and compared prehospital times before and after the intervention. Following the intervention, the proportion of patients transported 30-35 km and 50 km or more was 13.8% and 5.7%, respectively, indicating an increased distance compared to before the intervention. Although the change in the AD rate was insignificant, the daily AD rate significantly decreased after the intervention. Prehospital times significantly increased after the intervention in all patients (p < 0.001) and by disease group; all prehospital times except for the scene time of cardiac arrest patients increased. In order to achieve optimal treatment times for critically ill patients in a situation that pushes the limits of the medical system, such as the COVID-19 pandemic, even regional distribution of EMC-CC may be necessary, and priority should be given to the allocation of care for patients with mild symptoms.
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
06:59A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Related Concept Videos
01:23Cardiopulmonary Resuscitation III: AED Use
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Introduction Cardiac Emergencies