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Table 1 Description of the alternatives

From: Priority setting in the Brazilian emergency medical service: a multi-criteria decision analysis (MCDA)

Alternatives
Information Victim 1 Victim 2
Case Call to the 192 emergency number answered by the medical regulation assistant technician (MRAT). Reason for the call: “tightness in the chest and difficulty breathing” . The caller for the mobile emergency care service (SAMU), the victim’s co-worker, told the MRAT that a 22-year-old military firefighter was attacked by a swarm of African bees. The accident occurred when he was carrying out a training exercise in a region far from the municipality. At the time of the request, the victim had hives, itching and chest discomfort associated with sudden onset severe dyspnoea, at the time of the occurrence it started raining on the spot, the applicant insistently warned the regulatory physician that the victim was allergic to bee sting. The ambulance dispatch was authorized by the doctor to the advanced support unit (ASU). Diagnostic Hypothesis: anaphylaxis /poisoning syndrome Call to the 192 emergency number answered by the medical regulation assistant technician (MRAT). Reason for the call: motorcycle-bicycle collision. A passer-by triggers the mobile emergency service (SAMU) reporting to the MRAT that he witnessed a motorcycle-bicycle collision, leaving a male victim, apparently aged 40, breathing but unconscious, and bleeding profusely. To the regulator, the applicant reported that the victim was riding the motorcycle, without a helmet, and that, at the moment, he was not responsive and had severe bleeding from the nose and ear. The Advanced Support Unit was authorized. Diagnostic Hypothesis: severe traumatic brain injury
Victim’s location Pajuçara—12,4 km of the driving distance—30 min Lagoa Azul—12,1 km of the driving distance—27 min
Location’s Characteristcs Traffic congestion; native vegetation area; no paving; raining; there is insistence by people close to the victim Traffic congestion; duplicate road; on the road; high incidence of sunlight; agglomeration of people
Information Victim 3 Victim 4
Case Call to the 192 emergency number answered by the medical regulation assistant Technician (MRAT). Reason for the call: motorcycle fall. The caller reaches the mobile emergency service (SAMU) to assist a 23-year-old victim of a motorcycle fall, who was conscious, breathing and bleeding profusely. To the regulator, he reported that the victim was driving the vehicle without wearing a helmet, lost consciousness at the time of the accident and had an apparently severe head injury. The Basic Support Unit was sent for the location. During the treatment, the patient developed an episode of post-traumatic tonic-clonic seizure crisis. The Regulatory Physician then authorized the Advanced Support Unit for the Site. Diagnostic Hypothesis: moderate traumatic brain injury, with evolution of tonic-clonic post-traumatic seizure crisis Call to the 192 emergency number answered by the medical regulation assistant technician (MRAT). Reason for the call: Difficulty breathing. The applicant, a relative of the victim, calls the mobile emergency service (SAMU), and informs the MRAT that a 60-year-old was at home when he felt nauseous with difficulty breathing. He reported to the regulator that the victim suffered from hypertension, heart disease and was presenting sudden dyspnoea followed by syncope and decreased level of consciousness. The applicant also reported that the pulse was still palpable, but very weak. Diagnostic Hypothesis: Respiratory insufficiency, plus a decrease in the level of consciousness
Victim’s location Nossa Senhora da Apresentação—118 km of the driving distance—28 min Ponta Negra Village—12 km of the driving distance—30 min
Location’s Characteristcs Traffic congestion; narrow streets; Victim is on the road exposed to change of climate Heavy traffic; duplicate road; victim is home; there is insistence by relatives