scholarly journals The Birth and Growth of the National Ambulance Service in Ghana

2016 ◽  
Vol 32 (1) ◽  
pp. 83-93 ◽  
Author(s):  
Ahmed Zakariah ◽  
Barclay T. Stewart ◽  
Edmund Boateng ◽  
Christiana Achena ◽  
Gavin Tansley ◽  
...  
Keyword(s):  
Emergency Services ◽  
Prehospital Care ◽  
Public Awareness ◽  
Ambulance Service ◽  
Local Health ◽  
Publication Type ◽  
Middle Income ◽  
Stable Case ◽  
Mean Response Time ◽  
Emergency Medical

AbstractIntroductionThis study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified.MethodsData routinely collected by the Ghana NAS from 2004-2014 were described, including: patient demographics, reason for the call, response location, target destination, and ti1mes of service. Additionally, the organizational structure and challenges encountered during the development and maturation of the NAS were reported.ResultsIn 2004, the NAS piloted operations with 69 newly trained emergency medical technicians (EMTs), nine ambulances, and seven stations. The NAS expanded service delivery with 199 ambulances at 128 stations operated by 1,651 EMTs and 47 administrative and maintenance staff in 2014. In 2004, nine percent of the country was covered by NAS services; in 2014, 81% of Ghana was covered. Health care transfers and roadside responses comprised the majority of services (43%-80% and 10%-57% by year, respectively). Increased mean response time, stable case holding time, and shorter vehicle engaged time reflect greater response ranges due to increased service uptake and improved efficiency of ambulance usage. Specific internal and external challenges with regard to NAS operations also were described.ConclusionThe steady growth of the NAS is evidence of the need for Emergency Medical Services and the effects of sound planning and timely responses to changes in program indicators. The way forward includes further capacity building to increase the number of scene responses, strengthening ties with local health facilities to ensure timely emergency medical care and appropriateness of transfers, assuring a more stable funding stream, and improving public awareness of NAS services.ZakariahA, StewartBT, BoatengE, AchenaC, TansleyG, MockC. The birth and growth of the National Ambulance Service in Ghana. Prehosp Disaster Med. 2017;32(1):83–93.

scholarly journals The Birth and Growth of the National Ambulance Service in Ghana

2019 ◽  
Vol 34 (s1) ◽  
pp. s106-s106
Author(s):  
Mawuli Kingsley
Keyword(s):  
Emergency Services ◽  
Prehospital Care ◽  
Public Awareness ◽  
Ambulance Service ◽  
Local Health ◽  
Middle Income ◽  
Stable Case ◽  
Mean Response Time ◽  
Steady Growth ◽  
Emergency Medical

Introduction:This study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified.Methods:Data routinely collected by the Ghana NAS from 2004–2014 were described, including: patient demographics, reason for the call, response location, target destination, and types of service. Additionally, the organizational structure and challenges encountered during the development and maturation of the NAS were reported.Results:In 2004, the NAS piloted operations with 69 newly trained emergency medical technicians (EMTs), nine ambulances, and seven stations. The NAS expanded service delivery with 199 ambulances at 128 stations operated by 1,651 EMTs and 47 administrative and maintenance staff in 2014. In 2004, nine percent of the country was covered by NAS services; in 2014, 81% of Ghana was covered. Health care transfers and roadside responses comprised the majority of services (43%–80% and 10%–57% by year, respectively). Increased mean response time, stable case holding time, and shorter vehicle engaged time reflect greater response ranges due to increased service uptake and improved efficiency of ambulance usage. Specific internal and external challenges with regard to NAS operations also were described.Discussion:The steady growth of the NAS is evidence of the need for Emergency Medical Services and the effects of sound planning and timely responses to changes in program indicators. The way forward includes further capacity building to increase the number of scene responses, strengthening ties with local health facilities to ensure timely emergency medical care and appropriateness of transfers, assuring a more stable funding stream, and improving public awareness of NAS services.

scholarly journals Collaboration for preliminary design of a mobile health solution for ambulance dispatch in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Ashley Rosenberg ◽  
◽  
Rob Rickard ◽  
Fraterne Zephyrin Uwinshuti ◽  
Gabin Mbanjumucyo ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Capital City ◽  
Medical Services ◽  
Middle Income ◽  
Golden Hour ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Prehospital Emergency

