PA 13-7-2910 EMS quality and safety of ramathibodi emergency medical service team


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Abstract

BackgroundNowadays, traumatic injury in Thailand are increasing, the estimated road traffic deaths in 2015 is 36.2 per 1 00 000 population. Traumatic injury patients need on scene advanced care by advance Emergency Medical Service(EMS) before transferred to Emergency Department(ED), evaluation of EMS performance is beneficial for EMS quality improvement while study of quality and safety of EMS system in traumatic injury in Thailand is limited. In Bangkok, Emergency medical service (EMS) system is under reponsibility of Bangkok Metropolitan Administration, Erawan Emergency Medical Centre. Ramathibodi hospital, a super tertiary university hospital located in central of Bangkok, Thailand, is responsible for zone 8 area EMS calls (6.10 Square kilometer around the hospital).Study of quality and safety of EMS in traumatic injury may be benefit to Ramathibodi EMS continuous quality improvement process to achieve higher quality of EMS.ObjectiveTo evaluate the EMS quality and safety performance of Ramathibodi EMS.MethodologyRetrospective descriptive study was conducted in Emergency medicine department. We studied Emergency Medical Record (EMR) of traumatic patients between 15–60 years who were transferred to ED by EMS between Jan 2017 – Dec 2017.ResultsThere were 416 patients were transferred to ED by EMS with 105 (25%) traumatic and 311 (74.7%) non-traumatic patients. The Ramathibodi EMS quality key performance indicators results were the average activation time within 2 min was 89.4%, response time within 10 min was 87.9%, scene time within 10 min was 75.6% for all EMS patients, 55.8%–30.2% and 14% for ESI triage level 1, 2 and 3 patients respectively. The Ramathibodi EMS safety results were : 100% of ESI triage Level 1 traumatic patients were treated by ATLS trainee physician within 1 min, only 46% of ESI triage Level 1 traumatic patients were treated by trauma specialist within 10 min, 100% of patients whose GCS<14 were done CT Brain within 1 hour, 100% of patients whose GCS<9 were intubation within 10 min, 100% of patients who had vascular injury were sent to operation room within 2 hour and 100% of patients who indicated for craniotomy were sent to operation room within 2 hour.ConclusionsRamathibodi emergency medical service team achieved good EMS quality and safety performance levels in compare with standard Thai EMS criteria.

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