Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-23T15:12:38.009Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments

Published online by Cambridge University Press:  19 September 2016

Olindi Wijesekera ,
Amanda Reed ,
Parker S. Chastain ,
Shauna Biggs ,
Elizabeth G. Clark ,
Tamorish Kole ,
Anoop T. Chakrapani ,
Nandy Ashish ,
Prasad Rajhans  and
Alan H. Breaud
...Show all authors
Olindi Wijesekera
Affiliation:
Boston University School of Medicine, Boston, MassachusettsUSA
Amanda Reed
Affiliation:
Boston University School of Public Health, Boston, MassachusettsUSA
Parker S. Chastain
Affiliation:
Boston University School of Public Health, Boston, MassachusettsUSA
Shauna Biggs
Affiliation:
Boston University School of Public Health, Boston, MassachusettsUSA
Elizabeth G. Clark
Affiliation:
Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
Tamorish Kole
Affiliation:
Max Hospital, New Delhi, India
Anoop T. Chakrapani
Affiliation:
Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
Nandy Ashish
Affiliation:
Fortis Hospital Anandapur, Kolkata, India
Prasad Rajhans
Affiliation:
Deenanath Mangeshkar Hospital, Pune, India
Alan H. Breaud
Affiliation:
Department of Emergency Medicine, Boston Medical Center, Boston, MassachusettsUSA
Gabrielle A. Jacquet*
Affiliation:
Boston University School of Medicine, Boston, MassachusettsUSA Department of Emergency Medicine, Boston Medical Center, Boston, MassachusettsUSA Boston University Center for Global Health and Development, Boston, MassachusettsUSA
*
Correspondence: Gabrielle A. Jacquet, MD, MPH Department of Emergency Medicine Boston Medical Center Dowling 1 South Emergency, 1 BMC Place Boston, Massachusetts 02118 USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Without a universal Emergency Medical Services (EMS) system in India, data on the epidemiology of patients who utilize EMS are limited. This retrospective chart review aimed to quantify and describe the burden of disease and patient demographics of patients who arrived by EMS to four Indian emergency departments (EDs) in order to inform a national EMS curriculum.

Methods

A retrospective chart review was performed on patients transported by EMS over a three-month period in 2014 to four private EDs in India. A total of 17,541 patient records were sampled from the four sites over the study period. Of these records, 1,723 arrived by EMS and so were included for further review.

Results

A range of 1.4%-19.4% of ED patients utilized EMS to get to the ED. The majority of EMS patients were male (59%-64%) and adult or geriatric (93%-99%). The most common chief complaints and ED diagnoses were neurological, pulmonary, cardiovascular, gastrointestinal, trauma, and infectious disease.

Conclusions

Neurological, pulmonary, cardiovascular, gastrointestinal, trauma, and infectious disease are the most common problems found in patients transported by EMS in India. Adult and geriatric male patients are the most common EMS utilizers. Emergency Medical Services curricula should emphasize these knowledge areas and skills.

WijesekeraO, ReedA, ChastainPS, BiggsS, ClarkEG, KoleT, ChakrapaniAT, AshishN, RajhansP, BreaudAH, JacquetGA. Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments. Prehosp Disaster Med. 2016;31(6):675–679.

Keywords

Emergency Medical Servicesemergency medical techniciansemergency medicineIndiaprehospital emergency care
Type
Brief Reports
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 6 , December 2016 , pp. 675 - 679
Copyright
© World Association for Disaster and Emergency Medicine 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Masterson, S, Wright, P, O’Donnell, C, et al. Urban and rural differences in out-of-hospital cardiac arrest in Ireland. Resuscitation. 2015;91:42-47.Google Scholar
2. Prekker, ME, Delgado, F, Shin, J, et al. Pediatric intubation by paramedics in a large Emergency Medical Services system: process, challenges, and outcomes. Ann Emerg Med. 2016;67(1):20-29.CrossRefGoogle Scholar
3. Seamon, MJ, Fisher, CA, Gaughan, J, et al. Prehospital procedures before emergency department thoracotomy: “scoop and run” saves lives. J Trauma. 2007;63(1):113-120.Google Scholar
4. WISQARS. Years of Potential Life Lost (YPLL) Reports. Secondary Years of Potential Life Lost (YPLL) Reports. http://webappa.cdc.gov/sasweb/ncipc/ypll10.html. Accessed April 26, 2016.Google Scholar
5. World Health Organization. World Health Statistics (India), 2015. http://apps.who.int/ iris/bitstream/10665/170250/1/9789240694439_eng.pdf. Accessed April 26, 2016.Google Scholar
6. Ministry of Health and Welfare, Government of India. Demographic and Health Surveys. India National Family Health Survey (NFHS-3) 2005-06 Volume I and Volume II. http://dhsprogram.com/pubs/pdf/FRIND3/FRIND3-Vol1andVol2.pdf. Accessed April 26, 2016.Google Scholar
7. World Bank. Secondary. http://data.worldbank.org/indicator/NY.GDP.PCAP.CD. Accessed April 26, 2016.Google Scholar
8. Joshipura, MK, Shah, HS, Patel, PR, et al. Trauma care systems in India. Injury. 2003;34(9):686-692.Google Scholar
9. SaveLifeFoundation. Secondary. http://savelifefoundation.org/wp-content/uploads/2014/10/2013-Fact-Sheet_October1.pdf. Accessed April 26, 2016.Google Scholar
10. Ministry of Road Transport and Highways. Road accidents in India 2011. http://www.unescap.org/sites/default/files/2.12.India_.pdf. Accessed April 26, 2016.Google Scholar
11. Bosson, N, Kaji, AH, Niemann, JT, et al. Survival and neurologic outcome after out-of-hospital cardiac arrest: results one year after regionalization of post-cardiac arrest care in a large metropolitan area. Prehosp Emerg Care. 2014;18(2):217-223.Google Scholar
12. Fujii, T, Masuda, N, Suzuki, T, et al. Impact of transport pathways on the time from symptom onset of ST-segment elevation myocardial infarction to door of coronary intervention facility. J Cardiol. 2014;64(1):11-18.Google Scholar
13. Malta Hansen, C, Kragholm, K, Pearson, DA, et al. Association of bystander and first-responder intervention with survival after out-of-hospital cardiac arrest in North Carolina, 2010-2013. JAMA. 2015;314(3):255-264.Google Scholar
14. Sharma, M, Brandler, ES. Emergency Medical Services in India: the present and future. Prehosp Disaster Med. 2014;29(3):307-310.Google Scholar
15. Joshipura, MK. Trauma care in India: current scenario. World J Surg. 2008;32(8):1613-1617.Google Scholar
16. Mishra, NK, Khadilkar, SV. Stroke program for India. Ann Indian Acad Neurol. 2010;13(1):28-32.CrossRefGoogle ScholarPubMed
17. Pal, R, Agarwal, A, Galwankar, S, et al. The 2014 Academic College of Emergency Experts in India’s INDO-US Joint Working Group (JWG) white paper on “Developing Trauma Sciences and Injury Care in India.” Int J Crit Iln Inj Sci. 2014;4(2):114-130.Google Scholar
18. Mercer, MP, Mahadevan, SV, Pirrotta, E, et al. Epidemiology of shortness of breath in prehospital patients in Andhra Pradesh, India. J Emerg Med. 2015;49(4):448-454.Google Scholar