Displaying publications 1 - 20 of 77 in total

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  1. The organisation of accident and emergency services in a developing country
    Silva JF
    Med J Malaysia, 1973 Sep;28(1):19-22.
    PMID: 4273776
    Matched MeSH terms: Emergency Medical Services*
  2. Internal iliac and ovarian artery ligation in the control of pelvic haemorrhage
    Thavarasah AS, Sivalingam N, Almohdzar SA
    Aust N Z J Obstet Gynaecol, 1989 Feb;29(1):22-5.
    PMID: 2562595
    Bilateral ligation of the internal iliac artery with or without ligation of the ovarian arteries was carried out in 17 patients who had life-threatening pelvic haemorrhage; 14 were due to obstetric haemorrhage, 2 followed abdominal hysterectomy and 1 intractable haemorrhage associated with carcinoma of the cervix. The procedure was successful in arresting the haemorrhage in 13 patients but 4 needed hysterectomy in spite of the ligation; 1 patient died from disseminated intravascular coagulation following surgery and 1 had cardiac arrest due to extensive blood loss during surgery and died 12 hours later. A review of the literature, a brief description of the procedure and its indications are discussed.
    Matched MeSH terms: Emergency Medical Services*
  3. Anatomy of a burns disaster: the Miri Bank explosion
    Wu WT, Ngim RC
    Ann Acad Med Singap, 1992 Sep;21(5):640-8.
    PMID: 1292393
    A bank explosion in a neighbouring country over 1000 km away resulted in ten badly burned victims being airlifted to the Burns Centre, Singapore General Hospital (BCSGH) for treatment. The severely injured included patients with 90%, 80%, 74%, 66%, 45%, 33% and 31% burns. Nine had respiratory burns (four severe, one moderate, four mild). One patient died, thus, the mortality rate for the six most severely injured was 16.7%. This differs from predicted mortality rates of 78% according to McCoy or 54% according to Thompson, Herndon et al. The factors contributing to this result were the small size of the disaster, the use of an established Burns Mass Disaster plan and an individual management policy that incorporates carefully monitored fluid resuscitation, recognition of respiratory burns with early treatment by intubation thus pre emptying complications, early surgery and a multidisciplinary approach to complications such as infection and renal failure. The average length of stay was 43 days (range 5-122 days). The cost of the hospitalisation of the ten casualties was $312,317.00.
    Matched MeSH terms: Emergency Medical Services
  4. Fulltext An audit on the assessment and management of acute bronchial asthma in the accident and emergency department of a district hospital
    Nivedita N
    Med J Malaysia, 1996 Mar;51(1):89-92.
    PMID: 10967985
    A study was undertaken to determine the assessment and management of adult asthmatic patients presenting to the Accident and Emergency department. The records of 50 consecutive adult asthmatic patients presenting to A & E with acute bronchial asthma between June 1993 to April 1994 were reviewed. Patients were also interviewed on their subsequent visit to hospital. Observations and measurements used to assess the severity of asthma were recorded with variable frequency--cyanosis 8%, inability to speak 2%, chest auscultation 64%, heart rate 10%, blood pressure 6%, respiratory rate 4%. The failure to record more objective measurements of severity of asthma and in particular extent of airflow obstruction is cause for concern. The drugs used to treat acute asthma in order of frequency were Beta agonists by nebuliser, 49 patients; intravenous aminophylline, 8 patients; and intravenous corticosteroids, 6 patients. 15 patients were admitted to the medical ward. The decision to admit patients appeared to be due to a lack of symptomatic improvement after treatment. Of the 35 patients who were discharged from A & E, 13 (37%) had an acute relapse within 10 days. None of the patients on discharge from A & E were given a short course of oral steroids or were advised an increase in steroid inhaler therapy. There was therefore a gross underuse of corticosteroids.
    Study site: Emergency department, Hospital Muar, Johor, Malaysia
    Matched MeSH terms: Emergency Medical Services*
  5. Designing a prehospital system for a developing country: estimated cost and benefits
    Hauswald M, Yeoh E
    Am J Emerg Med, 1997 Oct;15(6):600-3.
    PMID: 9337371
    Many of the costs associated with prehospital care in developed countries are covered in budgets for fire suppression, police services, and the like. Determining these costs is therefore difficult. The costs and benefits of developing a prehospital care system for Kuala Lumpur, Malaysia, which now has essentially no emergency medical services (EMS) system, were estimated. Prehospital therapies that have been suggested to decrease mortality were identified. A minimal prehospital system was designed to deliver these treatments in Kuala Lumpur. The potential benefit of these therapies was calculated by using statistics from the United States corrected for demographic differences between the United States and Malaysia. Costs were extrapolated from the current operating budget of the Malaysian Red Crescent Society. Primary dysrhythmias are responsible for almost all potentially survivable cardiac arrests. A system designed to deliver a defibrillator to 85% of arrests within 6 minutes would require an estimated 48 ambulances. Kuala Lumpur has approximately 120 prehospital arrhythmic deaths per year. A 6% resuscitation rate was chosen for the denominator, resulting in seven survivors. Half of these would be expected to have significant neurological damage. Ambulances cost $53,000 (US dollars) to operate per year in Kuala Lumpur; 48 ambulances would cost a total of $2.5 million. Demographic factors and traffic problems would significantly increase the cost per patient. Other therapies, including medications, airway management, and trauma care, were discounted because both their additional cost and their benefit are small. Transport of patients (including trauma) is now performed by police or private vehicle and would probably take longer by ambulance. A prehospital system for Kuala Lumpur would cost approximately $2.5 million per year. It might save seven lives, three of which would be marred by significant neurological injury. Developing countries would do well to consider alternatives to a North American EMS model.
    Matched MeSH terms: Emergency Medical Services/organization & administration*
  6. Out-of-hospital spinal immobilization: its effect on neurologic injury
    Hauswald M, Ong G, Tandberg D, Omar Z
    Acad Emerg Med, 1998 Mar;5(3):214-9.
    PMID: 9523928
    OBJECTIVE: To examine the effect of emergency immobilization on neurologic outcome of patients who have blunt traumatic spinal injuries.

