Prehospital response to respiratory distress by the public ambulance system in a Ukrainian city

• Published in: World journal of emergency medicine 2019, Vol.10 (1), p.42-45
• Main Authors: Meghoo, Colin A, Gaievskyi, Stanislav, Linchevskyy, Oleksandr, Oommen, Bindhu, Stetsenko, Kateryna
• Format: Article
• Language: English
• Subjects: Analysis; Cardiopulmonary resuscitation; Care and treatment; CPR; Dyspnea; Emergency services; Epidemiology; Hospitals; Medical care; Original; Patients; Response time; Services; Treatment outcome; Ukraine; Urban areas
• ISSN: 1920-8642
• DOI: 10.5847/wjem.j.1920-8642.2019.01.006

The capability of the public ambulance system in Ukraine to address urgent medical complaints in a prehospital environment is unknown. Evaluation using reliable sources of patient data is needed to provide insight into current treatments and outcomes. We obtained access to de-identified computer records from the emergency medical services (EMS) dispatch center in Poltava, a medium-sized city in central Ukraine. Covering a five-month period, we retrieved data for urgent calls with a patient complaint of respiratory distress. We evaluated ambulance response and treatment times, field diagnoses, and patient disposition, and analyzed factors related to fatal outcomes. Over the five-month period of the study, 2,029 urgent calls for respiratory distress were made to the Poltava EMS dispatch center. A physician-led ambulance typically responded within 10 minutes. Seventy-seven percent of patients were treated and released, twenty percent were taken to hospital, and three percent died in the prehospital phase. On univariate analysis, age over 60 and altered mental status at the time of the call were strongly associated with a fatal outcome. The EMS dispatch center in a medium-sized city in Ukraine has adequate organizational infrastructure to ensure that a physician-led public ambulance responds rapidly to complaints of respiratory distress. That EMS system was able to manage most patients without requiring hospital admission. However, a prehospital fatality rate of three percent suggests that further research is warranted to determine training, equipment, or procedural needs of the public ambulance system to manage urgent medical conditions.