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 <1 or >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.