No abstract

Introduction: Ambulance response time (ART) has an inseparable relationship with mortality rates and therefore is important to be reduced. However, an unprecedented increase in road traffic congestion has led to longer ART, especially during peak hours. To reduce ART despite congested traffic, a pre-dispatched ambulance is deployed at hotspot locations during peak hours. This study aims to determine if the hotspot strategy is able to reduce ART in an Urban Emergency Medical Services system.

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. There have been numerous reports documenting the differences in outcomes after carbon monoxide poisoning between men and women. There are also several reports mentioning the differences in presentation and outcome of poisoning in adults and children. Case Series: We report two construction workers who had carbon monoxide poisoning while watching television. They used a petrol generator to power their television during a power outage, and the generator was placed in the same confined room. All windows were closed due to heavy rain and strong winds outside. Both patients were found motionless the next morning in front of the television. The two patients aged 16 and 22 years old presented to emergency department with almost similar complaints but had a very differing hospital course. The 16-year-old had status epilepticus needing intubation and ICU admission while the other was well throughout his stay. Both patients underwent two courses of hyperbaric oxygen therapy using the Royal Malaysian Navy treatment table 18-60-30. The 16-year-old was placed in the multi-place hyperbaric chamber while still intubated. Both patients were discharged without any neurological deficits. Conclusion:The clinical course of patients with carbon monoxide poisoning may differ due to factors other than gas concentration and duration of exposure.

Background: PHC services particularly the ambulance call is traditionally a hospital-based system. Within the Kota Kinabalu area, there are 3 tertiary hospitals that provide the ambulance call service; and also provide the interfacility transfer, disaster management and medical team standby. How about the health clinics? Health clinics play a major role for primary healthcare and the interfacility transfer of patient from the health clinics to the hospital. Keywords: ambulance, health clinic, prehospital care