RESUMO
Background Nepal lacks a unified and countrywide emergency medical services system as other developing countries. However, the emergence of ambulance service initiatives in the past decade shows a promising future for pre-hospital care. Nepal Ambulance Service (Est. 2011) and Dhulikhel Emergency Medical Services (Est. 2013) are the existing emergency medical services initiatives in Nepal. Objective To describe the reason for summoning ambulance services and demographics of the patients who were transported by Dhulikhel Emergency Medical Services at Dhulikhel hospital, hilly region of Nepal. Method One thousand three hundred and ninety three patient records at Dhulikhel hospital transported by Dhulikhel Emergency Medical Services during the five-year period (2013 - 2018) were included in the study. Chief complaints and demographic data were collected and categorized into overarching systemic categories. Result Among 1393 patients, majority were female (60.4%) and the most common age group was 20-29 years. The most common reason for calling ambulances was gastrointestinal problem (22.6%). Similarly, respiratory (17%), obstetric and gynecological (15.2%), trauma (12.7%) and neurological (9.6%) problems were other common reasons. The number of respiratory problem was increased during the winter season. The overall percentage of patients arriving at hospital with trauma problems was increased steadily, but it was not statistically significant. Conclusion Gastrointestinal problem was the most common reason, followed by respiratory and obstetric and gynecological problems for summoning ambulances services in the hilly regions of Nepal. The incidence of respiratory problem significantly increased during the winter season.
Assuntos
Ambulâncias/estatística & dados numéricos , Fenômenos Geológicos , Hospitais/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Nepal , Gravidez , Estudos Retrospectivos , Estações do Ano , Fatores Sexuais , Fatores Socioeconômicos , Adulto JovemRESUMO
Blunt traumatic rupture of the left ventricle of the heart is rarely diagnosed preoperatively and is usually fatal, with only a few survivors reported in the literature. This report describes a case of a 54-year-old woman who survived a left ventricular rupture from a motor vehicle accident. Her cardiac injury was not suspected because she was not hypotensive and had no signs of pericardial tamponade. She developed circulatory arrest 2 hours after her injury, during induction of anesthesia.
