Effect of Use of Ambulance as Emergency Medical Service in Patients of ST-Elevation Myocardial Infarction
Abstract
Objective: To study the frequency of ambulance utilization by the St-elevation Myocardial Infarction patients to
reach hospital, perception of ambulance users about the facilities available in the ambulance, and evaluate the
clinical outcomes of STEMI between ambulance users and non-users.
Study Design: Cross-section survey-based study.
Place and Duration of Study: The study was carried out in the Department of Cardiology at Chaudry Pervaiz
th th Elahi Institute of Cardiology (CPEIC) Multan from 14 April 2020 to 14 September 2020.
Materials and Methods: Patients with the diagnosis of STEMI were included in the study and were classified
into two groups' ambulance and non-ambulance users, to reach the facility. Patients' demographics, initial
presenting symptoms, availability of ambulance, and time to reach the hospital were recorded. Moreover, they
were followed for complication during their stay and base line laboratory indicators. Ambulance users were
also evaluated for their perception about availability of medical services in the ambulance. The data collected
from both of the groups were compared through student's t-test and chi-square test. Statistical value less than
0.05 was considered as significant.
Results: Out of 300 patients, 32.6% were ambulance users while 67.4% were non-ambulance user. No
significant difference was found in age, gender, underlying comorbidity, and initial presenting symptoms
between two groups. Majority of ambulance users (74%) arrived in less than 45minutes. Different
complications were recorded but no significant difference was found between two groups. Majority of
ambulance users 31.5% were neutral about the level of satisfaction for ambulance facilities.
Conclusion: Frequency of ambulance utilization by STEMI patients is not only low in Pakistan, but ambulance
system is also not successful in producing significant change in clinical outcomes. Therefore an awareness
campaign along with ambulance improvement campaigns should be launched to bring a meaningful change.
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