How do patients come to the Accident and Emergency Department of RIPAS Hospital?

Introduction: The mode and speed of transportation to the Accident and Emergency Department (AED) of hospitals is very important for critically ill patients. This study looked at the mode of transportation to the AED at the Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital. Materials and Methods: Three different time periods: Period A from 15th May to 31st May 2004, (17 days, n=2,170 without prioritising), Period B from 1st January 2004 to 31st July 2006 (31 months, n=235 dead on arrival and resuscitation cases), and Period C from 20th to 26th November 2006 (7 days, all Priority Cases 1 to 3) were reviewed. Data on mode of transportation and triage categories were extracted from the ambulance response sheets. Results: During Period A, the main mode of transportation to the AED was private vehicles (90.7%) followed by ambulance (7.9%), and other transportation (1.4%). During study Period B, the main mode of transportation was also private transports (50.2%) followed closely by ambulance (48.5%) and other transportation (1.3%). During Period C, Priority 1 cases (life-threatening conditions, n=7(, most were transported with private transport (71.4%) followed by ambulance (28.6%); Priority 2 (n=232) cases, majority were transported with private transport (89.2%), followed by ambulance (10.3%), and one case used police transportation; and in Priority 3 cases (non-life threatening conditions, n=1,010), almost all were transported with private transport (98.7%), followed by police (0.9%) and ambulance (0.4%) respectively. Conclusion: Utilisation of designated emergency transportation is low especially for the moderate to seriously ill (Priority 1 and 2) patients when compared to other well developed countries. More needs to be done to improve the usage of emergency transportations especially for the seriously ill cases.

Why do patients come to the Accident and Emergency Department, RIPAS Hospital?

Introduction The total number of patients, especially the non-urgent cases (Priority 3) attending the Accident and Emergency Department (AED) of the RIPAS Hospital have increased from 1996 to 2003. This questionnaire study looked at the reasons for attending the AED of RIPAS Hospital instead of the outpatient peripheral clinics or health centres. Materials and Methods The study was conducted using prepared survey questions (17 questions) from 15th May to 15th June 2004 (32 days) on patients/care-givers/accompanying persons (Priority 3 - non-urgent/not serious cases) who attended the AED for various reasons. A total of 398 respondents participated in the study. Results Most of the respondenta were Bruneian (88.9%) with the rest consisting of permanent residents 4.6% and expatriates (7.2%). The majority of respondents were in the age group between 16 to 45 years (32.8%). Reasons for going the AED RIPAS hospital included complete facilities (Radiology, Laboratory and etc, 87.7%), provision of a 24 hours service (89.8%), patients' perception of their illnesses being serious (81.9%), more comprehensive check-ups (66%) and less traffic leading to the AED at certain times of the day (61.2%). Interestingly, some were unaware of available specified health services in their area and that extended services were available in Ong Sum Ping Health Centre. Conclusion A majority of responders attended the AED for various reasons. Patient education is important to increase awareness so that priority 3 cases can be directed to peripheral clinics to reduce congestions at the AED RIPAS Hospital.