Usage of Emergency Medical Services by Emergent and Resuscitation Patients in an Urban Area
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Published:
Apr 1, 2018
Keywords:
Ambulance Emergency Medical Services EMS, Utilization Emergent Resuscitation
Main Article Content
Abstract
Objective: To examine the current usage of emergency medical services (EMS) vehicles and to ascertain factors that may be associated with their use by emergent and resuscitative patients in an urban setting
Methods: A prospective study of 210 patients who were 18 years old or more and categorized in both resuscitation and emergent levels at one urban teaching hospital in Bangkok, Thailand from July 1 to December 31, 2015. Mode of transportation to the Emergency Department and other information about the patients was collected by a structured interview and from medical records. Those transferred in, or who had trauma as an etiology were excluded.
Results: Of the 210 patients with emergency and resuscitation triage level, only 31 patients (15%) arrived at the hospital via an EMS vehicle, while the remaining 179 (85%) were non-users. Those in the EMS utilizing group tended to be older (p=0.001), had used EMS services in the past (p=0.006), knew about the EMS and its contact number(s) (p<0.001), had a higher level of education (p<0.01), and had a first-responder in their neighborhood (p<0.001).
Conclusions: Most of emergency patients in urban area rely on self-transport. Ignorance of the EMS and its telephone number, lack of a first-responder in the neighborhood, and lower education levels may be correlated with self-transport to the emergency department.
Article Details
How to Cite
Nithimathachoke, A., Sanketchon, C., & Surijamorn, P. (2018). Usage of Emergency Medical Services by Emergent and Resuscitation Patients in an Urban Area. Vajira Medical Journal : Journal of Urban Medicine, 62(2), 85–96. Retrieved from https://he02.tci-thaijo.org/index.php/VMED/article/view/195634
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Original Articles
References
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11. Squire BT, Tamayo A, Tamayo-Sarver JH. At-risk populations and the critically ill rely disproportionately on ambulance transport to emergency departments. Ann Emerg Med. 2010; 56(4):341-7.
12. Wai AK, Chor CM, Lee AT, Sittambunka Y, Graham CA, Rainer TH. Analysis of trends in emergency department attendances, hospital admissions and medical staffing in a Hong Kong university hospital: 5-year study. Int J Emerg Med. 2009;2(3):141-8.
13. Zia N, Shahzad H, Baqir SM, Shaukat S, Ahmad H, Robinson C, et al. Ambulance use in Pakistan: an analysis of surveillance data from emergency departments in Pakistan. BMC Emerg Med. 2015;15 Suppl 2:S9.
14. Kumar V, Khajanchi M, Raykar NP, Gerdin M, Roy N. Waiting at the hospital door: a prospective, multicentre assessment of third delay in four tertiary hospitals in India. Lancet. 2015;385 Suppl 2:S24.
15. Vidale S, Arnaboldi M, Bezzi G, Bono G, Grampa G, Guidotti M, et al. Reducing time delays in the management of ischemic stroke patients in Northern Italy. Int J Cardiol. 2016;215:431-4.
16. Tataris K, Kivlehan S, Govindarajan P. National trends in the utilization of emergency medical services for acute myocardial infarction and stroke. West J Emerg Med. 2014;15:744-8.
17. Goldberg RJ, Lamusta J, Darling C, DeWolf M, Saczynski JS, Lessard D, et al. Community trends in the use and characteristics of persons with acute myocardial infarction who are transported by emergency medical services. Heart Lung. 2012;41:323-31.
18. Ma J, Wang J, Zheng W, Zheng J, Wang H, Wang G, et al. Usage of ambulance transport and influencing factors in acute coronary syndrome: a cross-sectional study at a tertiary centre in China. BMJ Open. 2017;7(8):e015809.
19. Hong KS, Bang OY, Kim JS, Heo JH, Yu KH, Bae HJ, et al. Stroke Statistics in Korea: Part II Stroke Awareness and Acute Stroke Care, A Report from the Korean Stroke Society and Clinical Research Center For Stroke. J Stroke. 2013;15: 67-77.
20. Song L, Yan HB, Yang JG, Sun YH, Liu SS, Li C, et al. Factors associated with use of emergency medical service for acute myocardial infarction in Beijing. Zhonghua Yi Xue Za Zhi. 2010;90: 834-8.
