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Operations & systems
Longer on-scene intervals linked to 24-hour mortality
Association between On-Scene Interval and 24-Hour Mortality among Code Red Emergency Medical Services Patients: A Retrospective Cohort Study
Archives of Academic Emergency Medicine · 2026-09-10 · Added 28 October 2026
A Thai retrospective cohort of Code Red ALS activations found on-scene intervals of 21-25 minutes were associated with higher odds of 24-hour mortality compared with 5 minutes or less (adjusted OR 5.61), and intervals of 20 minutes or longer came with 321.7 fewer expected survival minutes.
- Study type
- Cohort
- Design
- Retrospective cohort, ALS dispatch, restricted cubic splines
- Participants
- 2,321 Code Red EMS activations, Saraburi Province
- Main finding
- On-scene interval of 21-25 minutes was associated with higher odds of 24-hour mortality versus 5 minutes or less (aOR 5.61, 95% CI 1.58-19.97); non-survivors had a longer median on-scene interval (12 vs 9 minutes)
- Caveat
- Prolonged scene time may reflect necessary on-scene care in sicker patients, and spline estimates at longer intervals were imprecise
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Scene-time benchmarks are an operations question for any ambulance service, but a Thai physician-supported ALS dispatch model and the observational design mean sicker patients likely drive some of the long scene times.
Learning goal
Strengthen my judgement on which on-scene interventions justify extended scene time in critically unwell patients.
More
- Topic: Operations & systems
- Daily scan: 28 October 2026
- Podcast: Paramedic Papers Daily, 28 October 2026
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