scholarly journals (A314) Challenges Faced in Establishing the Emergency Prehospital Ambulance Service in North Central Sri Lanka: Developing Something from Nothing

2011 ◽  
Vol 26 (S1) ◽  
pp. s88-s88 ◽  
Author(s):  
L. Dassanayake
Keyword(s):  
Sri Lanka ◽  
Prehospital Care ◽  
Initial Period ◽  
Ambulance Service ◽  
Prehospital Emergency Care ◽  
Trauma Patients ◽  
Infrastructure Development ◽  
North Central ◽  
Prehospital Emergency ◽  
Care System

The existence of a prehospital emergency care system signifies how secure an area is in aftermath of a health-related emergency. The systems save lives during most out-of-hospital health emergencies. Until 2010, there was no regular prehospital care system in Anuradhapura, or even in the entire north central region of Sri Lanka. Trauma patients were brought to the hospital generally with little or no prehospital care. They were transported to hospital by relatives or other people at the scene with using whatever vehicle was available at the time, which in many occasions was a trishaw. The concept of developing a prehospital emergency ambulance service to cover the municipality of Anuradhapura as a pilot project was formulated in 2009. The objectives were to: (1) provide emergency prehospital care in the municipality; (2) identify the difficulties; and (3) assess the feasibility of implementing it in the entire district. Some of the challenges faced in the process from the initial draft of the concept up to now include: 1. Studying an established emergency medical services (EMS) system; 2. Developing a pressure group in hospital; 3. Convincing the need to administration; 4. Funding in the initial period; 5. Selecting the proper team and supportive peers; 6. Providing standard training to selected staff; 7. Formulating duty norms and standard operating procedures; 8. Infrastructure development, acquiring instruments, and vehicles with limited fund capacities; 9. Cooperating with the trade unions and external/internal negative forces; 10. Rallying the collaborators with same interest; 11. Handling donors; 12. Getting the support of other key institutions (police/municipal council); 13. Utilizing local media to help promote the project; 14. Social mobilization to ensure sustainability; and 15. Ensuring worker satisfaction, encouragement, and liaison with other units of hospital.

Prehospital System Development in Jaffna, Sri Lanka

2013 ◽  
Vol 28 (5) ◽  
pp. 509-516 ◽  
Author(s):  
John R. Zimmerman ◽  
Kecia M. Bertermann ◽  
Paul J. Bollinger ◽  
Donnie R. Woodyard
Keyword(s):  
Sri Lanka ◽  
Medical Care ◽  
System Development ◽  
Prehospital Emergency Care ◽  
First Year ◽  
Emergency Medical Care ◽  
Middle Income ◽  
Emergency Medical ◽  
Prehospital Emergency ◽  
Care System

AbstractIntroductionThe building of prehospital emergency medical care systems in developing and lower middle-income countries (as defined by the World Bank) is a critical step in those countries’ efforts to reduce unnecessary morbidity and mortality. This case report presents the development of a prehospital care system in Jaffna District, Sri Lanka and provides the results of the system's first year of operations, the likely reasons for the results, and the prospects for sustained operations of the system. The goal of this report is to add to the literature surrounding Emergency Medical Services (EMS) in developing countries by providing insight into the implementation of a prehospital emergency care system in developing and lower middle-income settings.MethodsThe level of utilization and the financial performance of the system during its first year of operation were analyzed using data from the Jaffna Regional Director of Health Services (RDHS) Call Center database and information from the implementing organization, Medical Teams International.ResultsThe system responded to >2000 emergency calls in its first 11 months of operation. The most utilized ambulance of the system experienced only a US $13.50 loss during the first 12 months of operation. Factors such as up-front support, a systematic approach, and appropriateness contributed to the successful implementation of the Jaffna prehospital EMS system.ConclusionThe implementation of a prehospital EMS system and its functioning were successful in terms of utility and, in many regards, financial stability. The system's success in development may serve as a potential model for implementing prehospital emergency medical care in other developing and lower middle-income country settings, keeping in mind factors outside of the system that were integral to its developmental success.ZimmermanJR, BertermannKM, BollingerPJ, WoodyardDR. Prehospital system development in Jaffna, Sri Lanka. Prehosp Disaster Med. 2013;28(5):1-8.

scholarly journals (A17) Epidemiology of Non-Vehicular Trauma Patients in the Prehospital Setting in India

2011 ◽  
Vol 26 (S1) ◽  
pp. s5-s5
Author(s):  
N.A. Lodhia ◽  
M. Strehlow ◽  
E. Pirrotta ◽  
B.N.V. Swathi ◽  
A. Gimkala ◽  
...  
Keyword(s):  
Prehospital Care ◽  
Initial Study ◽  
Prehospital Emergency Care ◽  
Trauma Patients ◽  
Care Providers ◽  
Elderly Age ◽  
Post Injury ◽  
Lower Socioeconomic ◽  
Prehospital Emergency

