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

ABSTRACT

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.