ArticleBMC health services research2026
Insights into collapse in ambulances (CIA): a retrospective analysis of interfacility transfers from Emergency Medical Services (EMS) of Sindh, Pakistan.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency Medical Services (EMS) is the cornerstone of healthcare service delivery, especially in lower and middle-income countries (LMICs). Given the scarcity of literature, the study determines the rate of patient collapse in ambulances (CIA), in association with history, complaints, and other contributing factors. CIA is a novel terminology coined by the study team, referring to out-of-hospital deaths in ambulances.
methodsThe study employed a retrospective approach from EMS records in Sindh to determine the patient collapse rate from July 2023 to February 2024. The dataset included interfacility transfers in which patients were transported between health facilities. Data collected via reports of ambulance response and transfer reports were extensively studied to determine the rate of CIA, response time, types of cases, types of transfers, and need for transfers, along with patient condition, diagnosis, and procedures conducted en route to transfer.
resultsThe findings reported a rate of CIA as 0.019% (n = 37) out of 195,638 cases, with the average response time for all the cases being less than 10 min, highlighting the consistent service delivery. In line with the presenting complaints, the majority of CIAs resulted from abnormal breathing (32.4%) and cardiac/respiratory arrest (32.4%). All the CIA cases were either serious or life-threatening, transferred to the need for a higher level of care. All the requests were made from the public sector secondary hospital to a similar setup or tertiary care, thereby highlighting shortcomings in the existing model of healthcare service delivery in Sindh.
conclusionTo prevent the collapse of serious and life-threatening patients in ambulances regardless of uncontrolled risks, it is important to obtain comparative data as well as measure the performance of EMS and ambulance crews for healthcare improvement. In addition, addressing the healthcare inequities through a systems approach is vital to improve patient outcomes at both the prehospital and hospital levels through the provision of essential care before patient transfer.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.