BackgroundNon-vehicular trauma (NVT) accounts for 8% of all calls to the GVK Emergency Management and Research Institute (EMRI), which provides prehospital emergency care to 85 million residents of Andhra Pradesh, India. This study describes the characteristics and outcomes of patients with NVT transported by GVK EMRI.MethodsAll patients with NVT were prospectively enrolled over 28 12-hour periods (equally distributed over each hour of the day and day of the week) during July/August 2010. Patients not found at the scene, refusing service, or reporting self-inflicted injuries were excluded. Real-time demographic and clinical data were collected from prehospital care providers using a standardized questionnaire. Follow-up patient information was collected at 48-hours and 30-days following injury.ResultsA total of 1,569 patients were enrolled. Follow-up rates were 72% at 48 hours and 71% at 30 days. The mean patient age was 40 (SD = 18) and 67% were male. Adults (ages 18–64) accounted for most patients (80%), followed by elderly (age > 64, 12%) and children (age < 18, 8%). Of the patients, 71% were from rural/tribal areas and 89% from lower socioeconomic strata. Eighty-two percent called within 1 hour of injury. Median call-to-scene time was 19 minutes (SD = 15) and scene-to-hospital time was 25 minutes (SD = 21). Most patients suffered blunt injuries (85%) with falls accounting for 43% of all injuries. Of the injuries, 56% were accidents and 43% assaults. Most injuries involved head/neck (48%) and extremities (44%). Cumulative mortality rates prior to hospital arrival, at 48-hours and at 30-days were 1.1%, 3.2%, and 4.9% respectively. Falls accounted for 69% of all deaths. Falls and age > 65 were predictors of mortality (p < 0.0001). Of NVT survivors, 56% returned to baseline function and 28% were in significant pain or bed bound at 30-days post-injury.ConclusionThis initial study of prehospital NVT patients in India reveals that falls and elderly age were highly associated with death.

Challenges to Prehospital Care in Honduras

2018 ◽  
Vol 33 (6) ◽  
pp. 637-639
Author(s):  
Haley E. Bast ◽  
J. Lee Jenkins
Keyword(s):  
Health Care Services ◽  
Resource Constraints ◽  
Prehospital Care ◽  
Public Access ◽  
Public Health Care ◽  
Prehospital Emergency Care ◽  
Publication Type ◽  
Rural And Urban ◽  
Private And Public ◽  
Prehospital Emergency

AbstractThrough a longitudinal field experience and interviews with rural and urban clinic workers in Honduras, the following data were collated regarding the challenges to prehospital Emergency Medical Services (EMS) in this country. In Honduras, both private and public organizations provide prehospital emergency care for citizens and face both financial and resource constraints. These constraints manifest in operational concerns such as challenges of integration of EMS systems with each other, differences in medical direction oversight, and barriers to public access. Despite the availability of public health care services, authorities and locals alike do not recommend using the public systems due to lack of needed resources and time of emergency response.Private volunteer EMS organizations are scattered throughout the country and each operates as their own separate system. There is no single dispatch center available, nor is there a guarantee that calling for EMS will result in the patient’s desired response. In this report, the challenges are discussed with possible solutions presented.BastHE, JenkinsJL. Challenges to prehospital care in Honduras. Prehosp Disaster Med. 2018;33(6):637–639.

Prehospital Care for Patients with Head Injury and its Relevance to Post Traumatic Prognosis

1987 ◽  
Vol 3 (2) ◽  
pp. 15-20
Author(s):  
G. Singbartl
Keyword(s):  
Head Injury ◽  
Prehospital Care ◽  
Head Injuries ◽  
Cerebral Injury ◽  
Prehospital Emergency Care ◽  
Secondary Brain Damage ◽  
Thorax Trauma ◽  
Prehospital Emergency ◽  
Post Traumatic ◽  
Polytrauma Patients

Head injury has been demonstrated to be one of the most important lesions in polytrauma patients and of very decisive relevance to the posttraumatic prognosis. Moreover, other lesions and their sequelae (e.g. shock, thorax trauma) are known to worsen the primary cerebral injury by causing secondary brain damage due to hypotension and hypoxemia. This study considers the influence of prehospital emergency care to the posttraumatic prognosis in severe head injuries.

