Alanazy Ahmed Ramdan M, Wark Stuart, Fraser John, Nagle Amanda
School of Rural Medicine, Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia.
Saudi J Med Med Sci. 2021 Jan-Apr;9(1):38-44. doi: 10.4103/sjmms.sjmms_560_20. Epub 2020 Dec 26.
Callouts resulting in patient nontransportation can impact the overall quality of prehospital Emergency Medical Service (EMS), as resources in health care are finite. While some studies have investigated the causes of nontransportation, few have examined whether there are differences between urban and rural patients. Similarly, there has been limited research focused on rural EMS in locations such as the Middle East.
This study investigated EMS cases that resulted in nontransportation in the urban and rural areas of the Riyadh region in the Kingdom of Saudi Arabia.
A cross-sectional study of 800 (400 rural and 400 urban) patient records was undertaken, using 12 months (January 1 to December 31, 2017) of data from the Saudi Red Crescent EMS. A random sampling method was used to select ambulance records from the 78 urban and rural EMS stations in the Riyadh region, with demographic data and reasons for patient nontransport analyzed comparatively.
A total of 310 cases were nontransported (39%) (rural: 146; urban = 164). The highest rates of nontransportation cases were of medical and trauma callouts (44.6% and 39.6%, respectively), which was consistent in both areas. The most common reason for nontransportation in both urban and rural areas was refusal of treatment and transportation (66.5% and 59.9%, respectively). Further, 10 patients were treated on-scene and released by rural EMS, while no urban patients were treated and released. Overall, the case presentations of nontransported patients did not differ significantly between both areas, and it was found that gender, age, and geographic location were not predictors for nontransportation.
The high rate of nontransportation, particularly in medical and trauma callouts, indicates that a review of current EMS protocols may be required, along with consideration of relevant community education programs.
由于医疗资源有限，导致患者未被转运的情况会影响院前急救医疗服务（EMS）的整体质量。虽然一些研究调查了未转运的原因，但很少有研究探讨城乡患者之间是否存在差异。同样，针对中东等地农村EMS的研究也很有限。
本研究调查了沙特阿拉伯王国利雅得地区城乡导致患者未被转运的EMS病例。
采用横断面研究，对800份（400份农村和400份城市）患者记录进行分析，数据来自沙特红新月会EMS的12个月（2017年1月1日至12月31日）。使用随机抽样方法从利雅得地区的78个城乡EMS站点中选取救护车记录，对人口统计学数据和患者未被转运的原因进行比较分析。
共有310例患者未被转运（39%）（农村：146例；城市：164例）。未转运病例发生率最高的是医疗和创伤呼叫（分别为44.6%和39.6%），这在两个地区都是一致的。城乡未转运的最常见原因都是拒绝治疗和转运（分别为66.5%和59.9%）。此外，10名患者在农村EMS现场接受治疗后出院，而城市患者无人接受治疗后出院。总体而言，两个地区未转运患者的病例表现没有显著差异，并且发现性别、年龄和地理位置不是未转运的预测因素。
未转运率较高，尤其是在医疗和创伤呼叫中，这表明可能需要对当前的EMS协议进行审查，并考虑相关的社区教育项目。
