Impact of Acute, Major Infrastructure Failure on Emergency Medical Service Transport Times in Rhode Island

Pre-hospital emergency care depends on reliable infrastructure. On December 11, 2023, the westbound span of the Washington Bridge connecting eastern and western Rhode Island (RI) closed emergently due to structural issues. This study examines the impact of sudden infrastructure failure on Emergency Medical Services (EMS) transport in RI.

This retrospective observational study used a Rhode Island Department of Health dataset of 911 EMS calls from December 11, 2023 to December 11, 2024. Response-to-scene time, scene-to-destination time, and hospital destination for six months preceding bridge closure, the four days of full closure, and six months after the closure were compared, with additional comparison for the municipalities most likely to use this bridge (the "East Bay").

911-call volume and distribution did not significantly change. Statewide mean response-to-scene times increased from 4.64 min (SD 3.16) pre-closure to 4.88 min (SD 3.14) (p<.001) following full closure, while scene-to-destination times decreased from 10.57 min (SD 6.84) to 10.04 min (SD 6.64) (p<.001). No significant statewide differences were observed during the full- closure period. The East Bay, however, saw significantly increased scene-to-destination times during full closure and post-closure (17.00 min, SE=6.59; and 15.97 min, SE=7.04, compared to 14.97 min, SE=6.75 pre-closure, p<.001). Response-to-scene times in the East Bay did not significantly change. East Bay EMS decreased the use of general adult hospitals requiring travel over this bridge without significant difference in transport to specialty hospitals.

This study demonstrates that major infrastructure failures significantly affect ambulance transport times and destination patterns, highlighting the need to understand infrastructure vulnerability in emergency planning.