Outcome of the critically ill patient brought to emergency department and their mode of transportation

Introduction: General Practice and Emergency Medicine is the backbone of the health system of a developing country like Nepal with a significant number of cases being encountered in the general practice clinics and Emergency Department (ED). However, Emergency Medical Services in Nepal face significant challenges with a need for numerous improvements. The medical care provided while using ambulance services in Nepal is insufficient. This study assessed the outcomes of patients brought to Patan Hospital's ED, considering the method of transportation used for their arrival.

Method: A cross-sectional analytical study was conducted at Patan Hospital from April 2021 to March 2022. Total 72 patients were considered for the study. Frequency, Percentage, Median, and Inter-quartile Range were calculated for descriptive analysis. The Chi-square test was used for analytical study and p-value <0.05 was considered statistically significant.

Result: The maximum percentage of critically ill patient was 25.0% (in age group of >60 years) and the minimum was 8.3% (in age group of 0-14 years). 66.7% were male and 33.3% were female. Among all, 34.7% patients presented to emergency via ambulance (33.3% via ka/kha and 1.4% via gha ambulance), 37.5% via private transportation (27.8% via bike and 9.72 via car) and 27.8% patients via public transportation (18.05% via taxi and 9.72 via micro/bus/tempo). There was no association between the modes of transportation and the mortality outcomes and ICU admission among the critically ill patient (p=0.385, and p=0.716 respectively).

Conclusion: Regardless of the transportation method, there was no significant difference in mortality outcomes and the requirement for ICU care among critically ill patients presenting to the emergency department signifying the insufficient emergency medical services provided during the ambulance transportation.