Response times of ambulances to calls from Midwife Obstetric Units of the Peninsula Maternal and Neonatal Service (PMNS) in Cape Town

Abstract

Curationis 32 (1): 59-66MOU, am bulance, response tim e, Response times of ambulances to calls from Midwife Obstetric Units, although var-^MNS jc(j, are perceived as slow. Delays in transporting women experiencing complications during or after their pregnancies to higher levels o f care may have negative conse quences such as fetal, neonatal or maternal morbidity or death.An exploratory descriptive study was undertaken to investigate the response times of ambulances of the Western Cape Emergency Medical Services to calls from mid wife obstetric units (MOUs) in the Peninsula Maternal and Neonatal Services (PMNS) in Cape Town. Response times were calculated from data collected in specific MOUs using a specifically developed instrument. Recorded data included time o f call placed requesting transfer, diagnosis or reason for transfer, priority of call and the time of arrival o f ambulance to the requesting facility. Mean, median and range o f response times, in minutes, to various MOUs and priorities of calls were calculated. These were then compared using the Kruskal-Wallis test. A comparison was then made between the recorded and analysed response times to national norms and recommendations for ambulance response times and maternal transfer response times respectively.A wide range o f response times was noted for the whole sample. Median response times across all priorities o f calls and to all MOUs in sample fell short o f national norms and recommendations. No statistical differences were noted between various priorities o f calls and MOUs.

Responsiveness of emergency obstetric care systems in low‐ and middle‐income countries: a critical review of the “third delay”

“…Onwudiegwu et al point to poor management in primary‐level facilities as an important source of delays before referrals. Recorded time from requesting an ambulance to arrival at the referring facility ranged from 45 min to 48 h , emphasizing that the lack of ambulances stationed at lower‐level facilities are a significant component of referral delays. In South Africa, ambulance response time did not vary by priority of call , suggesting that patients in critical condition were not successfully prioritized for transport.…”

“…First, referrals are incorporated under the third delay (see Okonufua et al ) rather than the second delay, because the decision to refer and availability of ambulances directly depend on health system performance. Secondly, delays were reported between prescription and purchase of drugs or blood for transfusion , and between call and arrival of the ambulance : two additional steps were incorporated for “obtaining treatment” and “securing transport” on the treatment and referral pathways, respectively (these are shown in the shaded boxes in Figure ).…”

Near-miss maternal morbidity from severe haemorrhage at caesarean section: A process and structure audit of system deficiencies in South Africa

“…The national standard for ambulance waiting time is <1 hour. [10] The international standard for decision-to-incision interval (DII) for caesarean section is 30 minutes; the SA national guidelines, however, accept 60 minutes. [11] Oxytocin is administered routinely to all SA patients during the third stage of labour, regardless of mode of delivery.…”