Factors Related to Accessing the Emergency Medical Service System of Emergency Patients on Scene Incident in a District Network

Abstract

This research aims to study the factors related to accessing emergency medical service systems of emergency patients to receive on scene care by emergency district network. Information will be utilized to develop protocol for residents in the area to improve quality and efficiency of the emergency medical services such as appropriate, standardized, and prompted of emergency services. This correlational research was collected data from three sample groups, including: (1) the emergency patients (Level 1 & Level 2) and their care giver (n=389), (2) Emergency Medical Responders (EMR) (n=17), and (3) Advanced Life Support (ALS) practitioners working at the hospital command center (n=12). The research tools were included general information questionnaires, quality assessment questionnaires, and the interviews form on reasons for using emergency medical services. The data collection period from March to August 2022, totaling 6 months. Quantitative data were analyzed using descriptive statistical consisting of frequency, average, percentage, and standard deviation. ChiSquare test was performed to analyze factors related to accessing emergency medical service systems, while content analysis were conducted on qualitative data from interviews. The results indicated that Emergency Medical Responders lacking of knowledge and understanding on primary assessments on scene incidents. In particular, primary assessments for the level of consciousness and blood circulation were corrected only 93.16% and 92.63% respectively. The result enables accurate assessment of severity level and requests for Advanced Life Support Unit for only 71.05%. Moreover, the command center provided an incorrect incident dispatch code (IDC) and inappropriate command to the operational team. As a result, the patients received improper of care. Participants mentioned that they had known the number 1669 (82.41%), however, some of them preferred to come to health care services by their own cars as their convenience (20.1%). Participants said they did not want to waste their time for waiting the ambulance due to concerning about being too late (12.1%). Some participants stated that they did not familiar with the emergency number, 1669, because living in remoted area and insufficient information about 1669. Participants were also concerned about the cost of using the EMS services and did not trust the Emergency Medical System personnels regarding the services. Therefore, number of emergency patients accessed to emergency services were less than the standard. Recommendations from this study included: (1) the Emergency Medical Service personnels should have in-service training and skills assessment regarding to the emergency patient assessment and proper care, (2) Wang Chao Hospital Command Center staff should be received an up-skill, re-skill programs to enhanced their competency related classifying emergency patients, and (3) There should be enhanced public communication on emergency medical services such as emergency number, 1669, pro and con of accessing emergency medical services.