Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-23T10:50:43.260Z Has data issue: false hasContentIssue false
  • English
  • Français

Ambulance Service in Kathmandu, Nepal: Service Delivery Constraints, Challenges, and Achievements during the COVID-19 Pandemic

Published online by Cambridge University Press:  05 December 2022

Prativa Regmi Open the ORCID record for Prativa Regmi [Opens in a new window] ,
Damaru Prasad Paneru ,
Pratibha Oli ,
Upama Baral ,
Durga Poudel  and
Deepa Khadka Thapa
Prativa Regmi*
Affiliation:
Department of Public Health, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
Damaru Prasad Paneru
Affiliation:
Department of Public Health, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
Pratibha Oli
Affiliation:
Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Nepal
Upama Baral
Affiliation:
Department of Public Health, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
Durga Poudel
Affiliation:
Department of Public Health, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
Deepa Khadka Thapa
Affiliation:
Department of Public Health, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
*
Correspondence: Prativa Regmi, MPH Department of Public Health School of Health and Allied Sciences Pokhara University Kaski, Nepal E-mail: prativaregmi1@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

An Emergency Medical Service (EMS) is defined as a complete system that responds to public medical and surgical emergencies with prompt and adequate emergency care. Ambulance services are also classified as EMS in modern medical history. In the Nepalese context, prehospital care is very limited, and the EMS system is still a new concept in Nepal. In a study in the emergency room at Patan Hospital in Kathmandu, only 9.9% of patients came by ambulance, 53.6% by taxi, 11.4% by private car, 13.5% by bus, 5.4% by bicycle, and another 6.2% came with alternative routes.

Objectives:

This study aims to investigate the constraints, challenges, and achievements made by ambulances services during the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

The study design was phenomenological and the method was qualitative. In-depth interviews (IDIs) were conducted with six human resources working from the COVID-19 first wave pandemic in the ambulance service of Nepal Ambulance Service (NAS), Kathmandu.

Result:

Four themes were generated from IDIs: (1) challenges in service delivery; (2) constraints on service delivery; (3) working experiences; and (4) achievements of ambulatory service providers during the COVID-19 pandemic. Under these four themes, 12 sub-themes were constructed. The new nature of disease (COVID-19) in the first wave led to fear and anxiety, which also forced them to think about quitting the job; however, later on with proper training and safety measures, it led to working for COVID-19 patient transfers from home to hospital, as well as hospital to hospital, and proper prehospital care services were provided. The major challenges faced by ambulatory service providers were long working hours, wearing a single personal protective equipment (PPE) for long hours, confusing locations to pick up patients, and both stigma and discrimination.

Conclusion:

From IDIs, it was concluded that although constraints and challenges arise during a pandemic, from proper guidance and support through NAS, they are able to provide proper prehospital care for the patient. Challenges like fear, heavy workload, PPE, and other material barriers do not hamper in service delivery.

Keywords

ambulance serviceCOVID-19Emergency Medicineprehospital
Type
Research Report
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 1 , February 2023 , pp. 122 - 129
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rockwood, CA Jr., Mann, CM, Farrington, J, Hampton, OP Jr., Motley, RE. History of emergency medical services in the United States. J Trauma Acute Care Surg. 1976;16(4):299–308.CrossRefGoogle ScholarPubMed
Pantridge, JF, Wilson, C. A history of prehospital coronary care. Ulster Med J. 1996;65(1):68–73.Google ScholarPubMed
Walker, R, Auerbach, PS, Kelley, BV, Gongal, R, Amsalem, D, Mahadevan, S. Implementing an emergency medical services system in Kathmandu, Nepal: a model for “white coat diplomacy.” Wilderness Environ Med. 2014;25(3):311–318.CrossRefGoogle Scholar
Bhandari, D, Yadav, NK. Developing an integrated emergency medical service in a low-income country like Nepal: a concept paper. Int J Emerg Med. 2020;13(1):7.CrossRefGoogle Scholar
Arif, M, Doost, MM. Prevalence of COVID-19 among typical ambulatory care patients in a district general hospital in the United Kingdom. Cureus. 2020;12(11).Google Scholar
Paudel, S. Study of Ambulance Services in Nepal Including Lessons Learned and Recommendations. Kathmandu, Nepal: Centre for Policy Studies; 2002.Google Scholar
Bhanot, D, Singh, T, Verma, SK, Sharad, S. Stigma and discrimination during COVID-19 pandemic. Front Public Health. 2021;8:577018.CrossRefGoogle ScholarPubMed
Liu, Q, Luo, D, Haase, JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020;8(6):e790–e798.CrossRefGoogle ScholarPubMed
Mohammadi, F, Tehranineshat, B, Bijani, M, Khaleghi, AA. Management of COVID-19-related challenges faced by EMS personnel: a qualitative study. BMC Emerg Med. 2021;21(1):1–9.CrossRefGoogle ScholarPubMed
Chandy, P, Kanthi, E, Pradeep, P, et al. Lived experience of health-care providers during COVID-19: a meta-synthesis. Indian J Psychiatry. 2022;64(2):120–129.CrossRefGoogle ScholarPubMed
McGillis Hall, L, Kashin, J. Public understanding of the role of nurses during Ebola. J Nurs Scholarsh. 2016;48(1):91–97.CrossRefGoogle ScholarPubMed