Introduction: Delays in prehospital care attributable to the call-taking process can often be traced back to miscommunication, including uncertainty around the call location. Geolocation applications have the potential to streamline the call-taking process by accurately identifying the caller’s location. Objective: To develop and validate an application to geolocate emergency calls and compare the response time of calls made via the application with those of conventional calls made to the Brazilian Medical Emergency System (Serviço de Atendimento Médico de Urgência—SAMU). Methods: This study was conducted in two stages. First, a geolocating application for SAMU emergency calls (CHAMU192) was developed using a mixed methods approach based on design thinking and subsequently validated using the System Usability Scale (SUS). In the second stage, sending time of the geolocation information of the app was compared with the time taken to process information through conventional calls. For this, a hypothetical case control study was conducted with SAMU in the Maringá, Paraná, Brazil. A control group of 350 audio recordings of emergency calls from 2019 was compared to a set of test calls made through the CHAMU192 app. The CHAMU192 group consisted of 201 test calls in Maringá. In test calls, the location was obtained by GPS and sent to the SAMU communication system. Comparative analysis between groups was performed using the Mann-Whitney test. Results: CHAMU192 had a SUS score of 90, corresponding to a “best imaginable” usability rating. The control group had a median response time of 35.67 seconds (26.00–48.12). The response time of the CHAMU192 group was 0.20 (0.15–0.24). Conclusion: The use of the CHAMU192 app by emergency medical services could significantly reduce response time. The results demonstrate the potential of app improving the quality and patient outcomes related to the prehospital emergency care services.

Out-of-hospital cardiac arrests (OHCAs) have high mortality rates, worsened by limited access to automated external defibrillators (AEDs). This study analyzed OHCA response times, identified areas with prolonged ambulance travel times, and proposed optimal AED locations in a medium-sized city in southern Brazil. Data from 278 non-traumatic OHCA cases (2019–2022) in patients over 18 years old, with ambulance response times under 20 min, were included. Spatial survival analysis assessed the probability of exceeding the recommended 5-min (300 s) ambulance response time. The maximal covering location problem identified 100 strategic AED sites within a 150-s reach for bystanders. AED and ambulance travel times were compared using the Wilcoxon test (p < 0.01). Defibrillation occurred in 89 cases (31.01%), and bystander CPR was performed in 149 cases (51.92%). Despite these efforts, 77% of patients died. The median ambulance response time was 11.63 min, exceeding 5 min in most cases, particularly at peak times like 11 a.m. AED placement in selected locations could cover 76% of OHCA occurrences, with a mean AED travel time of 320 s compared to 709 s for ambulances. Strategic AED placement could enhance early defibrillation and improve survival outcomes.

Construir e validar um instrumento para o transporte ao RN no serviço de atendimento móvel de urgência. Estudo metodológico de construção de instrumento com base na literatura científica, sobre transporte do recém-nascido de alto risco. Realizou-se entre outubro de 2021 e janeiro de 2022 e desenvolvido em duas etapas, a saber: construção do instrumento e validação do conteúdo por especialistas. A construção do instrumento, se deu a partir da revisão integrativa e de documentos, tais como: manuais de orientações do transporte neonatal do Ministério da Saúde, nas Diretrizes da sociedade Brasileira de Pediatria no “Transporte do Recém-nascido de alto risco” e experiência da pesquisadora. O instrumento foi categorizado nos seguintes domínios: Identificação; transferência; hipótese diagnóstica, avaliação e intervenção/procedimentos, além de check-list de equipamentos e materiais necessários para o transporte e escalas para avaliar o RN. A validação de conteúdo do instrumento foi realizada por 20 especialistas no assunto. O instrumento mostrou-se apropriado, obtendo valor médio de 97,5%. A construção e validação do instrumento mostraram-se adequadas e relevantes, indicando que possa ser utilizado no transporte ao RN do serviço de atendimento móvel de urgência.

Objective: to identify scientific evidence on neonatal transport in the emergency medical service Methods: integrative review carried out between December 2020 and March 2021 in five national and international databases, and descriptors: “neonatal transport”, “newborn” and “ambulance”. 198 researches were found, of which 12 constituted the final sample. The material was analyzed and organized using simple descriptive statistics. Results: The publications highlighted that the use of neonatal transport is complex and requires assistive technology and specific qualified care. Conclusion: It is necessary to develop strategies that broaden the perspectives of professionals in neonatal transport.

The aim of this study was to conduct a detailed geospatial analysis of mobile phone signal coverage in the northwest macro-region of Paraná State, Brazil, seeking to identify areas where limitations in coverage may be related to lengthy travel times of the helicopter emergency medical service (HEMS) for the assistance of victims of road traffic injuries (RTIs). An observational study was conducted to examine mobile phone signal coverage and HEMS travel times from 2017 to 2021. HEMS travel times were categorized into four groups: T1 (0-15 min), T2 (16-30 min), T3 (31-45 min), and T4 (over 45 min). Empirical Bayesian Kriging was used to map areas with low mobile signal coverage. The Kruskal-Wallis test and Dwass-Steel-Critchlow-Fligner comparative analyses were performed to explore how mobile signal coverage relates to HEMS travel times to RTI locations. There were 470 occurrences of RTIs attended by HEMS, of which 108 (23%) resulted in on-site fatalities. Among these deaths, 47 (26.85%) occurred in areas with low mobile phone signal coverage ("shadow areas"). Low mobile phone signal coverage identified at 175 (37.24%) RTIs locations, was unevenly distributed across the macro-region. The lowest medians of mobile signal quality were predominantly found in areas with HEMS travel times exceeding 30 min, corresponding to signal strength values of -98.44 (T3) and -100.75 (T4) dBm. This scenario represents a challenge for effective communication to activate HEMS. In the multiple comparison analysis among travel time groups, significant differences were observed between T1 and T2 (p < 0.001), T1 and T3 (p < 0.001), T1 and T4 (p < 0.001), and T2 and T3 (p < 0.001), indicating a potential association between lower mobile phone signal coverage and longer HEMS travel times. It can be concluded that poor mobile phone signals in remote areas can hinder HEMS activation, potentially delaying the start of treatment for RTIs. Identification of the shadow areas can help communication and health managers in designing and implementing the necessary changes to improve mobile phone signal coverage and consequently reduce delays in the initial response to RTIs.

Objective: To analyze the impact of geographic location of coronary reperfusion (CR) services on acute myocardial infarction (AMI) mortality in Parana State, Brazil. Methods: This is a cross-sectional, ecologic study based on AMI mortality, between 2015 and 2019, among individuals aged 30–79 years. An spatial access index to CR services within 60 minutes of ground transportation was calculated using the enhanced two-step floating catchment area technique. AMI mortality rates were compared between municipalities with and without CR services coverage and between municipalities with low and high spatial access to CR services, both using the Wilcoxon test. Results: It was observed that 8.02% (32/399) of municipalities had access to two methods of reperfusion therapy, 24.56% (98/399) had access only to primary percutaneous coronary intervention, and 12.03% (48/399) had access only to chemical reperfusion. Municipalities with access to CR services had lower mortality rate (median = 74.67) than municipalities not covered by this service (median = 102.83) (p < 0.001). There was a significant difference between municipalities with low (median = 68.30) and high spatial access to CR services (median = 80.02) (p = 0.007). Conclusion: Increased spatial access to CR services is crucial for the survival of patients with AMI.