Emergency Response Time Of The National Ambulance Service And Pre-Hospital Trauma Survival Rate For 2014 In The Greater Accra Region

ABSTRACT

Background

It is a common goal among emergency medical systems all over the world to respond as fast as possible to the scene of emergencies in order to improve patient outcome. The study was done to assess whether ambulance response time has an influence on prehospital trauma survival.

Method:

A retrospective cross sectional study whereby data from trauma patients transported by ambulances belonging to the National Ambulance Service from January to December 2014 in the Greater Accra Region were reviewed. Chi squire test was conducted to test an association between emergency response time and pre- hospital trauma survival. Logistic regression was also used to determine if ambulance response time is a significant predictor of survival after controlling for age, sex, level of consciousness and types of injuries.

Results.

Out of 20,236 patient transported in the region, 652 trauma patients were included in the study. The proportion of the patients who survived pre-hospital trauma was 98.8%. The proportion of patients who were responded to within 8 minutes response time is 36.7%. The mean response time of the patients was 16.9 minutes with standard deviation of 0.68 and confidence interval of 15.6 to 18.2. The median time for an ambulance to receive a call for an emergency through to the time the patient is handed over to the hospital was 82 minutes (transportation time). The median time spent in managing patients on the scene of emergencies was 17 minutes. Pre-hospital trauma survival was associated with response time, when it was modeled as a continuous variable with odd ratio of 0.95 and confidence interval of 0.92 to 0.98 and a p-value of 0.001 after adjusting for age, sex, level of consciousness and types of injuries. 

Conclusion

There is a high trauma patient’s survival rate among victims of accident attended to by an ambulance in Ghana. The emergency response time in Ghana is twice higher than the national target of 8 minutes. The 90% of response times to the scene of emergencies within 8 minutes standard was also not achieved by Ghana. As response time to emergencies increases by one minute, the odds of dying from trauma in pre-hospital setting increased by 5%. In other words, there is a 95% chance of surviving pre-hospital trauma at every one-minute decrease in response time to an emergency scene. Emergency response time should be reduced in order to improve survival at the scene of emergencies