EMERGENCY MEDICAL SERVICE USAGE AND ITS EFFECTS ON OUTCOMES IN ROAD TRAFFIC ACCIDENT CASES AT DHQ HOSPITAL KOHAT: A DISTRICT LEVEL INVESTIGATION

Abstract

Background: Road traffic injuries remain a major cause of death and disability in Pakistan, and prehospital emergency medical services (EMS) are widely assumed to improve trauma outcomes, though evidence from district level Pakistani hospitals is limited.

Objective: To determine EMS usage patterns and compare clinical outcomes between EMS  and non EMS transported road traffic accident (RTA) victims presenting to DHQ Hospital Kohat.

Methods: A cross sectional analysis of 165 RTA patients was conducted, comparing those transported by EMS ambulance (Rescue 1122) against those transported by non EMS means (private vehicle, police, or other informal transport), using chi square tests for categorical outcomes.

Results: Out Of 165 patients, 72 (43.6%) were transported by EMS and 89 (53.9%) by non EMS means (4 responses were unclassifiable). Most patients were young adult (73.3% aged 19–30) males (87.3%), with a near even rural/urban split. In hospital mortality (by discharge disposition) was 3.0% overall (n=5), with no significant difference between EMS (2.8%) and non EMS (3.4%) groups (χ²<0.001, p=1.00). ICU admission was numerically higher among EMS patients (25.0% vs. 15.7%, p=0.205), as was mechanical ventilation (33.3% vs. 21.3%, p=0.126) and median length of stay (1–3 days vs. same day discharge, p=0.077) none reaching statistical significance. Favourable functional outcome (GOSE 5–8) was seen in 63.9% of EMS patients versus 71.9% of non EMS patients (p=0.359), also not significant. EMS transported patients were more likely to be documented as stabilized before arrival (93.1% vs. 84.3%, p=0.141).

Conclusion: In this district level (Kohat) sample, EMS transport was not associated with statistically significant improvements in mortality, ICU admission, mechanical ventilation, length of stay, or functional outcome.