    METHODS: A 5-year retrospective chart review was carried out at 2 university hospitals. All patients with acute blunt traumatic spinal or spinal cord injuries transported directly from the injury site to the hospital were entered. None of the 120 patients seen at the University of Malaya had spinal immobilization during transport, whereas all 334 patients seen at the University of New Mexico did. The 2 hospitals were comparable in physician training and clinical resources. Neurologic injuries were assigned to 2 categories, disabling or not disabling, by 2 physicians acting independently and blinded to the hospital of origin. Data were analyzed using multivariate logistic regression, with hospital location, patient age, gender, anatomic level of injury, and injury mechanism serving as explanatory variables.

    RESULTS: There was less neurologic disability in the unimmobilized Malaysian patients (OR 2.03; 95% CI 1.03-3.99; p = 0.04). This corresponds to a <2% chance that immobilization has any beneficial effect. Results were similar when the analysis was limited to patients with cervical injuries (OR 1.52; 95% CI 0.64-3.62; p = 0.34).

    CONCLUSION: Out-of-hospital immobilization has little or no effect on neurologic outcome in patients with blunt spinal injuries.

    Matched MeSH terms: Emergency Medical Services*
  7. Fulltext Profile of patients with abdominal aortic aneurysm referred to the Vascular Unit, Hospital Kuala Lumpur
    Zainal AA, Yusha AW
    Med J Malaysia, 1998 Dec;53(4):423-7.
    PMID: 10971988
    A prospective collection of patients referred with a diagnosis of abdominal aortic aneurysm (AAA) to the Vascular Unit, Hospital Kuala Lumpur (HKL) between February 1993 to July 1995 were analysed. There were a total of 124 patients, with a 85 per cent (%) male preponderance. Malays formed the largest ethnic group contributing about 60%. The median age of the patients was 69 years (range 49-84). Emergency referrals and admission accounted for 46.8% of patients. Hypertension and ischaemic heart disease were the two most common co-morbid medical conditions. The number of patients who underwent surgery was only 56 (45.2%). Of this total, 34 were done electively with an operative mortality of 8.8% (3 pts). The operative mortality for emergency surgery was 59.1%. AAA is relatively common in the older age group, especially in men and it should be actively looked for, as elective surgery can be offered with acceptable morbidity and mortality.
    Matched MeSH terms: Emergency Medical Services
  8. Fulltext Lower lip numbness due to peri-radicular dental infection
    Ngeow WC
    Med J Malaysia, 1998 Dec;53(4):446-8.
    PMID: 10971994
    Lower lip numbness has always been a sinister symptom. Much has been written about it being the sole symptom of pathological lesions and metastatic tumours in the mandible. It may also be a symptom of manifestations of certain systemic disorders. A case of lower lip numbness resulting from the compression of the mental nerve by a peri-radicular abscess is presented because of the unusual nature of this spread of infection.
    Matched MeSH terms: Emergency Medical Services
  9. Fulltext Multicentre study of preoxygenation practices by anaesthesia providers
    Wong AK, Sushila S, Thomas H, Tong JMG
    Med J Malaysia, 1999 Mar;54(1):102-9.
    PMID: 10972012
