Improving pre-hospital patient outcomes : deploying rapid response vehicles to ambulance calls

Abstract

Background: Objective: Ambulances are used in pre-hospital care to deliver medical assistance to those who require immediate attention. Rapid response vehicles (RRV) are new to roads when delivering pre-hospital care. The nearest RRV to the scene is dispatched with the ambulance that is dispatched form the ambulance station. Debates exist with regards to the effect of response time in relation to mortality and morbidity of the patient on those who require high priority care, as well as in the case on the usage of ambulance or RRV affects the outcome of the patient. The aim of this dissertation is to systematically review and assess by proposing the following PICO question: “Does the deployment of an RRV in addition to an ambulance reduce response time, morbidity, and mortality, when compared to an ambulance only dispatch for serious emergencies in the pre-hospital setting” Method: Eligibility criteria: Articles that were published in 2011-2021 in English and are peer-reviewed. Literatures that had high priority pre-hospital calls with the use of an ambulance or an RRV. Exclusion criteria: Articles that only focused on less emergency calls and that had fluid deployment ambulance. Articles that were published preprints. Appraisal of the literature: Two critical appraisal tools were used to criticise the literatures. These are the Critical Appraisal Skills Programme (CASP) and strengthening the reporting of observational studies in epidemiology (STROBE). Results: Included studies: Two cohort studies and three cross-sectional studies were employed and appraised. Description of effect: It has been shown that RRV can reduce response time more than the ambulance. With regards to mortality and morbidity, only those who had outside hospital cardiac arrest showed potential effect in relation to response time. However, not all literature provided the necessary data for this dissertation, which makes it inconclusive for the purpose of this dissertation. Discussion: Interpretation: Some studies have shown that the response time that the usage of the RRV impacted the outcome of the patients in high priority calls. However, there is a need for further investigation with regard to response time, and mortality and morbidity.