21. Platts-Mills TF, Leacock B, Cabañas JG, Shofer FS, McLean SA. Emergency medical services use by the elderly: analysis of a statewide database. Prehosp Emerg Care. 2010;14:329-33
22. Shah MN, Bazarian JJ, Lerner EB, Fairbanks RJ, Barker WH, Auinger P, et al. The epidemiology of emergency medical services use by older adults: an analysis of the National Hospital Ambulatory Medical Care Survey. Acad Emerg Med. 2007;14:441-7.
23. Goldstein J, Jensen JL, Carter AJ, Travers AH, Rockwood k. The Epidemiology of Prehospital Emergency Responses for Older Adults in a Provincial EMS System. CJEM. 2015;17:491-6.
24. Chi CH, Tsai MC, Chen KW, Wu MH. 119 emergency medical transport of the elderly. Kaohsiung J Med Sci. 1996;12:699-706.
25. Huang CC, Chen WL, Hsu CC, Lin HJ, Su SB, Guo HR, et al. Elderly and nonelderly use of a dedicated ambulance corps’ emergency medical services in Taiwan. Biomed Res Int. 2016;1506436.
26. Yanagida T, Fujimoto S, Inoue T, Suzuki S. Causes of prehospital delay in stroke patients in an urban aging society. J Gerontol Geriatr. 2014, 5(3):77-81.
27. Dundar C, Sunter AT, Canbaz S, Cetinoglu E. Emergency service use by older people in Samsun, Turkey. Adv Ther. 2006;23(1):47-53.
28. Monsomboon A, Chantawatsharakorn P, Suksuriyayothin S, Keorochana K, Mukda A, Prapruetkit N, et al. Prevalence of emergency medical service utilisation in patients with outof-hospital cardiac arrest in Thailand. Emerg Med J. 2016;33:213-7.
29. Ruger JP, Richter CJ, Lewis LM. Clinical and economic factors associated with ambulance use to the emergency department. Acad Emerg Med. 2006;13:879-85.
30. Jacob SL, Jacoby J, Heller M, Stoltzfus J. Patient and physician perspectives on ambulance utilization. Prehosp Emerg Care. 2008;12:176-81.
2. Kobusingye OC, Hyder AA, Bishai D, Hicks ER, Mock C, Joshipura M. Emergency medical systems in low- and middle-income countries: recommendations for action. Bull World Health Organ. 2005,83(8):626-31.
3. Nehme Z, Bernard S, Cameron P. Using a Cardiac Arrest Registry to Measure the Quality of Emergency Medical Service Care Decade of Findings from the Victorian Ambulance. Circ Cardiovasc Qual Outcomes. 2015;8:56-66.
4. Kobayashi A, Misumida N, Aoi S, Steinberg E, Kearney K, Fox JT, et al. STEMI notification by EMS predicts shorter door-to-balloon time and smaller infarct size. Am J Emerg Med. 2016, 34(8):1610-3.
5. Kamel H, Navi BB, Fajimi J. National Trends in Ambulance Use by Patients with Stroke, 1997-2008. JAMA. 2012,307(10):1026-8.
6. Harraf F, Sharma AK, Brown MM, Lees KR, Vass RI, Kalra L. A multicentre observational study of presentation and early assessment of acute stroke. BMJ. 2002,325: 1-5.
7. National Institute for Emergency Medicine. History [Internet]. 2016 [Cited 2016 August 12].Available from: http://www.niems.go.th/en/View/Page.aspx?PageId=25551114035939822
8. Beveridge R, Clarke B, Janes L, Savage N, Thompson J, Dodd G, et al. Implementation Guidelines for The Canadian Emergency Department Triage & Acuity Scale (CTAS).[Internet]. 1998 December. [Cited 2016 August 12]Available from http://www.caep.ca/template.asp?id=98758372CC0F45FB826FFF49812638DD
9. ณิชชาภัทร ขันส?ำค, ทัศนีย์ ศิลาวรรณ, ทัศนีย์ รวิวรกุล, วิริณธิ์ กิตติพิชัย, อุมาวดี เหลาทอง; สถาบันการแพทย์ฉุกเฉินแห่งชาติ (สพฉ.). ระบบบริการการแพทย์ฉุกเฉินสำหรับผู้สูงอายุ. [internet] 2016.[cite 2016 Jan 28]Available from: https://www.niems.go.th/th/Upload/File/255911291527463047_276dqvbz2kfisI9b.pdf
10. Phelps MA, Rodriguez RM, Passanante M, Dresden G, Driza K. EMS activation in a cohort of critically ill patients. J Emerg Med. 2002;22(2): 127-31.
11. Squire BT, Tamayo A, Tamayo-Sarver JH. At-risk populations and the critically ill rely disproportionately on ambulance transport to emergency departments. Ann Emerg Med. 2010; 56(4):341-7.