    A total of 155 consecutive anaesthetics in three public Malaysian hospitals were prospectively studied to assess preoxygenation practices by their anaesthesia providers. Preoxygenation was practised in 96.1% of patients. Specialist and non-specialist anaesthesiologist did not preoxygenate 8.8% and 2.3% of their patients, respectively. Overall incidence of arterial oxygen desaturation during induction was 15.5%. Arterial oxygen desaturation occurred more frequently with emergency surgery (30.2%) in comparison to elective surgery (9.8%). Arterial oxygen desaturation occurred more frequently with non-specialist (18.9%) than specialist anaesthesia providers (3.0%).
    Matched MeSH terms: Emergency Medical Services
  10. Animal health emergencies: prevention and preparedness in Asia
    Hashim HD
    Rev. - Off. Int. Epizoot., 1999 Apr;18(1):47-51.
    PMID: 10190203
    Besides response and recovery, prevention and preparedness are the two critical components of any contingency plan. The author discusses the various elements which must be present in the prevention and preparedness plan of countries in Asia. As the continent has such diverse peoples and veterinary infrastructures, the actual plan may vary from one country to another, but must incorporate those elements which are crucial to ensure the success of the preparedness plan.
    Matched MeSH terms: Emergency Medical Services/organization & administration
  11. Fulltext Revisiting the obstetric flying squad
    Ravindran J, Parampalam SD
    Med J Malaysia, 2000 Jun;55(2):280-2.
    PMID: 19839163
    The obstetric flying squad has been used in obstetric practice since 1933 to manage obstetric emergencies occurring in domicilliary practice. It has often been criticised in such situations as only delaying effective treatment to the patient. We have introduced the obstetric flying squad in an urban setting to cater for obstetric emergencies occurring in private practice. This service has been used on ten occasions since its inception without any maternal deaths being recorded or any delay in the provision of emergency care. The flying squad has led to closer cooperation between the government and private sectors in providing obstetric care.
    Matched MeSH terms: Emergency Medical Services*
  12. Risk of postnatal depression after emergency delivery
    Koo V, Lynch J, Cooper S
    J Obstet Gynaecol Res, 2003 Aug;29(4):246-50.
    PMID: 12959147
    AIM: To identify whether women having emergency delivery are at increased risk of developing postnatal depression (PND).

    METHODS: This is a retrospective comparative cohort study design. Two hundred and fifty Malaysian women were part of a previous study examining the prevalence of PND in a multiracial country and the effects of postnatal rituals. All women were at least 6 weeks post-partum when asked to complete the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic and birth data were obtained.

    RESULTS: Data collected were divided into two groups: 55 emergency delivery and 191 non-emergency delivery. There were four missing data. There was no significant difference in the mean age, parity, gestational period, baby birthweight, 5 min baby Apgar score and EPDS scores of the two groups. However, the analysis of PND indicated that women with emergency delivery had a relative risk of 1.81 compared with women with non-emergency delivery. The comparison of the two groups using chi2 indicated a significant (chi2 = 3.94, d.f. = 1, P = 0.04) increase in the presence of PND in the emergency delivery.

    CONCLUSION: When compared with women having non-emergency delivery, women having emergency delivery had about twice the risk of developing PND. Special attention to this group appears warranted.

