Abstract

The Point Pleasant Borough First Aid Squad answers 911 calls for medical service in the Borough of Point Pleasant. They see significantly more calls per day during the summer months. While during the day, average number of calls remains generally the same, during the night-time when there is an assigned duty crew, Friday and Saturday (nights) see a significantly higher call volume. The hours of 8AM to 8PM are the most likely to have calls, and the hours of 2PM to 9PM have the highest number of responders. While almost 15% of calls are for Fall victims, and over half of all calls are medically related (as opposed to trauma), there is uniform response to all call types. There has been an upward trend over several years of calls to Brick Township. Ultimately, the data show that the Squad is effective, having at least 2 responders in over 98% of calls. An area for improvement is number of responders between 6AM and 12PM.

Background

The Point Pleasant Borough First Aid Squad (PBFAS) is a volunteer Emergency Medical Service (EMS) agency that responds to 911 calls in the Borough of Point Pleasant. PBFAS also conducts vehicle extrication and rescue services through the Emergency Services Unit (ESU). During the day (between 6 AM and 11 PM) calls are dispatched to all members via issued radios and via a smartphone app. Available members then respond to the First Aid building and answer the call. Every night of the week, there is an assigned duty crew who is obligated to answer any calls which occur between 11 PM and 6 AM the next morning. Calls which cannot be answered are answered by the Point Pleasant Beach First Aid through a mutual aid agreement. PBFAS also responds to Brick Township through a mutual aid agreement. Members receive "points" for responding to a call, and must accumulate a certain number of points each month (determined by the total number of calls) in order to remain in good standing. Since 2014, PBFAS has been logging call data using a software application in order to keep track of points. This is the source of data for this analysis.

Leadership at the First Aid Squad expressed interest in gaining insight into times of higher call volume, volunteer response to calls, and length of calls, as well as concerns about ESU use, and frequency of mutual aid response to Brick Township.

Methodology

All data were analyzed and plots were generated using the R programming language. All analysis was conducted using accepted statistical methods, and no claims are made that are not substantiated with a statistical test. All tests are conducted with an alpha of 0.05, meaning that all claims are made with a 95% confidence level.

Anywhere a statistical claim is made a link will be provided to an article which details the test that was used.

Results

Calls

The following analysis includes 11,458 calls. 655 of those calls were cancelled. The frequency of first aid calls is theoretically a Poisson process, but analysis of the distribution found that it does follow the Poisson distribution.

Density

From approximately 9AM to 9PM is the most likely time for a call to occur.

Day Calls

During the day (6AM to 11PM), there is no significant difference between amount of calls on different days of the week. On average there are 3.14 calls per day during this time period.

Night Calls

Each member is assigned a duty night. Friday night and Saturday night are signficiantly more busy than the other nights of the week. Friday and Saturday night see an average of 0.72 calls where the rest of the nights see 0.52 calls on average.

Calls by Month

As one may expect the summer months of June, July, and August are the busiest months of the year. They are signficiantly more busy than February, March, April, October and November. The months of January, May, September, and December are not significantly different than any months. It makes sense that these months sit in the middle. January and December are holiday months which bring about more activity. May and September are the months around the summer. This data confirms the empirical observation that the summer is busier.

Holidays

No significant difference was found in the amount of calls on various holidays. The 4th of July and New Years do have higher averages, but since there are 8 years of data, there are only 8 observations for each holiday. This is not a large enough sample size to be able to draw conclusions with this data.

Call Types

Falls are the most common type of call making up 14.8% of calls since data collection began. 51.1% of calls were strictly medical calls (falling under Respiratory, Medical, General Weakness, Cardiac, Unresponsive, Abdominal pain, Seizures, Stroke, and Diabetic categories). Though, it is important to note, many calls (such as falls) have an underlying medical issue which is related to the event as well. Many people might expect that many EMS calls are trauma related, but the data show the opposite.

ESU has been called to service 65 times since 2014.

Mutual Aid to Brick

Brick Police EMS is the only non-volunteer agency which PBFAS has a mutual aid agreement with. The EMTs in Brick Township are paid, and patients receive a bill for services. If Brick's ambulances are all busy, or if there is a large scale incident, PBFAS can be called to service in Brick Township. Mutual aid calls to Brick have increased every year since 2015, with PBFAS being called for mutual aid 101 times in 2021.

Response

Of the 10,803 calls which were not cancelled, 208 of those calls (less than 2%) had only one responder. Two responders is the minimum number of personnel needed to respond to the call. There is no significant difference in the number of responders during any month. Although summer months are busier, the number of responders per call is consistent. All response data has outliers removed so the effect of meetings, drills, or events is removed from responder counts.

Hourly

Since 11PM to 6AM there is an assigned crew, I examined response outside of that time. The hours of 2PM-9PM had signficiantly more responders than the hours of 6AM-11AM. Empirically this makes sense, one would expect less responders in the morning right after duty night ends and people are waking up and going to work, and those who work in the evening/at night are likely to be asleep in the early morning.

This graph is a 2-dimensional histogram, showing the amount of responders by hour. A warmer color indicates a higher frequency. This graph shows the lower response in the morning and a higher response in the afternoon/evening, and also indicates a higher variance in call response as the day goes on.

Call Types

There is no significant difference among all the call types except for calls which ESU are dispatched for, this is expected because these events are dispatched as ESU callouts which require additional personnel.

Years

The years of 2016, 2018, 2019, and 2020 had signficiantly more responders per call than the other years.

Call Lengths

The average call length is 1 hour and 13 minutes. Notice the lack of density below the 1 hour line. An extra call "point" is assigned for calls over 1 hour, so calls close to an hour are often logged as a full hour in order to gain the extra point.

Discussion and Recommendations

PBFAS provides a free service to residents, 24 hours per day, 7 days per week. Being a volunteer service, this is at no cost to the patient. For most hours the response matches the call volume. The hours 6AM to 12PM see a lower response than other hours of the day, but the likelihood of having a call increases during those hours. PBFAS could benefit from incentivizing answering calls during those hours.

The Emergency Services Unit sees very few calls to service relative to the cost of the equipment. Additionally, the services provided by ESU are redundant to those provided by the Fire Department. However, the use of ESU as a recruiting and retention tool should not be discounted. Volunteers seek the training opportunities provided by ESU and some members may feel more espirt de corps from being a member of this unit. While not strictly necessary for operation, members of ESU answer regular EMS calls, which is the primary operation of PBFAS.

Mutual Aid calls to Brick have increased. PBFAS Leadership should consider discussusing this trend with Brick Township Police EMS. Even if many of these calls are cancelled, volunteers are inconvenienced by being called from their daily activities.

Friday and Saturday night are significantly busier but members who work a traditional Mon-Fri schedule will not have to wake up for work the following morning if they are called out so volunteering for these nights incentivizes itself. Unless conditions change, no changes to the assignments of duty nights are reccomended.

Dispatches should continue to not include the nature, as it has been successful in maintaining a generally uniform response to all calls, regardless of nature.

PBFAS should continue to recruit and train new members efficiently and continuously so that they can be utilized effectively.

Conclusion

The Point Pleasant Borough First Aid Squad has, since data collection began, provided consistent service and remained an effective asset to the Borough of Point Pleasant. Call volume trends tend to reflect empirical observations. If response rates were to fall in the future the biggest target for improvement will be during the 6AM to 12PM hours.