Shortening Door-to-Balloon Time: The Use of Ambulance versus Private Vehicle for Patients with ST-Segment Elevation Acute Myocardial Infarction

Abdulrhman Saleh Alghamdi,1,2 Abdullah Alshibani,1,2 Meshary Binhotan,1,2 Meshal Alharbi,1,2 Saleh S Algarni,2,3 Mohammed Musaed Alzahrani,1,2 Abdulmalik Nasser Asiri,1,2 Faisal Faleh Alsulami,1,2 Kamal Ayoub,2,4 Abdullah Alabdali1,2 1Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11481, Saudi Arabia; 4Ministry of the National Guard - Health Affairs, Riyadh, Saudi ArabiaCorrespondence: Abdulrhman Saleh Alghamdi, Emergency Medical Services, College of Applied Medical Sciences, Ext. 95186, Mail Code 3129, P.O. Box 3660, Riyadh, 11481, Saudi Arabia, Tel +96611 429 9999, Email [email protected]: Time is critical when dealing with acute myocardial infarction (AMI) patients in the Emergency Department (ED), as 90 min is crucial for overall health. Using non-EMS transportation for critical patients, such as patients with acute myocardial infarction, to a hospital might delay the rapid identification of the underlying medical disease and initiating definitive treatment. We aim to evaluate the association between the mode of transportation and the D2B time in patients presenting at the ED with AMI.Patients and Methods: We conducted a retrospective cohort study with patients who presented at ED with AMI and underwent percutaneous coronary intervention (PCI). The participants were patients with confirmed AMI at the ED of King Abdullah Medical City (KAMC) from January 2019 to December 2019.Results: In total, 162 AMI patients were enrolled in the study and divided based on the method of transportation. Less than half (n=65, 40.1%) were transported with an ambulance and 97 (59.9%) patients with a private car. The door-to-balloon (D2B) time for the ambulance group was 93.6± 38.31 minutes, and the private car group was 93.8± 30.88 minutes.Conclusion: There was no statistical significance when comparing the D2B time between the private car group and the ambulance group (P = 0.1870). Finally, ambulance transport significantly shortened the time to first ED physician contact. However, it was not associated with shortened D2B time when compared to private vehicle transport.Keywords: chest pain, acute myocardial infarction, ambulance, door to balloon, emergency departmen

Exploring the Relationship Between Stress and Satisfaction During Clinical Training Among Respiratory Therapy Students: A Nationwide Cross-Sectional Survey

Rayan Siraj,1 Abdulelah M Aldhahir,2 Jaber S Alqahtani,3 Samah Bakhadlq,3 Saeed Alghamdi,4 Abdullah A Alqarni,5 Turki M Alanazi,6,7 Abdullah Alruwaili,6,7 Saleh S Algarni,8,9 Abdulrhman S Alghamd,10 Mushabbab Alahmari,11 Abdulmajeed Baogbah,12 Nawaf A Alsolami,13 Mufleh Alrougi,14 Kamal Hamed Al Khodidi,15 Fahad Alahmadi16 1Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, 31982, Saudi Arabia; 2Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia; 3Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia; 4Department of Clinical Technology, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 5Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, 22254, Saudi Arabia; 6College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Al Ahsa, 31982, Saudi Arabia; 7King Abdullah International Medical Research Center, Al Ahsa, 31982, Saudi Arabia; 8Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 9King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 10Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 11Department of Respiratory Therapy, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia; 12Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta GA, 30303, USA; 13Department of Respiratory Therapy, East Jeddah Hospital, Jeddah, Saudi Arabia; 14Department of Respiratory Care, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia; 15Respiratory Therapy Unit, Children’s Hospital, Taif, Saudi Arabia; 16Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi ArabiaCorrespondence: Rayan Siraj, Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, 31982, Saudi Arabia, Email [email protected]: Although clinical training is an important component of healthcare education, it is nevertheless a significant source of stress for students. There is limited information on stress and satisfaction perceived by clinical-level undergraduate students studying respiratory therapy (RT) in Saudi Arabia.Methods: A descriptive, cross-sectional study design with an online questionnaire was employed to conduct this study. Data collection occurred during the academic year 2022– 2023 among RT students throughout Saudi Arabia. Patricians responded to demographic questions, the Students Stress Scale and Students Professional Satisfaction questionnaires. Descriptive, inferential, and correlational statistics were used to analyze the collected responses.Results: A total of 1001 undergraduate RT students completed the online survey. RT students and interns had an overall moderate to high stress level (mean (SD); 3.55 (0.49)), while satisfaction was perceived as mild to moderate (mean (SD): 2.56 (0.65)). In addition, 38% of the study participants have considered quitting the RT program. Female students showed higher stress levels in the following domains: inadequate knowledge and training, adverse and embarrassing experiences, clinical supervision, patients’ pain, and Education–reality conflict (p< 0.005) compared to male students. Additionally, students who considered quitting the RT program revealed higher stress levels in all domains (p< 0.005). There were negative correlations between satisfaction and stress domains: inadequate knowledge and training (r = − 0.32; p = 0.001), adverse and embarrassing experience (r = − 0.31; p = 0.025), close supervision (r = − 0.24; p = 0.001), insufficient hospital resources (r = − 0.30; p 0.002), patients’ pain and suffering (r = 0.28; p = 0.04), and education – reality conflict (r = − 0.30; p = 0.001).Conclusion: During clinical training, respiratory therapy students experience moderate to high-stress levels and low satisfaction. There need to be tailored interventions to reduce stress and intention to quit and increase students’ clinical experience satisfaction.Keywords: stress, satisfaction, clinical training, intention to qui