    Matched MeSH terms: Emergency Medical Services
  13. The burden of terrorism in Malaysia
    Abul Aziz A
    Prehosp Disaster Med, 2003 Apr-Jun;18(2):115-9.
    PMID: 15074492
    In the peace-loving, moderate and progressive country of Muslim-dominated Malaysia, violence generally is alien to the culture. Terrorism initially took shape during the post-independence, communist era by jungle recalcitrant actions. In recent years, this has been superceded by a more internationally related trend of violence. Only very few incidents were based locally, while the majority were linked to international groups or organizations abroad, including the Kumpulan Mujahidin Malaysia (KMM), Jemaah Islamiyah (JI), and the Abu Sayyaf Group (ASG). Kidnapping with ransom seemed to have been the most commone modus operandi, while killing and robbery accounted for very few of these incidents. The number of victims in each event so far has been small, and smaller for those physically harmed or killed. This pattern of terrorist attacks suggests that the current level of provision of emergency medical services is sufficient to handle such incidents. Recent advances in local emergency medicine also have witnessed the establishment of various teaching and training modules, a pivotal role played by university hospitals and supported by the Ministry of Health. However, the spate of ongoing events of mass destruction such as the conflict in Israel/Palestine, wars in Afghanistan and Iraq, the World Trade Center and Pentagon tragedies of 11 September 2001, and the Bali bombing in Indonesia, remain as great concerns to Malaysians. Both the government and the people of Malaysia abhor such unjustified uses of terror, and take every measure to curtail them. The National Security Council policies of Arahan No. 18 and Arahan No. 20 detail specific roles and responsibilities of various agencies in managing terrorism and disasters respectively, while the use of the stern Internal Security Act that allows indefinite detention without trial, evidently has been an efficient intelligence and security apparatus. With more recent developments of terrorist events regionally and globally, Malaysia continues to face an ongoing threat from such activities. Various measures have been and will be actively undertaken both by government and non-governmental agencies in facing these challenges.
    Matched MeSH terms: Emergency Medical Services/organization & administration*
  14. The evidence for emergency obstetric care
    Paxton A, Maine D, Freedman L, Fry D, Lobis S
    Int J Gynaecol Obstet, 2005 Feb;88(2):181-93.
    PMID: 15694106
    We searched for evidence for the effectiveness of emergency obstetric care (EmOC) interventions in reducing maternal mortality primarily in developing countries.
    Matched MeSH terms: Emergency Medical Services/standards*
  15. Ambulance services at hospital universiti sains malaysia and hospital kota bharu: a retrospective study of calls
    Shah Che Hamzah MS, Ahmad R, Nik Abdul Rahman NH, Pardi KW, Jaafar N, Wan Adnan WA, et al.
    Malays J Med Sci, 2005 Jul;12(2):34-42.
    PMID: 22605956
    This retrospective study attempted to identify the pattern of ambulance calls for the past two years at the Hospital Universiti Sains Malaysia (HUSM) and Hospital Kota Bharu (HKB). This study will provide a simple method of acquiring information related to ambulance response time (ART) and to test whether it met the international standards and needs of the client. Additionally, this paper takes into account the management of emergency calls. This included ambulance response time, which was part of Emergency Medical Services (EMS) episode: onset of ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint had been noted. ART ended when the emergency team arrived at the scene of incident. Information regarding ambulance calls from the record offices of HUSM and HKB was recorded for the year 2001 and 2002, tabulated and analyzed. There was a significant difference in the total number of calls managed by HUSM and HKB in the year 2001. It was noted that 645 calls were managed by HUSM while 1069 calls were recorded at HKB. In the year 2002, however, HUSM led with 613 extra numbers of calls as compare to HKB with 1193 numbers of calls. The pattern of ambulance calls observed is thought to possibly be influenced by social activities like local festivities, school holidays and the seasons. Further, it is observed that no studies were previously undertaken to compare the ART at both the HUSM and HKB to that of the international standards. In fact, a literature review undertaken so far showed no similar studies have been done for the whole Malaysia.
    Matched MeSH terms: Emergency Medical Services
  16. Prehospital emergency medical services in Malaysia
    Hisamuddin NA, Hamzah MS, Holliman CJ
    J Emerg Med, 2007 May;32(4):415-21.
    PMID: 17499697
