Abstract
Purpose :
Timely access to medical care for open globe injuries (OGIs) may improve clinical outcomes. The purpose of this study was to describe emergency medical services (EMS) response and scene times for OGIs.
Methods :
A retrospective analysis was performed using 2017–2021 data from the National EMS Information System. Characteristics of EMS activations for OGI cases at primary impression were recorded including: age, sex, day of week, time of day, response mode to scene, region, and urbanicity. Multivariable binary logistic regression measured significant predictors of meeting the “8-minute response time” and “15-minute scene time”, the EMS benchmarks.
Results :
Our study identified 89,038 eligible EMS activations for OGI. Most encounters involved males (55%), were emergent responses to the scene (lights and sirens) (85%), and were in urban areas (80%). EMS encounters for older age groups relative to the 1-15 years age group were significantly more likely to meet the 8-minute response time (OR=1.282, 95%CI=1.185–1.388) but less likely to meet the 15-minute scene time benchmark (OR=0.603, 95%CI=0.592–0.646). Emergent response to the scene was associated with greater adherence to the 8-minute (OR=1.811, 95%CI=1.737–1.888) but not the 15-minute (OR=0.923, 95%CI=0.887–0.962) benchmark. EMS response times in the Midwest compared to the West were significantly more likely to meet benchmark times (OR=1.369, 95%CI=1.296–1.446) while the South was less likely to meet the 8-minute response time (OR=0.705, 95%CI=0.672–0.739). Furthermore, response times in rural (OR=0.784, 95%CI=0.732–0.841) regions vs the urban areas were significantly less likely to meet response time benchmarks. EMS encounters with female patients relative to males were significantly less likely to meet the 15-minute scene time benchmark (OR=0.856, 95%CI=0.833–0.880).
Conclusions :
Our findings suggest regional and demographic disparities exist in ambulatory response and scene times for severe ocular injuries. This is especially true for those who are older adults, females, and those located in the wilderness or rural areas. Future investigations should continue to highlight barriers to accessibility of care for medical emergencies such as ocular trauma.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.