VCU news

By Mike Porter

The right mix of Emergency Medical Service resources -- and proper management of those resources -- is important in improving response times and saving the lives of cardiac arrest patients, according to a Virginia Commonwealth University researcher.

In the research, Laura A. McLay, Ph.D., an assistant professor in the Department of Statistical Sciences & Operations Research, uses discrete optimization models to determine how best to stage ambulances and employees in a way that saves the most lives.

McLay, whose research was published in the August 2009 issue of the journal IIE Transactions, consulted with the medical community, including with Joseph Ornato, M.D., chair of VCU’s Department of Emergency Medicine, who is also the medical director of the Richmond Ambulance Authority and operational medical director of Hanover Fire and EMS.

McLay examined the role of transportation in reducing response time intervals, and her research challenges the traditional approach to EMS management that bases units at fixed locations like fire houses. Her research focused on staging resources so that the first responder can be dispatched to patients in a way that saves the most lives. 

As part of her approach, McLay examined how non-traditional resources can be dispatched to patients in order to supplement ambulances. This includes the use of medically equipped Sport Utility Vehicles, called quick response vehicles, which can be dispatched to stabilize a patient until an ambulance arrives.

The research also considered differences between paramedics and emergency medical technicians and determined that while paramedics have more training and ideally should respond to the highest priority life-threatening calls, emergency medical technicians can play an equally important role as first responders in helping departments meet performance standards. 

“The medical community illustrates that it doesn’t really matter who gets to the scene first, just as long as somebody gets there with the right equipment and skills,” McLay said. “There is essentially, in practice, no practical difference between an EMT and a paramedic in the first couple of minutes of treating a cardiac arrest victim.
 
“So we cast this model through the lens of the first responder and determined how to locate ambulances optimally to have the biggest impact on response time,” McLay said. “Additionally, in this study, we also looked at the impact of having QRV’s, quick response vehicles, for responding to patients.”

McLay said the mathematical and analytical models she employed to reduce EMS response times in Virginia’s Hanover County can be employed nationwide, particularly in suburban and rural regions.

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