Need of Improvement in Emergency Medical Service in Urban Cities

  • Rajesh Gongal Patan Hospital, Lalitpur
  • B Dhungana Patan Hospital, Lalitpur
  • S Regmi Patan Hospital, Lalitpur
  • M Nakarmi Health Care Foundation, Kathmandu
  • B Yadav Patan Hospital, Lalitpur


Introduction: 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
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.
Key Words: ambulance, emergency medical service, para-medics, triage
Need of Improvement in Emergency Medical Service in Urban Cities
Gongal R,1
Dhungana B,
Regmi S,
Nakarmi M,2
Yadav B
Patan Hospital, Lalitpur, Nepal,
Health Care Foundation, Kathmandu, Nepal
Dr. Rajesh Gongal
Department of Surgery
Patan Hospital, Patan, Nepal.
ORIGINAL ARTICLE J Nepal Med Assoc 2009;48(174):139-43
The sophisticated Emergency Medical Service (EMS)
is limited to developed country only. Many developing
countries are now slowly developing such system
although most services are localized to the urban areas.
Although inadquate ambulance services are available
in the capital city of Nepa

How to Cite
Gongal, R., Dhungana, B., Regmi, S., Nakarmi, M., & Yadav, B. (2009). Need of Improvement in Emergency Medical Service in Urban Cities. Journal of Nepal Medical Association, 48(174), 139-43.
Original Article