Need of Improvement in Emergency Medical Service in Urban Cities

Introduction: An effective Emergency Medical Service system does not exist in Nepal. For an effective EMS system to be developed the scale of the problem and the existing facilities need to be studied. Methods: Prospective observational study was carried out on 1964 patients attending Emergency Department at Patan Hospital during one month period of September 2006. The patients were specifically enquired on mode of transport used, place of origin and whether they called for an ambulance or not. Patients triage category at the time of triaging was also noted. Information on ambulance service were collected by direct interview with the service providers and the total number of patients attending Emergency Departments daily were collected from the major hospitals of the urban Lalitpur and Kathmandu. MS Excel and SPSS software were used for data entry, editing and analysis.Results: Total 9.9% patients arrived in ambulance whereas 53.6% came in a Taxi, 11.4% came in private vehicle, 13.5 % came by bus, 5.4% came by bike and the rest 6.2% came by other modes of transportation. Only 13.5% of triage category I patients took the ambulance. There were 31 service providers with 49 ambulances and 720 patients per day attend Emergency Departments in the surveyed area. Conclusions: Very less number of patients use the ambulance service for emergency services. The available ambulances are not properly equipped and do not have trained staff and as such are only a means of transportation to the hospitals of urban Lalitpur and Kathmandu.Key Words: ambulance, emergency medical service, para-medics, triage Need of Improvement in Emergency Medical Service in Urban Cities Gongal R,1Dhungana B,1Regmi S,1Nakarmi M,2Yadav B11Patan Hospital, Lalitpur, Nepal, 2Health Care Foundation, Kathmandu, NepalCorrespondence:Dr. Rajesh GongalDepartment of SurgeryPatan Hospital, Patan, Nepal.Email: [email protected] ARTICLE J Nepal Med Assoc 2009;48(174):139-43INTRODUCTIONThe sophisticated Emergency Medical Service (EMS) is limited to developed country only. Many developing countries are now slowly developing such system although most services are localized to the urban areas.1-5 Although inadquate ambulance services are available in the capital city of Nepa

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Feedback to Emergency Medical Services Providers: The Good, the Bad, and the Ignored

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00037444 ◽

1997 ◽

Vol 12 (2) ◽

pp. 74-77 ◽

Cited By ~ 3

Author(s):

Elisabeth F. Mock ◽

Keith D. Wrenn ◽

Seth W. Wright ◽

T. Chadwick Eustis ◽

Corey M. Slovis

Keyword(s):

Emergency Department ◽

Emergency Medical Services ◽

Emergency Medical Service ◽

Medical Service ◽

Service Providers ◽

Medical Services ◽

Emergency Medical Service System ◽

Constructive Feedback ◽

Emergency Medical ◽

Emergency Medical Service Provider

AbstractHypothesis:To determine the type and frequency of immediate unsolicited feedback received by emergency medical service (EMS) providers from patients or their family members and emergency department (ED) personnel.Methods:Prospective, observational study of 69 emergency medical services providers in an urban emergency medical service system and 12 metropolitan emergency departments. Feedback was rated by two medical student observers using a prospectively devised original scale.Results:In 295 encounters with patients or family, feedback was rated as follows: 1) none in 224 (76%); 2) positive in 51 (17%); 3) negative in 19 (6%); and 4) mixed in one (<1%). Feedback from 254 encounters with emergency department personnel was rated as: 1) none in 185 (73%); 2) positive in 46 (18%); 3) negative in 21 (8%); and 4) mixed in 2 (1%). Patients who had consumed alcohol were more likely to give negative feedback than were patients who had not consumed alcohol. Feedback from emergency department personnel occurred more often when the emergency medical service provider considered the patient to be critically ill.Conclusion:The two groups provided feedback to emergency medical service providers in approximately one quarter of the calls. When feedback was provided, it was positive more than twice as often as it was negative. Emergency physicians should give regular and constructive feedback to emergency medical services providers more often than currently is the case.

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Organizational aspects of optimizing the work of the ambulance service in Surgut

Medical Science And Education Of Ural ◽

10.36361/1814-8999-2020-21-4-78-83 ◽

2020 ◽

Vol 21 (4) ◽

pp. 78-83

Author(s):

Yu. M. Salmanov ◽

◽

A. M. Suldin ◽

N. S. Brynza ◽

◽

...

Keyword(s):

Medical Care ◽

Emergency Medical Service ◽

Emergency Departments ◽

Medical Service ◽

Quality Criteria ◽

Ambulance Service ◽

Outpatient Clinics ◽

Emergency Medical Care ◽

Successful Resuscitation ◽

Emergency Medical

Aim. To analyze the quantitative and qualitative indicators of the ambulance and emergency medical services in Surgut in the conditions of redirecting calls with urgent conditions to the emergency departments of outpatient clinics. Materials and methods. The study was conducted in the period from 2013 to 2018 on the basis of the Surgut city clinical ambulance station in Surgut. In accordance with the set aim of the research was defined these forms of statistical reporting № 40 “Report of the station (Department), hospital of emergency medical care” (app. by order of the Ministry of health and social development of the Russian Federation from December 2, 2009 № 942 “On approval of statistical tools stations (offices), hospital emergency medical service”). Results. The experience of redirecting calls with urgent conditions to emergency departments of outpatient clinics in Surgut, which began at the end of 2012, showed that during the period from 2013 to 2018, with an increase in the number of calls (by 15.9%) to the ambulance service, there was a decrease (by 6.4%) in the daily load on the team from 15.8 visits in 2013 to 14.8 visits in 2018. At the same time, the share of departures of the ambulance with the arrival time to the patient in less than 20 minutes after the call, the total number of calls, with an increase from 63.9% in 2013 to 78.1% in 2018, mortality before the arrival of the ambulance, with a reduction (36.1%) from 302,0%000 in 2013 to 192,8%000 in 2018, successful resuscitation at the exit from height (22.3%) from 8.5%000 in 2013 to 10.4%000 in 2018. Conclusion. Reducing the number of visits of emergency medical service teams for urgent conditions, by redirecting requests from patients with chronic diseases to the emergency departments of medical organizations of outpatient clinics during the operation of these institutions, reduced mortality at the pre-hospital stage of medical care, and increased the efficiency of the ambulance station when providing emergency medical care. Due to the control of the standard time for making emergency calls by the dispatcher service of the ambulance station, cases of unintentional failure to provide medical care are excluded. All cases of return of forwarded calls to the ambulance service are transferred to the ambulance team for execution, followed by an analysis of the reasons for violation of the quality criteria established by the Territorial program of state guarantees of free medical care to the population of the Khanty-Mansiyskiy Autonomous okrug – Yugra.

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