Browsing by Author "Weiner, Y"
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Publication Reasons for Summoning Ambulance Services in the Hilly Region of Nepal(Kathmandu University, 2019) Shrestha, SK; Jacobson, C; Dahal, S; Shrestha, R; Weiner, Y; Sheridan, AABSTRACT Background Nepal lacks a unified and countrywide emergency medical services system as other developing countries. However, the emergence of ambulance service initiatives in the past decade shows a promising future for pre-hospital care. Nepal Ambulance Service (Est. 2011) and Dhulikhel Emergency Medical Services (Est. 2013) are the existing emergency medical services initiatives in Nepal. Objective To describe the reason for summoning ambulance services and demographics of the patients who were transported by Dhulikhel Emergency Medical Services at Dhulikhel hospital, hilly region of Nepal. Method One thousand three hundred and ninety three patient records at Dhulikhel hospital transported by Dhulikhel Emergency Medical Services during the five-year period (2013 - 2018) were included in the study. Chief complaints and demographic data were collected and categorized into overarching systemic categories. Result Among 1393 patients, majority were female (60.4%) and the most common age group was 20-29 years. The most common reason for calling ambulances was gastrointestinal problem (22.6%). Similarly, respiratory (17%), obstetric and gynecological (15.2%), trauma (12.7%) and neurological (9.6%) problems were other common reasons. The number of respiratory problem was increased during the winter season. The overall percentage of patients arriving at hospital with trauma problems was increased steadily, but it was not statistically significant. Conclusion Gastrointestinal problem was the most common reason, followed by respiratory and obstetric and gynecological problems for summoning ambulances services in the hilly regions of Nepal. The incidence of respiratory problem significantly increased during the winter season. KEY WORDS Ambulance services, Dhulikhel hospital, Emergency medical services, Pre-hospital carePublication The Current State of Ambulances and Emergency Medical Services in the Hilly Region of Nepal(Kathmandu University, 2024) Shresha, SK; Weiner, Y; Therriault, CABSTRACT Background Pre-hospital care in Nepal has seen marked improvement in recent years. Emergency medical services means out of hospital acute medical care and/or transportation provided to a patient with an illness or an injury. It continues to lack centralization of resources and standardization across personnel and patient transport vehicles operating in the country. Objective To describe the current state of ambulances including on-board equipment, emergency medical services and driver training among ambulances servicing a hilly region of Nepal. Method A descriptive study was conducted among 117 ambulance drivers transporting patients to the Emergency Department at Dhulikhel Hospital in Kavre, Nepal. A convenience sampling was done to collect data using the self-structured questionnaire during a one-month period from 1st to 30th November 2021. The questionnaire contained 21 items to gather information about the status of ambulance services. Data was analyzed using descriptive statistics. Result The majority of ambulances lack basic and advanced life support equipment. None of the ambulance drivers surveyed had completed formal ambulance driver training and only 35% had received some form of medical training. Most ambulances (70.1%) did not have a licensed paramedic onboard during transport. Majority of the ambulances (91%) were functioning as patient transport vehicle only and these were classified as C-grade ambulances. Conclusion Ambulances remain poorly staffed and under-resourced and ambulance drivers largely lack formal training and credentialing. Targeted interventions and investment are required to bring emergency medical services into compliance with national standards. KEY WORDS Ambulance, Emergency medical services, Pre-hospital care