title: Need of improvement in emergency medical service in urban cities.
abstract: BACKGROUND
  An effective Emergency Medical Service system does not exist in Nepal. For an effective EMS system to be developed the scale of the problem and the existing facilities need to be studied.
  
  
  METHODS
  Prospective observational study was carried out on 1964 patients attending Emergency Department at Patan Hospital during one month period of September 2006. The patients were specifically enquired on mode of transport used, place of origin and whether they called for an ambulance or not. Patients triage category at the time of triaging was also noted. Information on ambulance service were collected by direct interview with the service providers and the total number of patients attending Emergency Departments daily were collected from the major hospitals of the urban Lalitpur and Kathmandu. MS Excel and SPSS software were used for data entry, editing and analysis.
  
  
  RESULTS
  Total 9.9% patients arrived in ambulance whereas 53.6% came in a Taxi, 11.4% came in private vehicle, 13.5 % came by bus, 5.4% came by bike and the rest 6.2% came by other modes of transportation. Only 13.5% of triage category I patients took the ambulance. There were 31 service providers with 49 ambulances and 720 patients per day attend Emergency Departments in the surveyed area.
  
  
  CONCLUSIONS
  Very less number of patients use the ambulance service for emergency services. The available ambulances are not properly equipped and do not have trained staff and as such are only a means of transportation to the hospitals of urban Lalitpur and Kathmandu.
authors.affiliation: Department of Surgery, Patan Hospital, Patan, Nepal. rajgongal@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Gongal
authors.forename: B
authors.initials: B
authors.lastname: Dhungana
authors.forename: S
authors.initials: S
authors.lastname: Regmi
authors.forename: M
authors.initials: M
authors.lastname: Nakarmi
authors.forename: B
authors.initials: B
authors.lastname: Yadav
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002947:Cities; D004636:Emergency Service, Hospital / Q000592:standards / Q000639:trends*; D005260:Female; D006786:Hospitals, Urban / Q000592:standards* / Q000600:supply & distribution; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009390:Nepal; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000639:trends*; D014218:Triage / Q000592:standards / Q000639:trends; D014505:Urban Population; D055815:Young Adult