    Once a very slowly developing country in a Southeast Asia region, Malaysia has undergone considerable change over the last 20 years after the government changed its focus from agriculture to developing more industry and technology. The well-known "Vision 2020," introduced by the late Prime Minister, set a target for the nation to be a developed country in the Asia region by the year 2020. As the economy and standard of living have improved, the demand from the public for a better health care system, in particular, emergency medical services (EMS), has increased. Despite the effort by the government to improve the health care system in Malaysia, EMS within the country are currently limited, best described as being in the "developing" phase. The Ministry of Health, Ministry of Education, Civil Defense, and non-governmental organizations such as Red Crescent and St. John's Ambulance, provide the current ambulance services. At the present time, there are no uniform medical control or treatment protocols, communication systems, system management, training or education, or quality assurance policies. However, the recent development of and interest in an Emergency Medicine training program has gradually led to improved EMS and prehospital care.
    Matched MeSH terms: Emergency Medical Services/organization & administration*; Emergency Medical Services/standards; Emergency Medical Services/supply & distribution
  17. Giving a hand for Nias: a testimony of relief work during the Nias earthquake disaster
    Idrose AM
    J Emerg Med, 2008 Feb;34(2):209-11.
    PMID: 18282539 DOI: 10.1016/j.jemermed.2007.05.029
    Matched MeSH terms: Emergency Medical Services*
  18. Fulltext How frequent is bystander cardiopulmonary resuscitation performed in the community of Kota Bharu, Malaysia?
    Chew KS, Mohd Idzwan Z, Nik Hishamuddun NA, Wan Aasim WA, Kamaruddin J
    Singapore Med J, 2008 Aug;49(8):636-9.
    PMID: 18756348
    INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) serves as a vital link to improve the chance of survival among the out-of-hospital cardiac arrest (OHA) patients. The frequency of bystander CPR in Malaysia is largely unknown. The aim of this study was to find out how frequently bystander CPR was performed among OHA patients with CPR performed at the Emergency Department (ED), Hospital Universiti Sains Malaysia (HUSM), prior to their arrival to the department.
    METHODS: In this one-year observational study, data was collected from cases of CPR performed in ED, HUSM. In the OHA category, a subanalysis was further performed to look into the frequency and effects of bystander CPR on achieving return of spontaneous circulation and survival to hospital admission. The categorical data collected was analysed using chi-square test or Fisher-exact test.
    RESULTS: Out of a total of 23 OHA patients that had CPR performed on arrival at the ED, HUSM, from March 2005 to March 2006, only two cases (8.7 percent) had bystander CPR performed. None of these two cases achieved return of spontaneous circulation.
    CONCLUSION: Although this study has many limitations, it does indicate that the frequency of bystander CPR is dismally low in our community and the mere fact that bystander CPR was reported to be done does not seem to translate into a higher chance of survival to admission. The quality and effectiveness of the technique is equally important.
    KEYWORDS: bystander cardiopulmonary resuscitation, cardiopulmonary resuscitation, out-of-hospital cardiac arrest , return of spontaneous circulation
    Matched MeSH terms: Emergency Medical Services/statistics & numerical data
  19. Fulltext Patients' perception of the ambulance services at Hospital Universiti Sains Malaysia
    Anisah A, Chew KS, Mohd Shaharuddin Shah CH, Nik Hisamuddin NA
    Singapore Med J, 2008 Aug;49(8):631-5.
    PMID: 18756347
    Little is known regarding public opinion of prehospital care in Malaysia. This study was conducted to find out the public's perception and expectations of the ambulance services in one of the university hospitals in Malaysia.
    Matched MeSH terms: Emergency Medical Services
  20. Fulltext A Study of Patients’ Satisfaction with the Emergency Department (ED) of Hospital Universiti Kebangsaan Malaysia (HUKM)
    Isamil Saiboon, Ho, Siew Eng, Krishnan, Bala, Siti Norraini Ali, Noorafindi Murad, Pathnathan, Audrey, et al.
    Medicine & Health, 2008;3(1):7-13.
    MyJurnal
    Patients’ satisfaction is of critical interest to all healthcare providers. Satisfied patients are more likely to seek health care and to comply with prescribed treatment regimes. The objective of the study was to identify factors that influence patient satisfaction with Emergency Department HUKM (ED HUKM). This study was conducted at ED HUKM from January 2007 till March 2007. A convenience sample of 100 participants was recruited from triage 4. The Davis Consumer Emergency Care Satisfaction Scale (CECSS) was adopted and modified. It consists of 19 questions; used a 5 point, Likert type scale of 1 to 5 (1= completely disagree and 5= completely agree) to measure patient satisfaction with triage, health care providers caring behaviours and health teaching. Results showed that 75 participants (75%) were satisfied. There were no significant difference found between male and female patients with total CESCC scores (t=0.308, p values >0.05). Pearson product moment correlation coefficients showed a positive relationship between total and subscale patient satisfaction scores, caring scores (r=0.905, p value
    Matched MeSH terms: Emergency Medical Services
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