Quality of life (QoL) is essential for maintaining a healthy, balanced lifestyle, especially among individuals with chronic diseases. Saudi Arabia (SA) launched a health sector transformation program as part of the nationwide Vision 2030 initiative to ensure the sustainable development of efficient healthcare services, aiming to improve health by increasing well-being and QoL. More investigation into the current status of health rehabilitation services provided to individuals with chronic diseases and future needs to optimize services and improve QoL is needed. This was narratively discussed by experts from different health rehabilitation services in SA. Comprehensive health rehabilitation services including orthopedic, occupational, cardiac, pulmonary, critical care, perioperative, hearing and speech, substance use disorders, and vocational rehabilitation services were addressed. Health rehabilitation services in SA, as in other countries, are suboptimal for individuals in health rehabilitation programs. To optimize the QoL of individuals with chronic diseases, health rehabilitation services should be tailored based on the unique requirements of each service and its serving patients. The shared need to improve health rehabilitation services includes the adoption of home-based and telehealth services, the integration of multi-governmental sectors, the empowerment and allocation of health rehabilitation specialists, public awareness campaigns, policy legislation and guideline development, and the implementation of a long-term follow-up system. This review is one of the first to address the intersection of health rehabilitation services and QoL in SA; urgent and holistic actions are paramount to address the pressing need to optimize SA’s health rehabilitation services. The experts’ recommendations in this study may be applicable to other countries’ health systems, as health rehabilitation services are not well optimized globally.

Introduction: Stroke is a major emergency that can cause a significant morbidity and mortality. Advancement in stroke management in recent years has allowed more patients to be diagnosed and treated by stroke teams; however, stroke is a time-sensitive emergency that requires a high level of coordination, particularly within the prehospital phase. This research is to determine whether patients received by Emergency Medical Services (EMS) at a tertiary health care facility had shorter stroke team activation, time to computed tomography (CT), or time to receive intravenous thrombolytics.Methods: This research is a prospective cohort study of adults with stroke symptoms who required stroke team activation at a tertiary medical facility. The study included all patients received from September 1, 2017 through August 31, 2018. The primary outcome was the time difference to stroke team activation between patients received by EMS compared to patients that arrived by a private method of transportation. The secondary outcomes were the difference in time to CT scan and the time to receive intravenous recombinant tissue plasminogen activator (rtPA).Results: There were 75 (34.1%) patients who had been received by EMS, while 145 (65.9%) patients arrived via private transportation method (private car or by a friend/family member). The mean time to stroke team activation, time to CT, and time to receive thrombolytic therapy for the EMS group were: 8.19 (95% CI, 6.97 - 9.41) minutes; 18 (95% CI, 15.9 - 20.1) minutes; and 13.1 (95% CI, 6.95 - 19.3) minutes, respectively. Those for the private car group, on the other hand, were: 16 (95% CI, 12.4 - 19.6) minutes; 23.39 (95% CI, 19.6 - 27.2) minutes; and nine (95% CI, 4.54 -13.5) minutes, respectively. There was a significantly shorter time to stroke team activation for patients arriving via EMS compared to private car (P ≤ .00), but no significant difference was found on time to CT (P = .259) or time to receive rtPA (P = .100).Conclusion: Emergency Medical Service transportation of stroke patients can significantly shorten the time to stroke team activation, leading to shorter triage and accelerated patient management. However, there was no statistical difference in time to CT or time to receive rtPA. Patients with stroke symptoms may benefit more from EMS transportation compared to private methods of transportation.

The Saudi Out-of-Hospital Cardiac Arrest Registry (SOHAR) is the first out-of-hospital cardiac arrest (OHCA) registry in Saudi Arabia. This study aimed to describe the epidemiology and outcomes of OHCA in Saudi Arabia. The SOHAR is a prospective data collection system. Data were collected monthly from defined regions, and registry measured variables were adopted from the Utstein recommendations. During the period from 01/01/2019 to 31/12/2022, 3671 patients were included in the registry. The mean age was 62 years, and 6.5% (240) of patients were under the age of 18 years. The most common cause of OHCA was medical 3439 (93.6%). A total of 641 (17.4%) and 129 (3.9%) had presumed cardiac and respiratory causes. Additionally, most OHCA in Saudi Arabia (3034, 82.6%) occurred at home. Prehospital Return Of Spontaneous Circulation (ROSC) was achieved in 275 (7.4%) cases, and 491 (13.3%) patients were pronounced dead upon arrival at the hospital. Survival to hospital discharge was achieved in 107 (2.9%) of the cases, and good neurological outcomes, defined as a Cerebral Performance Category (CPC) of 1–3, occurred in < 0.5% of patients. The Saudi out-of-hospital ROSC was 7.4%. The survival to hospital discharge rate was 2.9%, and less than 1% of patients were discharged with good neurological outcomes. Further research and the continuation of registry data collection is highly recommended. Additionally, a national-level out-of-hospital cardiac arrest system is recommended to ensure the standardization of medical care provided to patients with OHCA.

