{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T22:37:08Z","timestamp":1788302228997,"version":"build-2803163510"},"reference-count":11,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1049023X22002242_as1\"><jats:title>Introduction:<\/jats:title><jats:p>An Emergency Medical Service (EMS) is defined as a complete system that responds to public medical and surgical emergencies with prompt and adequate emergency care. Ambulance services are also classified as EMS in modern medical history. In the Nepalese context, prehospital care is very limited, and the EMS system is still a new concept in Nepal. In a study in the emergency room at Patan Hospital in Kathmandu, only 9.9% of patients came by ambulance, 53.6% by taxi, 11.4% by private car, 13.5% by bus, 5.4% by bicycle, and another 6.2% came with alternative routes.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X22002242_as2\"><jats:title>Objectives:<\/jats:title><jats:p>This study aims to investigate the constraints, challenges, and achievements made by ambulances services during the coronavirus disease 2019 (COVID-19) pandemic.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X22002242_as3\"><jats:title>Methods:<\/jats:title><jats:p>The study design was phenomenological and the method was qualitative. In-depth interviews (IDIs) were conducted with six human resources working from the COVID-19 first wave pandemic in the ambulance service of Nepal Ambulance Service (NAS), Kathmandu.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X22002242_as4\"><jats:title>Result:<\/jats:title><jats:p>Four themes were generated from IDIs: (1) challenges in service delivery; (2) constraints on service delivery; (3) working experiences; and (4) achievements of ambulatory service providers during the COVID-19 pandemic. Under these four themes, 12 sub-themes were constructed. The new nature of disease (COVID-19) in the first wave led to fear and anxiety, which also forced them to think about quitting the job; however, later on with proper training and safety measures, it led to working for COVID-19 patient transfers from home to hospital, as well as hospital to hospital, and proper prehospital care services were provided. The major challenges faced by ambulatory service providers were long working hours, wearing a single personal protective equipment (PPE) for long hours, confusing locations to pick up patients, and both stigma and discrimination.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X22002242_as5\"><jats:title>Conclusion:<\/jats:title><jats:p>From IDIs, it was concluded that although constraints and challenges arise during a pandemic, from proper guidance and support through NAS, they are able to provide proper prehospital care for the patient. Challenges like fear, heavy workload, PPE, and other material barriers do not hamper in service delivery.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1049023x22002242","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T13:25:20Z","timestamp":1670246720000},"page":"122-129","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Ambulance Service in Kathmandu, Nepal: Service Delivery Constraints, Challenges, and Achievements during the COVID-19 Pandemic"],"prefix":"10.1017","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8639-6680","authenticated-orcid":false,"given":"Prativa","family":"Regmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damaru Prasad","family":"Paneru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratibha","family":"Oli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upama","family":"Baral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durga","family":"Poudel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Khadka Thapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"S1049023X22002242_ref1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-197604000-00008"},{"key":"S1049023X22002242_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2014.04.006"},{"key":"S1049023X22002242_ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.577018"},{"key":"S1049023X22002242_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30204-7"},{"key":"S1049023X22002242_ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12873-021-00489-1"},{"key":"S1049023X22002242_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12182"},{"key":"S1049023X22002242_ref2","first-page":"68","article-title":"A history of prehospital coronary care","volume":"65","author":"Pantridge","year":"1996","journal-title":"Ulster Med J."},{"key":"S1049023X22002242_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s12245-020-0268-1"},{"key":"S1049023X22002242_ref5","article-title":"Prevalence of COVID-19 among typical ambulatory care patients in a district general hospital in the United Kingdom","volume":"12","author":"Arif","year":"2020","journal-title":"Cureus."},{"key":"S1049023X22002242_ref10","doi-asserted-by":"publisher","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_1403_20"},{"key":"S1049023X22002242_ref6","volume-title":"Study of Ambulance Services in Nepal Including Lessons Learned and Recommendations","author":"Paudel","year":"2002"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X22002242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T03:35:47Z","timestamp":1698636947000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X22002242\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,5]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["S1049023X22002242"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x22002242","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,5]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}