Assessment of Major Outcomes of Emergency Medical Services (EMS) in Relation to Signs and Symptoms at the Time of EMS Call

Submitted by sys1 on Wed, 03/01/2017 - 11:42
International Journal of Medicine and Public Health,2017,7,1,18-22.
Published:March 2017
Type:Original Article

Assessment of Major Outcomes of Emergency Medical Services (EMS) in Relation to Signs and Symptoms at the Time of EMS Call

Rajhans Prasad Anant1, Kulkarni Priya Yogesh2, Kelkar Dhananjay Shrikrishna3, Jog Sameer Arvind4, Ranade Gouri4, Utpat Sonal5, Hande Varsha6

1FICCM,Chief Intensivist, Deenanath Mangeshkar Hospital and research centre, Pune, India.

2Associate Professor, Community Medicine, SMBT Medical College, Nasik.

3Medical director, Deenanath Mangeshkar Hospital and research centre, Pune, India.

4Consultant Intensivist, Deenanath Mangeshkar Hospital and research centre, Pune, India.

5Head of Emergency Department, Deenanath Mangeshkar Hospital and research centre, Pune, India.

6Senior emergency medical officer, Deenanath Mangeshkar Hospital and research centre, Pune, India.

Abstract:

Background: EMS is in developing phase in India. There is a need to assess its outcomes based on signs and symptoms of patients at the time of EMS call. Aim: To assess the major outcomes of patients utilizing emergency medical services (EMS). Materials and Methods: Study was designed to assess major outcomes among patients brought to the hospital by EMS in Pune. It was hospital record based study. A person with medical background was trained to extract required data as per proforma enlisting all the required information. Glass gow coma scale (GCS) was used to assess severity of the patients. Patients with incomplete records were excluded. Data were entered in Microsoft excel and imported in SPSS 15.0 software for analysis. Frequencies and proportions were enlisted. Associations were tested by Chi squared test. Results: 849 patients were enrolled. 39.75% were females, 61.0% were males. Mean age 62.56 years (+20.76). Ambulance services reached at scene within 25 minutes in 75% cases. Highest number (38.4%) of patients had altered sensorium. 28% of the patients were in severe category and majority (62%) were in mild to moderate category of GCS scale. 9.7% patients with mild to moderate GCS died while 12.3% (27/212) patients with severe GCS died, difference in mortality was not significant (p=0.220, OR= 1.266, 95% CI= 0.814-1.969). Highest percentage of deaths among severe GCS category were recorded in patients with road traffic accidents (VIII) and seizures (XI). Conclusion: Study re-emphasizes importance of to reduce mortality among patient with severe GCS to the extent of mild to moderate GCS.

Keywords:EMS, GCS, Mortality

Signs and symptoms of EMS patients

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