Purpose: Unit-hour utilization (UHU) is the most common metric for evaluating the productivity of ambulances and crews for ambulance services. Calculating UHU is essential for maximizing profitability and evaluating the number of hours of ambulance utilization during a shift. This has not been examined previously at King Abdulaziz Medical City (KAMC). KAMC is a major tertiary-care medical center in Riyadh, Saudi Arabia, with dedicated ALS (Advanced Life Support) and BLS (Basic Life Support) ambulance units. This study aimed to determine the cost of operating the emergency calls (advanced life support [ALS]) unit and non-emergency calls (basic life support [BLS]) unit and compare the costs of emergency calls (ALS) and non-emergency calls (BLS). The study used a standardized institutional checklist that itemizes expenditures across logistics, equipment, maintenance, salary, pharmacy, and fuel cost components. Methods: This was a retrospective cross-sectional study. Institutional Review Board approval was obtained from King Abdullah International Medical Research Center. The study examined emergency and non-emergency calls for a period of 12 months. This study was based on a checklist assessing various expenditures to calculate the cost of ambulance utilization at KAMC in 2022. Results: The total average ambulance utilization cost per year for ALS was 4,806,245.7 SR, and the average ambulance utilization cost per hour was 548.65 SR; these costs were to operate the ALS crew for 24 hours, seven days a week. Conversely, the total average ambulance utilization cost per year for BLS was 3,934,156.92 SR, and the average ambulance utilization cost per hour was 449.10 SR. The main expenses concerned salaries and overhead costs for ALS and BLS. Conclusion: This study provides insights into the cost of ambulance utilization between ALS and BLS. The higher cost of ALS calls may be attributed to the higher level of training, equipment, and staffing required.

Background/Objectives: The demand for Emergency Medical Services (EMS) has increased over the past few years, increasing the EMS burden. Public utilization of EMS for non-emergency cases is a major global issue contributing to this burden. This study explores the public’s ability to accurately recognize emergency situations and appropriately request ambulance services. Methods: This cross-sectional study utilized a survey to explore public awareness among residents of Riyadh, Saudi Arabia. The survey was developed from the relevant literature and panel discussions, followed by validation through a pilot study. Recruitment was conducted in different publicly accessible places to capture the diverse demographics of the residents. The sample size was statistically calculated using the Raosoft sample size calculator to identify significant differences. Results: This study included 522 respondents, predominantly females (79%) aged 18–34 (42%) and 35–54 (41%) years. Both males and females correctly identified around two-thirds of the total emergency cases, with means of 6.49 (SD = 1.27) and 6.55 (SD = 1.32), respectively. Appropriate ambulance requests were made in less than one-third of the emergencies by both males and females, with means of 2.29 (SD = 1.29) and 2.38 (SD = 1.32), respectively. Stroke and older adults with hip pain were the most accurately recognized emergency cases at 92.5% and 90%, respectively, while mild chest pain and child head hematoma were the least accurately recognized at 36.6% and 38.5%. Women in labor and objects in the ear canal were the most misidentified as emergencies at 97.3% and 87.7%, respectively. Conclusions: This study highlights the prevalence of unrecognized emergency situations and the underutilization of EMS for real emergency cases. The findings recommend the need for national training programs and provide valuable insights for EMS dispatcher training programs regarding public perceptions of emergency and non-emergency situations. While the findings provide insights into targeted preventive measures to alleviate the EMS burden, they also demonstrate the critical role of public awareness in enhancing public health safety concerning emergency situations.

Introduction: Stroke is an emergency condition that can lead to long-term disability or death if not recognized early and managed appropriately. Emergency medical service (EMS) providers play a significant role in recognizing, stabilizing, and transporting patients with suspected stroke to the nearest appropriate facility. Recently, a new stroke pathway was implemented in Riyadh, Saudi Arabia, in which suspected stroke patients are transported immediately to King Fahad Medical City (KFMC), and the stroke team is notified prior to the patient's arrival. Study Objective: This study aimed to compare the time of care access for stroke patients transported by EMS using the new stroke pathway with that when transporting by private cars. Methods This prospective study was conducted at KFMC from January 17 to December 31 2022, focusing on adult patients whose stroke codes were activated during that year. Patient characteristics, time to care access, and their 90-day mortality outcomes were also recorded. The SAS software (version 9.4; SAS Institute Inc., Cary, North Carolina, USA) was used for all analyses. Results Altogether, 478 patients were included in the study; 173 were transported by EMS, whereas the remaining 305 were transported by private car. The majority of cases in the EMS group were categorized as moderate, moderate-to-severe, and severe based on the National Institutes of Health Stroke Scale, compared to the majority of cases in the private car group that were categorized as moderate, minor, or severe. The median time to stroke care access was significantly shorter in the private car group than in the EMS group. Additionally, the EMS group had a higher mortality rate than the private car group, although the difference was not significant (P = 0.2826). Conclusion The significant difference in the time of care access between the two groups indicated that patients transported by EMS using the new stroke pathway received care faster than those transported by private cars.