Academic Journal
Using geographic information systems (GIS) to assess response intervals for diffuse community bystander-driven (Tier-1) emergency medical services integrated with emergency medical dispatch in Tanzania: an 8-year analysis.
| Τίτλος: | Using geographic information systems (GIS) to assess response intervals for diffuse community bystander-driven (Tier-1) emergency medical services integrated with emergency medical dispatch in Tanzania: an 8-year analysis. |
|---|---|
| Συγγραφείς: | Delaney PG; Cleveland Clinic, Cleveland, OH USA. Electronic address: delanep@ccf.org., Eisner ZJ; University of Michigan Medical School, Ann Arbor, MI USA., Pine H; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA., Friesen J; Trek Medics International, Mwanza, Tanzania., Raghavendran K; University of Michigan Medical School, Ann Arbor, MI USA., Patterson B; Cleveland Clinic, Cleveland, OH USA., Vallier H; Cleveland Clinic, Cleveland, OH USA., Piuzzi NS; Cleveland Clinic, Cleveland, OH USA., Hingi M; Tanzania Rural Health Movement, Mwanza, Tanzania. |
| Πηγή: | Injury [Injury] 2026 May; Vol. 57 (5), pp. 112910. Date of Electronic Publication: 2025 Nov 26. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0226040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0267 (Electronic) Linking ISSN: 00201383 NLM ISO Abbreviation: Injury Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2002->: Amsterdam : Elsevier Original Publication: Bristol, Wright. |
| Ιατρικοί όροι (MeSH): | Emergency Medical Services*/organization & administration , Emergency Medical Dispatch*/organization & administration , Geographic Information Systems* , Emergency Medical Service Communication Systems*, Tanzania/epidemiology ; Humans ; Triage ; Ambulances ; Male ; Female |
| Περίληψη: | Introduction: The global trauma burden disproportionately affects low- and middle-income countries(LMICs), which lack robust emergency medical services(EMS). The Global Prehospital Consortium determined Tier-1 EMS response intervals are a priority for investigation. On-scene response intervals for professional ambulance-driven Tier-2 EMS vary by density of centralized ambulance dispatch sites per population, requiring costly infrastructure to improve response times. Community bystander-driven (Tier-1) systems are less costly with diffuse and non-centrally dispatched responders. Therefore, we hypothesized Tier-1 EMS response intervals to emergencies are not distance-related, due to the inherent diffusion of Tier-1 responders. Methods: In 2016, Tanzania Rural Health Movement launched a Tier-1 lay first responder(LFR) program in Tanzania integrated with Beacon, a mobile emergency medical dispatch(EMD) platform. LFRs were provided with a two-day training course. Chief complaints, diurnal emergency variation, and response/triage/encounter intervals were prospectively recorded for analysis. GIS software (ArcGIS Pro 2.8) evaluated encounter latitude/longitude and distance from Mwanza city center, compared with response interval, using a logarithmic distribution for correlational analysis. Results: 1273 entries were prospectively catalogued (2017-2024). 60 encounters lacked ≥67 % data compliance, 136 lacked GPS coordinates, and 89 geographic/time outliers were excluded, leaving 988 encounters for analysis (77.6 %). Of chief complaints, 81.0 % were road traffic injury-related. Median dispatch to on-scene arrival interval = 1 minute 4 seconds (IQR:36s-5m9s) and median on-scene arrival to triage decision interval = 1 minute 2 seconds (IQR:37s-2m32s) (n = 988). There was no correlation between log (response time interval) and log (distance from Mwanza center) (r = 0.028, p = 0.380) (n = 1012). Conclusions: In this community-based EMS model, response times were rapid and not associated with geographic distance, highlighting the effectiveness of decentralized Tier-1 systems when combined with mobile dispatch technology. These findings support the scalability of low-cost, bystander-driven EMS networks in LMICs without reliance on traditional costly dispatch infrastructure, offering a promising strategy to address the global trauma burden. (Copyright © 2025 Elsevier Ltd. All rights reserved.) |
| Competing Interests: | Declaration of competing interest Jason Friesen - Founder of Trek Medics International, which developed Beacon Dispatch software Nicolas Santiago Piuzzi - The Journal of Bone and Joint Surgery, Executive Editor: Type: Editorial or governing board - Journal of Knee Surgery, Associate Editor: Type: Editorial or governing board - Osteal Therapeutics: Type: Stock Option Zimmer Biomet Holdings, Inc.: Type: Other Professional Activities - Ethicon Endo-Surgery: Type: Other Professional Activities - Stryker Corporation: Type: Other Professional Activities - Pacira Pharmaceuticals Incorporated: Type: Other Professional Activities. Other authors have no conflicts of interest to declare. |
| Contributed Indexing: | Keywords: Emergency medical services; First responders; Tanzania; Trauma |
| Entry Date(s): | Date Created: 20251130 Date Completed: 20260430 Latest Revision: 20260430 |
| Update Code: | 20260501 |
| DOI: | 10.1016/j.injury.2025.112910 |
| PMID: | 41320615 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1879-0267 |
|---|---|
| DOI: | 10.1016/j.injury.2025.112910 |