Update on prehospital emergency care of severe trauma patients

2013 ◽  
Vol 32 (7-8) ◽  
pp. 477-482 ◽  
Author(s):  
K. Tazarourte ◽  
E. Cesaréo ◽  
D. Sapir ◽  
A. Atchabahian ◽  
J.-P. Tourtier ◽  
...  
Keyword(s):  
Emergency Care ◽  
Severe Trauma ◽  
Prehospital Emergency Care ◽  
Trauma Patients ◽  
Prehospital Emergency

A systematic review of prehospital telehealth utilization

2017 ◽  
Vol 24 (7) ◽  
pp. 473-481 ◽  
Author(s):  
Andrew S Winburn ◽  
Juliana J Brixey ◽  
James Langabeer ◽  
Tiffany Champagne-Langabeer
Keyword(s):  
Emergency Care ◽  
Prehospital Care ◽  
Feasibility Studies ◽  
The United States ◽  
Prehospital Emergency Care ◽  
Positive Trend ◽  
Prehospital Emergency ◽  
Store And Forward ◽  
Meta Analyses ◽  
Future Work

Objective There has been moderate evidence of telehealth utilization in the field of emergency medicine, but less is known about telehealth in prehospital emergency medical services (EMS). The objective of this study is to explore the extent, focus, and utilization of telehealth for prehospital emergency care through the analysis of published research. Methods The authors conducted a systematic literature review by extracting data from multiple research databases (including MEDLINE/PubMed, CINAHL Complete, and Google Scholar) published since 2000. We used consistent key search terms to identify clinical interventions and feasibility studies involving telehealth and EMS, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results We identified 68 articles focused specifically on telehealth interventions in prehospital care. The majority (54%) of the studies involved stroke and acute cardiovascular care, while only 7% of these (4) focused on telehealth for primary care. The two most common delivery methods were real-time video-conferencing capabilities (38%) and store and forward (25%); and this variation was based upon the clinical focus. There has been a significant and positive trend towards greater telehealth utilization. European telehealth programs were most common (51% of the studies), while 38% were from the United States. Discussion and Conclusions Despite positive trends, telehealth utilization in prehospital emergency care is fairly limited given the sheer number of EMS agencies worldwide. The results of this study suggest there are significant opportunities for wider diffusion in prehospital care. Future work should examine barriers and incentives for telehealth adoption in EMS.

Ethical Conflicts in Prehospital Emergency Care

2006 ◽  
Vol 13 (6) ◽  
pp. 592-607 ◽  
Author(s):  
Lars Sandman ◽  
Anders Nordmark
Keyword(s):  
Emergency Care ◽  
Prehospital Care ◽  
Self Determination ◽  
Prehospital Emergency Care ◽  
Best Interest ◽  
Focus Group Interviews ◽  
Self Identity ◽  
Ethical Conflicts ◽  
Prehospital Emergency ◽  
Group Interviews

This article analyses and presents a survey of ethical conflicts in prehospital emergency care. The results are based on six focus group interviews with 29 registered nurses and paramedics working in prehospital emergency care at three different locations: a small town, a part of a major city and a sparsely populated area. Ethical conflict was found to arise in 10 different nodes of conflict: the patient/carer relationship, the patient’s self-determination, the patient’s best interest, the carer’s professional ideals, the carer’s professional role and self-identity, significant others and bystanders, other care professionals, organizational structure and resource management, societal ideals, and other professionals. It is often argued that prehospital care is unique in comparison with other forms of care. However, in this article we do not find support for the idea that ethical conflicts occurring in prehospital care are unique, even if some may be more common in this context.

Emergency Medical Services in India: The Present and Future

2014 ◽  
Vol 29 (3) ◽  
pp. 307-310 ◽  
Author(s):  
Mohit Sharma ◽  
Ethan S. Brandler
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Publication Type ◽  
Emergency Medical ◽  
Trauma Service ◽  
Care System

AbstractIndia is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.SharmaM, BrandlerES. Emergency Medical Services in India: the present and future. Prehosp Disaster Med. 2014;29(3):1-4.

Military Prehospital Emergency Care: defining and professionalising the levels of care provided along the Operational Patient Care Pathway

2018 ◽  
Vol 165 (3) ◽  
pp. 188-192 ◽  
Author(s):  
Danny Sharpe ◽  
J McKinlay ◽  
S Jefferys ◽  
C Wright
Keyword(s):  
Patient Care ◽  
Emergency Care ◽  
Care Pathway ◽  
Prehospital Care ◽  
The Body ◽  
Prehospital Emergency Care ◽  
Levels Of Care ◽  
Prehospital Emergency ◽  
The Right ◽  
Care Support

The Defence Medical Services aims to provide gold standard care to ill and injured personnel in the deployed environment and its prehospital emergency care (PHEC) systems have been proven to save lives. The authors have set out to demonstrate, using existing literature, consensus and doctrine that the NHS Skills for Health framework can be reflected in military prehospital care and provides an existing model for defining the levels of care our providers can offer. In addition, we have demonstrated how these levels of care support the Operational Patient Care Pathway and add to the body of evidence for the use of specialist PHEC teams to allow the right patient to be transported on the right platform, with the right medical team, to the right place. These formalised levels allow military planners to consider the scope of practice, amount of training and appropriate equipment required to support deployed operations.

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