12. Wai AK, Chor CM, Lee AT, Sittambunka Y, Graham CA, Rainer TH. Analysis of trends in emergency department attendances, hospital admissions and medical staffing in a Hong Kong university hospital: 5-year study. Int J Emerg Med. 2009;2(3):141-8.
13. Zia N, Shahzad H, Baqir SM, Shaukat S, Ahmad H, Robinson C, et al. Ambulance use in Pakistan: an analysis of surveillance data from emergency departments in Pakistan. BMC Emerg Med. 2015;15 Suppl 2:S9.
14. Kumar V, Khajanchi M, Raykar NP, Gerdin M, Roy N. Waiting at the hospital door: a prospective, multicentre assessment of third delay in four tertiary hospitals in India. Lancet. 2015;385 Suppl 2:S24.
15. Vidale S, Arnaboldi M, Bezzi G, Bono G, Grampa G, Guidotti M, et al. Reducing time delays in the management of ischemic stroke patients in Northern Italy. Int J Cardiol. 2016;215:431-4.
16. Tataris K, Kivlehan S, Govindarajan P. National trends in the utilization of emergency medical services for acute myocardial infarction and stroke. West J Emerg Med. 2014;15:744-8.
17. Goldberg RJ, Lamusta J, Darling C, DeWolf M, Saczynski JS, Lessard D, et al. Community trends in the use and characteristics of persons with acute myocardial infarction who are transported by emergency medical services. Heart Lung. 2012;41:323-31.
18. Ma J, Wang J, Zheng W, Zheng J, Wang H, Wang G, et al. Usage of ambulance transport and influencing factors in acute coronary syndrome: a cross-sectional study at a tertiary centre in China. BMJ Open. 2017;7(8):e015809.
19. Hong KS, Bang OY, Kim JS, Heo JH, Yu KH, Bae HJ, et al. Stroke Statistics in Korea: Part II Stroke Awareness and Acute Stroke Care, A Report from the Korean Stroke Society and Clinical Research Center For Stroke. J Stroke. 2013;15: 67-77.
20. Song L, Yan HB, Yang JG, Sun YH, Liu SS, Li C, et al. Factors associated with use of emergency medical service for acute myocardial infarction in Beijing. Zhonghua Yi Xue Za Zhi. 2010;90: 834-8.
21. Platts-Mills TF, Leacock B, Cabañas JG, Shofer FS, McLean SA. Emergency medical services use by the elderly: analysis of a statewide database. Prehosp Emerg Care. 2010;14:329-33
22. Shah MN, Bazarian JJ, Lerner EB, Fairbanks RJ, Barker WH, Auinger P, et al. The epidemiology of emergency medical services use by older adults: an analysis of the National Hospital Ambulatory Medical Care Survey. Acad Emerg Med. 2007;14:441-7.
23. Goldstein J, Jensen JL, Carter AJ, Travers AH, Rockwood k. The Epidemiology of Prehospital Emergency Responses for Older Adults in a Provincial EMS System. CJEM. 2015;17:491-6.
24. Chi CH, Tsai MC, Chen KW, Wu MH. 119 emergency medical transport of the elderly. Kaohsiung J Med Sci. 1996;12:699-706.
25. Huang CC, Chen WL, Hsu CC, Lin HJ, Su SB, Guo HR, et al. Elderly and nonelderly use of a dedicated ambulance corps’ emergency medical services in Taiwan. Biomed Res Int. 2016;1506436.
26. Yanagida T, Fujimoto S, Inoue T, Suzuki S. Causes of prehospital delay in stroke patients in an urban aging society. J Gerontol Geriatr. 2014, 5(3):77-81.
27. Dundar C, Sunter AT, Canbaz S, Cetinoglu E. Emergency service use by older people in Samsun, Turkey. Adv Ther. 2006;23(1):47-53.
28. Monsomboon A, Chantawatsharakorn P, Suksuriyayothin S, Keorochana K, Mukda A, Prapruetkit N, et al. Prevalence of emergency medical service utilisation in patients with outof-hospital cardiac arrest in Thailand. Emerg Med J. 2016;33:213-7.
29. Ruger JP, Richter CJ, Lewis LM. Clinical and economic factors associated with ambulance use to the emergency department. Acad Emerg Med. 2006;13:879-85.
30. Jacob SL, Jacoby J, Heller M, Stoltzfus J. Patient and physician perspectives on ambulance utilization. Prehosp Emerg Care. 2008;12:176-81.