How weather and age-gender can provide insight for emergency management in predicting cardiac arrest occurrence
The key factor in weather and age-gender differences
One of the key factors that impact the occurrence of cardiac arrest outside the hospital is temperature. There have been various studies all over the world concerning the influence of temperature on out of hospital cardiac arrests (OHCA) and other cardiovascular diseases. However, there exist no substantial research studies in Hong Kong. According to Low et al. (2018), it is important to study the influence of environmental factors such as temperature as well as the relationship between age-gender differences and ambient temperature in Hong Kong.
The study of Low et al. (2018) further provides substantial evidence in relation to associating demographic effects and weather about OHCA in Hong Kong. Likewise, study offer experimental evidence and information to the administrators and policymakers, which can be used for supporting the current emergency services and medical amenities. Moreover, using regression analyses and simple correlation, the researchers examined the association between temperature, gender, age, and OHCA. The findings of the study showed that the emergency medical services related to cardiac arrests were higher in morning time i.e. between 6:00 and 11:00 in the winter season.
In pre-hospital setting
An ambulance service plays a substantial role in the health care management system. There is a significant number of ambulance services operating around the world. The ambulance data is used for both operational purposes and evaluation of public health. Likewise, the data is used to obtain valuable and real-time information to evaluate the effects of environmental conditions on human health.
Other research results by ARIMA
According to Wong & Lai (2014), there is an increasing demand for ambulance services in Hong Kong. Recent research studies show that weather factors such as humidity and temperature play a crucial role in the demand of such services. The research study developed short-term predictors and forecasting models. These models use day-to-day ambulance calls using seven-day weather forecasting data as predictors. Wong & Lai (2014) implemented the “auto-regressive integrated moving average” (ARIMA) system for the analysis of over one million emergency cases.
The result of the research study showed that the ARIMA system can offer accurate forecasts of ambulance calls daily at seven days ahead of time and with enhanced accuracy by including the factors of weather such as temperature and humidity. The ARIMA model can also provide improved predictability by processing the factor of temperature alone. The findings of the study put forward that the system measuring temperature data can improve the forecasts of daily ambulance demand.
Forecast data about temperature, humidity, and other environmental factors are readily available on the official website of Hong Kong Observatory. Moreover, there is no cost to including the data in the ARIMA models. Therefore, it yields enhanced prediction for forwarding planning as well as the deployment of ambulances. The presence of high temperature or strong weather effects different target groups indicating the possibility for the development and advancement of a forecast system of day-to-day ambulance demand using weather variables. Similarly, the accessibility of such a forecasting system will render more active deployment of the ambulance services to come across the sudden increase in service demands (Wong & Lai, 2014).
The air temperature data can be used to establish the relevance of climate and weather conditions for ambulance dispatch in emergency situations. This relationship is closely observed in various experimental studies conducted in the United Kingdom. According to Thornes, Fisher, Rayment-Bishop, and Smith (2014), observations on data from London Ambulance Service detected tendencies for performance against the indicators to deteriorate in warm (higher than 20-degree Celsius) and cold weather (below 2-degree Celsius). The findings of the study were validated and confirmed in 2014 and 2017 with reference to data from Birmingham and London (Mahmood et al., 2017).
Likewise, the research study suggests two weather-related impacts on ambulance deployment in an emergency situation, which are weather-related health prevalence effects and demand-side impacts. The weather-related impacts emphasized fainting and dizziness at warmer temperature and fractures in cold weather. Besides the significant contribution of temperature to predict forecast and deploy ambulances in an emergency situation, another factor includes the supply-side effects, for instance, the road conditions i.e. poor visibility and icy roads can also leave the ambulance service short-handed.
According to Claeys et al. (2017), the challenges involved in attaining better actionable insights from temperature data are comparatively well thought out in research studies. The technical qualms for the ambulance service remain substantial. Though air temperature correlations with collective demand are recognized and clinical functions are aware of establishing knowledge about the contributory relationships. There is no substantiation that spatial differences in weather are pertinent to resource distribution planning or that ambulance service should be trailing other weather metrics such as humidity. Predictions are also not considered as totally reliable.
Moreover, there is an increasing demand for ambulance services in harsh weather conditions such as heavy rain, snow, or extreme heat. The air temperature data is helpful in providing significant insights into the deployment of ambulance resources in an emergency situation. Using both “training and testing” data in artificial neural network system software and tools, it is not easy to analyze the magnitude of ambulance dispatch because these tools allow the emergency care management team to predict the call-out rates in a better way. Due to climate change, warming temperatures could decrease the total number of callouts or dispatches. Studies show that ambulance callouts increase in summer and decrease in winter. There is also evidence that cold waves and heat waves can increasingly cause increasing demands and delays in ambulance response times (Mahmood et al. 2017).
The weather affects directly on daily operations while the environmental factors contribute to the level services required in the emergency situation, for example, the total number of ambulances and staff required to carry out the operation in the emergency situation. The weather impacts directly on day-to-day operations whilst the climate contribute to the level of service required (e.g., the total number of staff and ambulances). As the climate changes affect the frequency of cold and hot weather events, the ambulance service becomes more resilient and requires better preparation by utilizing bespoke weather or temperature forecasts for daily operations. This also includes climate predictions for a better strategic planning.
Better prediction
The impact of climate and weather on ambulance service is comparatively a new research domain. The scientific community and emergency department along with health institutions are collaboratively making significant efforts to advance the scope of research. The novel research and experimental studies using weather forecasting and air temperature data would allow better predictions and emergency management (Thornes et al., 2014).
Research regarding the usage of relative environmental factors such as temperature, humidity, and air pollution will further improve ambulance callouts and response times. In addition, Mahmood et al. (2017) recommended to use satellite air temperature estimates for accurate spatial predictions so that the whole emergency management system work more actively in an improved way. Furthermore, recent developments in estimating temperature data from satellite observations are supportive in emergency planning and deployment of ambulance resources.
References
Wong, H. T., & Lai, P. C. (2014). Weather factors in the short-term forecasting of daily ambulance calls. International journal of biometeorology, 58(5), 669–678.
Thornes, J. E., Fisher, P. A., Rayment-Bishop, T., & Smith, C. (2014). Ambulance call-outs and response times in Birmingham and the impact of extreme weather and climate change. Emerg Med J, 31(3), 220–228.
Mahmood, M. A., Thornes, J. E., Pope, F. D., Fisher, P. A., & Vardoulakis, S. (2017). Impact of air temperature on London ambulance call-out incidents and response times. Climate, 5(3), 61.
Claeys, M. J., Rajagopalan, S., Nawrot, T. S., & Brook, R. D. (2017). Climate and environmental triggers of acute myocardial infarction. European heart journal, 38(13), 955–960.
Low, C. T., Lai, P. C., Yeung P. S. S., Siu A. Y. C., Leung, K. T. Y., & Wong, P. P. Y. (2018). Temperature and age-gender effects on out-of-hospital cardiac arrest cases. Hong Kong Journal of Emergency Medicine, 25(2), 83–90.
