Effect of Use of Ambulance as Emergency Medical Service in Patients of ST-Elevation Myocardial Infarction

Abstract

Objective: To study the frequency of ambulance utilization by the St-elevation Myocardial Infarction patients toreach hospital, perception of ambulance users about the facilities available in the ambulance, and evaluate theclinical outcomes of STEMI between ambulance users and non-users.Study Design: Cross-section survey-based study.Place and Duration of Study: The study was carried out in the Department of Cardiology at Chaudry Pervaizth th Elahi Institute of Cardiology (CPEIC) Multan from 14 April 2020 to 14 September 2020.Materials and Methods: Patients with the diagnosis of STEMI were included in the study and were classifiedinto two groups' ambulance and non-ambulance users, to reach the facility. Patients' demographics, initialpresenting symptoms, availability of ambulance, and time to reach the hospital were recorded. Moreover, theywere followed for complication during their stay and base line laboratory indicators. Ambulance users werealso evaluated for their perception about availability of medical services in the ambulance. The data collectedfrom both of the groups were compared through student's t-test and chi-square test. Statistical value less than0.05 was considered as significant.Results: Out of 300 patients, 32.6% were ambulance users while 67.4% were non-ambulance user. Nosignificant difference was found in age, gender, underlying comorbidity, and initial presenting symptomsbetween two groups. Majority of ambulance users (74%) arrived in less than 45minutes. Differentcomplications were recorded but no significant difference was found between two groups. Majority ofambulance users 31.5% were neutral about the level of satisfaction for ambulance facilities.Conclusion: Frequency of ambulance utilization by STEMI patients is not only low in Pakistan, but ambulancesystem is also not successful in producing significant change in clinical outcomes. Therefore an awarenesscampaign along with ambulance improvement campaigns should be launched to bring a meaningful change.