Performance of an Emergency Road Ambulance Service in Bhutan: Response Time, Utilization, and Outcomes

• Published in: Tropical medicine and infectious disease 2022-05, Vol.7 (6), p.87
• Main Authors: Tshokey, Tshokey, Tshering, Ugyen, Lhazeen, Karma, Abrahamyan, Arpine, Timire, Collins, Gurung, Bikash, Subedi, Devi Charan, Wangdi, Kencho, Vilas, Victor Del Rio, Zachariah, Rony
• Format: Article
• Language: English
• Subjects: Bhutan; Call centers; emergency ambulance performances; Emergency medical care; Global positioning systems; GPS; Health facilities; Hospitalization; Low income groups; operational research; Personal protective equipment; Population; Response time; Roads & highways; SDGs; SORT IT; Telephone hotlines; Trends; universal healthcare
• ISSN: 2414-6366; 2414-6366
• DOI: 10.3390/tropicalmed7060087

Background: An efficient ambulance service is a vital component of emergency medical services. We determined the emergency ambulance response and transport times and ambulance exit outcomes in Bhutan. Methods: A cross-sectional study involving real-time monitoring of emergency ambulance deployments managed by a central toll-free (112) hotline (20 October 2021 to 20 January 2022) was carried out. Results: Of 5092 ambulance deployments, 4291 (84%) were inter-facility transfers, and 801 (16%) were for emergencies. Of the latter, 703 (88%) were for non-pregnancy-related emergencies (i.e., medical, surgical, and accidents), while 98 (12%) were for pregnancy-related emergencies. The median ambulance response and patient transport times were 42 (IQR 3–271) and 41 (IQR 2–272) minutes, respectively. The median round-trip distance travelled by ambulances was 18 km (range 1–186 km). For ambulance exit outcomes that were pregnancy-related (n = 98), 89 (91%) reached the health facility successfully, 8 delivered prior to ambulance arrival at the scene or in the ambulance during transport, and 1 had no outcome record. For the remaining 703 non-pregnancy deployments, 29 (4.1%) deployments were deemed not required or refusals, and 656 (93.3%) reached the health facility successfully; 16 (2.3%) died before the ambulance’s arrival at the scene, and 2 (0.3%) were not recorded. Conclusions: This first countrywide real-time operational research showed acceptable ambulance exit outcomes. Improving ambulance response and transport times might reduce morbidities and mortalities further.