ems in tainan city - scri - singapore clinical research … in tainan city chih-hao lin, m.d. taiwan...
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EMS in Tainan City
Chih-Hao Lin, M.D. Taiwan
Emergency Department, National Cheng Kung University Hospital
Medical Director, Fire Bureau of Tainan City
Deputy Manager, South branch of Medical Emergency Operation Center
Introduction of Taiwan
Population: 23 Million (2008)
Area: 36,000 km2
Population Density
Number of Fire Stations
and Public Ambulances in Taiwan
EMT Numbers and Training Levels in Taiwan
Grouping of Medical Resource and
Geography CharacteristicsBy Frank Fuh-Yuan Shih
Which 119 is the Best Life-Saver?
Tainan City(Area: 175 KM2, Population: 760,000人)
It’s the oldest fire
station in Taiwan!
Frame of Tainan Fire Bureau
119ALS Team
ALS Team
BLS Team
BLS Team
Two Tiered BLS / ALS
Hospitals
Integrated Information System for Medical Resources
各區救災救護指揮中心工作站
路由器
各區衛生局工作站
消防單位工作站
醫事機構工作站
防火牆
磁帶機
全國緊急醫療資料庫
衛生署資訊中心系統管理員
緊急醫療管理伺服器
FTP Server
INTERNET
DMZ1
DMZ2
ExternalInternal
備援ISDN
消防署伺服器
Annual Dispatch Volume in Tainan City
43424647
5172
6202
7598
8965
10406
10989
11773
12688
1401714336
1511415582
18041
20963
2454424517
25581
24742669
3027
3819
4895
6041
73287820
8572
940310508
1086110945
11689
13547
15884
1893518894
19615
0
5000
10000
15000
20000
25000
30000
Num
ber
Year
Tainan City EMS
Dispatch Transport
Etiology of Ambulance Run in Tainan City
Area/Station Ratio in Tainan City
東區
8%南區
16%
北區
6%
安南區
60%
安平區
6%
中西區
4%
東區
南區
北區
安南區
安平區
中西區
面 積 / 隊 數
4.479.09
5.22
35.73
3.696.26
0
10
20
30
40
東區 南區 北區 安南區 安平區 中西區
平方
公里
東區, 32, 19%
中西區, 13, 8%
安平區, 31, 18%
北區, 22, 13%
南區, 33, 19%
安南區, 39, 23%
南區
北區
安南區
安平區
中西區
東區
Population/EMTs Ratio
in Tainan City
0
1000
2000
3000
4000
5000
6000
7000
東區 南區 北區 安南區 安平區 中西區
人口/救護人員
人口/救護人員
Volume of Ambulance Runs
for Each Fire Station in Tainan City
What do EMTs do?
They have to… Disaster Exercise
They have to… Teaching Material
They have to…
Teach Clerks, Interns, Nurses, Residents…
CPR training in publics: 65%
They have to…
Life-long Internship in Teaching Hospitals…
They have to…
Mutual Evaluation
Using a Discrete-event Simulation to Balance
Ambulance Availability and Demand in Static
Deployment Systems Ching-Han Wu, Kevin P. Hwang,
Laryngeal Mask Airway by EMT-II
LMA/OHCA
54.41% 58.25%
77.78% 79.38%
0%
20%
40%
60%
80%
100%
2004 2005 2006 2007
222
300
420 408
186
215
120
106
0
100
200
300
400
500
600
OH
CA
BVM 186 215 120 106
LMA 222 300 420 408
2004 2005 2006 2007
LMＡ Utilization in
OHCA patients
LMA in Trauma/NonTrauma OHCA
28 3551
37
22
39
36
24
194
264
369 371
164
176
84 82
0
50
100
150
200
250
300
350
400
450
500
2004 2004 2005 2005 2006 2006 2007 2007
Year
Nu
mb
er
LMA-Trauma-OHCA BVM-Trauma-OHCA
LMA-NonTrauma-OHCA BVM-NonTrauma-OHCA
LMA rate in Trauma/NonTrauma OHCA
56.00%47.30%
58.62% 60.66%
54.19%60.00%
81.46% 81.90%
0%
20%
40%
60%
80%
100%
2004 2005 2006 2007
Year
Ra
te
Trauma-OHCA NonTrauma-OHCA
LMA in ALS/BLS OHCA
85.14%73.10%
90.22%85.44%
36.92%
50.87%
68.89%
75.32%
0%
20%
40%
60%
80%
100%
2004 2005 2006 2007
YearLMA-ALS-OHCA rate LMA-BLS-OHCA rate
LMA in ALS/BLS OHCA
126 125
203
176
22
46
22
30
96
175
217232
164
16998
76
0
50
100
150
200
250
300
350
400
2004 2005 2006 2007
Year
Nu
mb
er
LMA-ALS-OHCA BVM-ALS-OHCA
LMA-BLS-OHCA BVM-BLS-OHCA
Small and Luxury
Thank you [email protected]