629 Operational assessment of government ambulance and police based prehospital response for road traffic crashes in Delhi

Background Timely access to in-hospital treatment, effective management of airway, bleeding and circulation are crucial for post-crash outcomes. Police and ambulances play vital role as emergency responders to road crash injuries in low- and middle-income countries (LMICs). Objectives This study attempts to assess the operations of Delhi's post-crash emergency response system by police and ambulances in terms of pre-travel time and response time. This study then attempts to collectively assess the call logs of both the responders to identify and unify the gaps in resource utilization. Methodology The data was collected from the respective emergency responders' historical database. A multi-variable and time window matching technique was formulated to link the data variables available in both datasets. The cleaned and complied dataset was used to estimate the operational metrics of these systems. Results Current data systems could not be mapped to each other with 100% accuracy. Call log data available in the police control room was identified as a reliable quicker data resource for smarter actions and policy decisions. The study finds that 40% of the ambulance resources were underutilized as the patient was not found on the crash site on ambulance arrival. Conclusion A common database system would be helpful in the efficient management of existing resources. Establishing follow-up coordination between the responder and the caller could help effectively utilize existing ambulatory resources and improve performance. Establishing unified and coordinated EMS response systems would improve the efficiency of the existing system by saving such ambulance resources that may be serviceable to other highpriority calls. The study gives useful insights for integrating pre-hospital transport and strengthening the emergency response system in India.