Study of early warning of accident and emergency departments by ambulance services

Objective-To determine the warning time given to accident and emergency (A& E) departments by the ambulance service before arrival of a critically ill or injured patient. To determine if this could be increased by ambulance pe rsonnel alerting within five minutes of arrival at scene. Methods-Use of computerised ambulance control room data to find key times i n process of attending a critically ill or injured patient. Modelling was u ndertaken with a scenario of the first responder alerting the A&E departmen t Eve minutes after arrival on scene. Results-The average alert warning time was 7 min (range 1-15 min). Mean tim e on scene was 22 min (range 4-59 min). In trauma patients alone, the avera ge alert time was 7 min, range 2-15 min, with an average on scene time of 2 3 min, range 4-53 min. There was a potential earlier alert time averaging 2 5 min (SD 18.6, range 2-59 min) if the alert call was made five minutes aft er arrival on scene. Conclusions-A&E departments could be alerted much earlier by the ambulance service. This would allow staff to be assembled and preparations to be made . Disadvantages may be an increased ((alert rate)) and wastage of staff tim e while waiting the ambulance arrival.