Time Synchronization in Emergency Response Time Measurement

F. Jordan Srour, Nabil Georges Badr


Emergency response time reporting requires data provided by multiple systems. Whenever more than one system produces a time stamp, issues of time synchronization across systems manifest. As emergency response time targets are often short (8 minutes or less) and critical to public perceptions of service, errors in reporting these times are unacceptable. This article seeks to quantify the probability and magnitude of such errors through an empirical study of one emergency medical dispatch system.


  1. Blackwell, T. H., Kline, J. A., Willis, J. J., and Hicks, G. M. (2009). Lack of association between prehospital response times and patient outcomes. Prehospital Emergency Care, 13(4):444-450.
  2. Bravo, M., Diegues, N., Zeng, J., Romano, P., and Rodrigues, L. E. (2015). On the use of clocks to enforce consistency in the cloud. IEEE Data Eng. Bull., 38(1):18-31.
  3. Campbell, J. P., Gridley, T. S., and Muelleman, R. L. (1997). Measuring response intervals in a system with a 911 primary and an emergency medical services secondary public safety answering point. Annals of Emergency Medicine, 29(4):492 - 496.
  4. Clark USA (2014). Public safety plan ordinance. http://www.clarkhealth.net/pdf/public safety plan ordinance adopted 1-2014.pdf.
  5. Cristian, F. (1989). Probabilistic clock synchronization. Distributed Computing, 3(3):146-158.
  6. EMS World (2015). Should response time be a performance indicator? http://www.emsworld.com/article/12071652/responsetime-expert-opinions.
  7. Grolemund, G. and Wickham, H. (2011). Dates and times made easy with lubridate. Journal of Statistical Software, 40(3):1-25.
  8. Gusella, R. and Zatti, S. (1989). The accuracy of the clock synchronization achieved by tempo in berkeley unix 4.3bsd. IEEE Trans. Softw. Eng., 15(7):847-853.
  9. IEEE (2008). 1588-2008 - ieee standard for a precision clock synchronization protocol for networked measurement and control systems. Standard ieee 1588, Institute for Electrical and Electronics Engineers.
  10. ISO (2004). Data elements and interchange formats - information interchange - representation of dates and times. Standard ISO 8601:2004(E) 01.140.03, International Organization for Standardization, Geneva, Switzerland.
  11. Klyne, G. and Newman, C. (2002). Date and time on the internet: Timestamps. Standard rfc 3339, Internet Engineering Taskforce.
  12. Lamport, L. (1978). Time, Clocks, and the Ordering of Events in a Distributed System. Commun. ACM, 21(7):558-565.
  13. Mallada, E., Meng, X., Hack, M., Zhang, L., and Tang, A. (2015). Skewless network clock synchronization without discontinuity: Convergence and performance. IEEE/ACM Transactions on Networking, 23(5):1619- 1633.
  14. Manitoba Canada (2016). Statistical and response time information. http://www.gov.mb.ca/health/ems/stats.html.
  15. Mills, D., Martin, J., Burbank, J., and Kasch, W. (2010). Network time protocol version 4: Protocal and algorithms specification. Standard rfc 5905, Internet Engineering Taskforce.
  16. New South Wales Government (2016). Response times. http://www.ambulance.nsw.gov.au/OurPerformance/response-times.html.
  17. Pons, P. T., Haukoos, J. S., Bludworth, W., Cribley, T., Pons, K. A., and Markovchick, V. J. (2005). Paramedic response time: does it affect patient survival? Academic Emergency Medicine, 12(7):594-600.
  18. Pons, P. T. and Markovchick, V. J. (2002). Eight minutes or less: does the ambulance response time guideline impact trauma patient outcome? The Journal of emergency medicine, 23(1):43-48.
  19. R Core Team (2016). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria.
  20. Rentel, C. H. and Kunz, T. (2005). A clock-sampling mutual network time-synchronization algorithm for wireless ad hoc networks. In IEEE Wireless Communications and Networking Conference, 2005, volume 1, pages 638-644. IEEE.
  21. Sherman, J. A. and Levine, J. (2016). Usage analysis of the nist internet time service. Journal of Research of the National Institute of Standards and Technology, 121:33.

Paper Citation

in Harvard Style

Srour F. and Badr N. (2017). Time Synchronization in Emergency Response Time Measurement . In Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 5: HEALTHINF, (BIOSTEC 2017) ISBN 978-989-758-213-4, pages 199-204. DOI: 10.5220/0006096001990204

in Bibtex Style

author={F. Jordan Srour and Nabil Georges Badr},
title={Time Synchronization in Emergency Response Time Measurement},
booktitle={Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 5: HEALTHINF, (BIOSTEC 2017)},

in EndNote Style

JO - Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 5: HEALTHINF, (BIOSTEC 2017)
TI - Time Synchronization in Emergency Response Time Measurement
SN - 978-989-758-213-4
AU - Srour F.
AU - Badr N.
PY - 2017
SP - 199
EP - 204
DO - 10.5220/0006096001990204