Achievements in emergency medical care service, North-West province, 2002 -2004

Objective. To analyse the performance of the Emergency Medical Rescue Service (EMRS) in North-West province. Design. A prospective study of the activity of the EMRS. Setting. North-West province, 2002 - 2004. Results. During this period the EMRS response time tended to decrease (reduction of 8 minutes for rural and 6 minutes for urban areas), and the province is now within the national goals. The number of EMRS calls and patients transported increased by a monthly average of 4.8% for the first year and 4.1% for the second year. This means an increase of 357 calls and 487 patients per month. The number of first priority (P-1) (7.4 - 9.0%) and second priority (P-2) (50.2 - 51.4%) cases transported is higher; this represents a more effective service. Mortality during transport remains the same (0.2%), while mortality at the scene has increased from 0.8% to 1% of calls. Medical cases (32.8%), maternity cases (24.1%), assaults (10.6%) and motor vehicle trauma (6.0%) were the main causes of EMRS requests during the 3 years of the study. Conclusion. Before 2003, the EMRS in North-West was one of the most undeveloped provinces in the country. The achievements (without any increase in resources) during the study period are good, and they result from changes in structure and policies, more effective control of resources, fleet management, and improvement in the medical qualification of staff. Southern African Journal of Critical Care Vol. 22 (1) 2006: pp. 22-27