Simulation of emergency care for patients with ACS in Saint Petersburg for ambulance decision making

One of the stages of emergency medical care in case of Acute Coronary Syndrome (ACS) (if there are medical conditions for surgical intervention) is directly linked to the time between the first contact with the patient and the and inflating the balloon in the coronary artery (in a medical institution). Time of the operation start a medical facility depends on the time of patient delivery to hospital, as well as on the waiting time in the queue in the institution. This paper describes a development of ambulance model for obtaining aggregate estimation of these two periods of time. The estimation time is obtained by means of described in the article the decision support system (DSS) in the ambulance service. Unlike modern navigation systems DSS takes into account ambulance vehicle behavior (the ability to exit into oncoming traffic) and availability of free operation rooms. With the help of the described simulation model of the ambulance service we carried out the time distribution analysis (between the first contact with the patient and surgical intervention in case of ACS) in St. Petersburg, Russia. Simulation scenario uses real data on the work of ambulance service in the city.