Faster emergency response
times are generally considered to have a positive effect on life expectancy of patients with a life-threatening event, leading many communities to determine response
time intervals. However, worldwide, increasing urbanization and traffic congestion threatens ambulance response
times. An emergency motorcycle response
vehicle (MRV) can overcome these hurdles more easily than a larger ambulance
. It also offers dispatch flexibility in responding to calls estimated to have a low likelihood of a patient who needs transport. The first aim of this study was to determine whether an MRV can shorten response
times and impact on resuscitation outcomes in a heavily urbanized and densely populated region in the Netherlands. The second aim was to evaluate differences in dispatch and transport between MRV and ambulance
This was a nonrandomized, prospective cohort study comparing an MRV unit with regular ambulances in a Dutch city of 265 000 people. Included were all ‘urgent patient’ cases within operating time of the MRV between January 2003 and August 2003.
A total of 1664 patients was evaluated, including 468 motorcycle
and 1196 ambulance
responses. Use of MRVs led to a decrease in response
time of 54 s (P≤
0.01). We could not show a decrease in mortality risk in cases of resuscitation [relative risk (RR): 2.50, confidence interval (CI): 0.17–36.21]. There was a slightly improved 1-year survival
in other life-threatening cases (RR: 1.13, CI: 1.03–1.24). However, this is most likely because of differences in dispatch decisions (the MRV is sent to ‘lighter’ cases) and not because of faster assistance. The MRV paramedic was more likely to treat and release the patient (RR: 2.21, CI: 1.80–2.73) or refer them to a general practitioner (RR: 2.11, CI: 1.73–2.58) and much less likely to refer them to the hospital emergency department (41.2 vs. 72.6%). Referrals to the hospital by the MRV were mostly by the patient's own means of transportation (RR: 13.14, CI: 5.89–29.32) rather than by ambulance
Using motorcycles in a Dutch setting lead to better emergency medical service response
times. The MRV serves a different population. Resulting in a higher treat and release rate and less transportation to hospital.