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Does Ambulance Crew Size Affect On-Scene Time or Number of Prehospital Interventions?

  • Lawrence H. Brown (a1), Charles F. Owens (a2), Juan A. March (a1) (a3) and Elizabeth A. Archino (a3)
Abstract
Introduction:

While large cities typically staff ambulances with two emergency medical services (EMS) professionals, some EMS agencies use three people for ambulance crews. The Greenville, North Carolina, EMS agency converted from three-person to two-person EMS crews in July 1993. There are no published reports investigating the best crew size for out-of-hospital emergency care.

Hypothesis:

Two-person EMS crews perform the same number and types of interventions as three-person EMS crews. Two-person EMS crews do not have longer on-scene times than do three-person EMS crews.

Methods:

Data for the two most common advanced life support calls in this system—seizures and chest pains—were collected for the months of June and August 1993. Three-person EMS crews responded to both types of calls in June. In August, two-person EMS crews responded to seizure calls; two-person EMS crews accompanied by a fire department engine (pumper) with additional manpower responded to chest pain calk. The frequency of specific interventions, number of total interventions, and scene times for the August calls were compared to their historical control groups, the June calls.

Results:

One hundred twenty-six patient contacts were included in the study. There were no significant differences in total number or types of procedures performed for the two patient groups. Mean on-scene time for patients with seizures was 11.0±4.2 minutes for three-person crews and 19.4±8.3 minutes for two-person crews (p <0.001). Mean on-scene time for patients with chest pain was 13.6±4.9 minutes for three-person crews, and 15.4±3.2 minutes for two-person crews assisted by fire department personnel (p >0.05).

Conclusion:

Two-person EMS crews perform the same number of procedures as do three-person EMS crews. However, without the assistance of additional responders, two-person EMS crews may have statistically significantly longer onscene times than three-person EMS crews.

Copyright
Corresponding author
East Carolina, University School of Medicine, Department of Emergency Medicine, Division of Emergency Medical Services, Building M, Physicians' Quadrangle, Greenville, NC 27858, USA
References
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1. Staff: EMS providers in America's 200 most populous cities. Journal of Emergency Medical Services 1994;19:101112.
2. Pollock, MJ, Prasad, NH, Perkins, PK: Pitt County EMS Protocols, 4th rev. Greenville, N.C.: East Carolina University School of Medicine, Division of Emergency Medical Services, 1992, pp 32, 36.
3. SAS Institute Inc., SAS/STAT User's Guide, Version 6. 4th ed. Cary, N.C.: SAS Institute Inc., 1989. pp 13261339, 1633-1640.
4. McCloskey, KA, King, WD, Byron, L: Pediatric critical care transport: Is a physician always needed on the team? Ann Emerg Med 1989;18:247249.
5. Baxt, WG, Moody, P: The impact of a physician as part of the aeromedical prehospital team in patients with blunt trauma. JAMA 1987:257:32463250.
6. Hamman, BL, Cue, JI, Miller, FB, et al. : Helicopter transport of trauma victims: Does a physician make a difference? J Trauma 1991;31:490494.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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