Prehospital Time Intervals in Thailand during COVID-19

Abstract

Objective: To determine the effect of the coronavirus disease, 2019 (COVID-19) pandemic on the prehospital time intervals of emergency medical services (EMS) in Thailand. Material and Methods: This retrospective cohort study analyzed the prehospital time intervals of EMS in Thailand; from January 1, 2019 to September 30, 2021 using data obtained from the national EMS database. Patients with incomplete medical records, prehospital time intervals 300 minutes, and those admitted between January 1 and March 31, 2020 were excluded. Data were compared between the following groups: Group 1, pre-COVID-19; Group 2, first- and second-wave of COVID-19; and Group 3, third-wave of COVID-19: Kruskal–Wallis, Wilcoxon rank-sum, and chi-square tests were used. Results: A total of 3,863,153 patients were enrolled into this study. The median total prehospital time was significantly longer in Group 2 when compared to Group 1, [25 (17,34) vs. 24 (17,33) minutes, p-value<0.001]; longer on-scene time, [4 (2,7) vs. 3 (2,6) minutes, p-value<0.001]; shorter transportation time, [10 (6,17) vs. 11 (6,18) minutes, p-value<0.001]. The median total prehospital time [27 (19,37) vs. 25 (17,34) minutes, p-value<0.001], response time [8 (5,14) vs. 7 (4,11) minutes, p-value<0.001], and transportation time were significantly longer in Group 3 than in Group 2 [11 (6,18) vs. 10 (6,17) minutes, p-value<0.001]. Conclusion: The EMS prehospital time intervals in Thailand during COVID-19 were significantly longer in both the non-trauma and trauma subgroups. Appropriate pre-hospital strategies and monitoring should be developed to manage future pandemics.

Keywords

• covid-19
• emergency medical services
• pandemic
• prehospital time intervals
• thailand