• Richard P Gonzalez, Glenn R Cummings, Shanna M Harlan, Maduri S Mulekar, and Charles B Rodning.
• Department of Surgery, Center for the Study of Rural Vehicular Trauma, University of South Alabama, Mobile, Alabama, USA. rgonzalez@usouthal.edu
• J Trauma. 2011 Oct 1;71(4):1023-6.

ObjectiveTo assess whether repositioning of ambulance stations in a rural county of Alabama can improve emergency medical services (EMS) response time to motor vehicle crashes (MVCs) without adversely affecting response time to non-MVC-related emergencies.MethodsUsing geographical information system software, locations of MVCs during a 9-month period in a rural county of Alabama were plotted on a map. A single ambulance station provided EMS for the entire county. Based on the number of ambulances serving the county and concentrated areas of MVCs, the county was geographically divided into two regions. A new ambulance station was assigned to each region based on high MVC concentrations and access to a major thoroughfare. The number of ambulances in-service did not change. Following establishment of both ambulance stations (redeployment), data were prospectively collected for EMS miles to scene, EMS time to scene, fatalities, and type of call (MVC vs. non-MVC) during a 9-month period (January 2006 to September 2006). The prospective data were compared with historical data (non-redeployment) from a similar time period (January 2005 to September 2005).ResultsDuring the redeployment period, 597 EMS calls were documented, 106 (17.8%) of which were MVCs. In all, 764 EMS calls were documented before the redeployment period, 62 (8.1%) of which were MVCs. During the redeployment period, the mean miles EMS traveled to an MVC scene was 8.6 miles versus 10.7 miles before redeployment (p=0.038). The mean time to an MVC scene was 8.0 minutes during redeployment versus 9.5 minutes before redeployment (p=0.03). During the redeployment period, the mean time to non-MVC emergencies was 8.6 minutes versus 9.2 minutes during the period before redeployment (p=0.27).ConclusionsUtilizing geographical information system software, EMS response time to MVCs could be improved in rural areas by optimal location of ambulance stations based on geographical highest concentration of MVCs and vicinity of major thoroughfares. This can be accomplished without adversely affecting response time to non-MVC-related emergencies.

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