The association of crash response times and deaths at the crash scene: A cross‐sectional analysis using the 2019 National Emergency Medical Service Information System

• Published in: The Journal of rural health Vol. 38; no. 4; pp. 1011 - 1024
• Main Authors: Adeyemi, Oluwaseun J., Paul, Rajib, DiMaggio, Charles, Delmelle, Eric, Arif, Ahmed
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-09-2022; John Wiley and Sons Inc
• Subjects: Accidents, Traffic; Crash Fatalities; crash response time; Cross-Sectional Studies; deaths at the crash scene; Emergency Medical Services; Emergency services; EMS travel time; Fatalities; Health services; Humans; Information services; Information Systems; Original; Reaction Time; Regions; Response time; Rural areas; Rural health care; Rurality; rurality/urbanicity; rush hour; Substance abuse; Substance use; Trauma; Travel time; Urban areas; deaths at the crash scene; rurality/urbanicity; crash response time; rush hour; EMS travel time
• ISSN: 0890-765X; 1748-0361
• DOI: 10.1111/jrh.12666

Background
Deaths at the crash scene (DAS) are crash deaths that occur within minutes after a crash. Rapid crash responses may reduce the occurrence of DAS.
Objectives
This study aims to assess the association of crash response time and DAS during the rush and nonrush hour periods by rurality/urbanicity.
Method
This single‐year cross‐sectional study used the 2019 National Emergency Medical Services (EMS) Information System. The outcome variable was DAS. The predictor variables were crash response measures: EMS Chute Initiation Time (ECIT) and EMS Travel Time (ETT). Age, gender, substance use, region of the body injured, and the revised trauma score were used as potential confounders. Logistic regression was used to assess the unadjusted and adjusted odds of DAS.
Results
A total of 654,675 persons were involved in EMS‐activated road crash events, with 49.6% of the population exposed to crash events during the rush hour period. A total of 2,051 persons died at the crash scene. Compared to the baseline of less than 1 minute, ECIT ranging from 1 to 5 minutes was significantly associated with 58% (95% CI: 1.45‐1.73) increased odds of DAS. Also, when compared to the baseline of less than 9 minutes, ETT ranging between 9 and 18 minutes was associated with 34% (95% CI: 1.22‐1.47) increased odds of DAS. These patterns were consistent during the rush and nonrush hour periods and across rural and urban regions.
Conclusion
Reducing crash response times may reduce the occurrence of DAS.