Variation in on-scene time of emergency medical services and the extent of the difference of on-scene time between genders: a retrospective population-based registry study in Riyadh Province, Saudi Arabia

Abstract

ObjectivesTo identify the intergender variation of on-scene time (OST) for highly urgent emergency cases conveyed by emergency medical services (EMS) in Saudi Arabia and to assess other predictors of OST and hypothesise for possible factors delaying OST.DesignA retrospective population-based registry study.SettingRiyadh Province is the largest province in terms of population and the second in terms of geographical area.ParticipantsAll highly urgent transported patients from the scene to emergency departments, be they medical emergencies or trauma emergencies during 2018.Outcome measureOST difference between men and women transported by EMS.ResultsIn total, 21 878 patients were included for analysis: 33.9% women and 66.1% men. The median OST for women was 22 min (IQR 15–30) and 18 min (IQR 11–26) for men (p<0.001); for medical cases, median OST was 23 min (IQR 16–31) for women compared with 20 min (IQR 13 – 29) for men (p<0.001); for trauma cases, the median OST of both sexes was equal. We found the following additional predictors of OST: factors of emergency type, sex, age category, geographical areas, type of ambulance vehicle and hospital type were all significantly associated with OST in the crude or adjusted analyses. Factors of emergency type, sex, age category, geographical areas, type of ambulance vehicle and hospital type were also significantly associated with the odds of OST of more than 15 min in the crude and adjusted regression analyses.ConclusionsThe median OST was longer than 15 min for more than half of transported cases. For medical cases, women had a longer median OST than men. Additional predictors associated with prolonged OST were the patient’s age, area (ie, urban vs rural), type of ambulance vehicle and season. These findings are hypothesis generating and require further studies.

Factors associated with EMS on-scene time and its regional difference in road traffic injuries: a population-based observational study

“…Older age is also known to be associated with longer on-scene time [3,22]. Age-related cognitive bias is one reason; another is failure of triage criteria to correctly identify elderly patients as they may sometimes appear to have less severe injury [23], even though this population can be severely injured from a less traumatic mechanism of injury [24].…”

Factors associated with prolonged on-scene time in ambulance transportation among patients with minor diseases or injuries in Japan: a population-based observational study

“…Older age is associated with prolonged OSTs in patients with trauma [ 14 ], those with road traffic injuries, highly-urgent transported patients [ 15 ], and transported patients [ 39 ]. Older people are likely to have more serious injuries than younger adults; thus, they may require a thorough assessment and a longer time for on-scene stabilization [ 39 ].…”

“…The present study also revealed that the female sex was associated with prolonged OSTs. Females had longer median or average OSTs than males in urgent cases [ 15 ], trauma [ 7 ], and coronary artery syndrome [ 40 – 42 ]. However, the plausible reasons for the prolonged OST among female patients in these cases and those with minor diseases or injuries are unclear.…”

“…Previous studies have reported the following factors related to prolonged OSTs: older age, female sex, blunt trauma, nighttime, and holidays in patients with trauma [ 7 , 13 , 14 ], and older age, female sex, minor diseases, intoxication, winter season, hospital type, and geographical areas in those with critical medical conditions [ 15 , 16 ]. However, factors related to prolonged OSTs in patients with minor diseases or injuries remain unclear.…”

Factors Associated with EMS On-Scene Time and Its Regional Difference in Road Traffic Injuries: A Population-based Observational Study

“…Older age is also known to be associated with longer on-scene time [3,23]. Age-related cognitive bias is one reason; another is failure of triage criteria to correctly identify elderly patients as they may sometimes appear to have less severe injury [24], even though this population can be severely injured from a less traumatic mechanism of injury [25].…”