The first 60 minutes after a trauma are described as “the golden hour.” For each minute of prehospital time, the risk of dying increases by 5% (Sampalis et al., 1999). Since 90% of the global burden of injuries occur in low- and middle-income countries and lead to 5.8 million deaths annually, addressing rapid access to emergency services is critical in these settings (Nielsen et al., 2012). In most low- and middle-income countries (LMICs), there are no formal trauma systems, and many lack organized prehospital care (Nielsen et al., 2012). Emergency medical dispatch and communication systems are a foundational component of emergency medical services (World Health Organization, 2005). Yet there are no established recommendations of creating these systems inLMICs.Rwanda, a country of over 12 million people, is a rapidly developing leader in East Africa. The Ministry of Health of Rwanda established the Service d’Aide Medicale Urgente (SAMU) in 2007, recognizing the need for public emergency medical services. SAMU’s national dispatch center receives roughly 3,000 calls per month through a national 912 hotline. It organizes regional transportation with 260 total ambulances located at hospitals throughout the country and provides prehospital emergency services in the capital city of Kigali with a fleet of 12 ambulances. In the city, each ambulance has a driver, nurse and anesthetist dispatched for every call. Emergency department nursing and anesthetist staff are dispatched from hospitals around the country to respond to regional emergencies. No formal prehospital cadre of the workforce exists although the SAMU staffhave extensive field experience in prehospital care. SAMU has several challenges to rapid prehospital emergency care including lack of addresses beyond the capital city, unclear location data in densely populated areas, complex communication processes with little information about health facility capacity, and no established electronic dispatch system. The average response time for SAMU ambulances was 59 minutes in 2018, but 39% of calls were not completed within the golden hour.

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.

scholarly journals Optimizing Emergency Medical Service Structures Using a Rule-Based Discrete Event Simulation—A Practitioner’s Point of View

2021 ◽  
Vol 18 (5) ◽  
pp. 2649
Author(s):  
Christoph Strauss ◽  
Günter Bildstein ◽  
Jana Efe ◽  
Theo Flacher ◽  
Karen Hofmann ◽  
...  
Keyword(s):  
Discrete Event Simulation ◽  
Emergency Services ◽  
Prehospital Care ◽  
Discrete Event ◽  
Point Of View ◽  
Public Healthcare ◽  
Healthcare Organizations ◽  
Rule Based ◽  
Event Simulation ◽  
Emergency Medical

Many studies in research deal with optimizing emergency medical services (EMS) on both the operational and the strategic level. It is the purpose of this method-oriented article to explain the major features of “rule-based discrete event simulation” (rule-based DES), which we developed independently in Germany and Switzerland. Our rule-based DES addresses questions concerning the location and relocation of ambulances, dispatching and routing policies, and EMS interplay with other players in prehospital care. We highlight three typical use cases from a practitioner’s perspective and go into different countries’ peculiarities. We show how research results are applied to EMS and healthcare organizations to simulate and optimize specific regions in Germany and Switzerland with their strong federal structures. The rule-based DES serves as basis for decision support to improve regional emergency services’ efficiency without increasing cost. Finally, all simulation-based methods suggest normative solutions and optimize EMS’ performance within given healthcare system structures. We argue that interactions between EMS, emergency departments, and public healthcare agencies are crucial to further improving effectiveness, efficiency, and quality.

Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study

2016 ◽  
Vol 32 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Seth A. Brown ◽  
Theresa C. Hayden ◽  
Kimberly A. Randell ◽  
Lara Rappaport ◽  
Michelle D. Stevenson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Emergency Medical Services ◽  
Prehospital Care ◽  
Educational Interventions ◽  
Medical Services ◽  
Theory Approach ◽  
Publication Type ◽  
Pediatric Education ◽  
Emergency Medical

AbstractObjectivesPrevious studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements.MethodsPurposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data.ResultsForty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements.ConclusionFocus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care.BrownSA, HaydenTC, RandellKA, RappaportL, StevensonMD, KimIK. Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20–26.

scholarly journals The prehospital community-volunteer model has a place in rural Australia

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Peter O’Meara
Keyword(s):  
Local Governance ◽  
Prehospital Care ◽  
Ambulance Service ◽  
Advanced Technology ◽  
Urgent Care ◽  
Local Health ◽  
Systems Methodology ◽  
Community Volunteer ◽  
Starting Point ◽  
Rural Australia

Introduction Australian ambulance services rely on the community-volunteer model of prehospital care in many rural areas. The aim of this study was to conceptually describe the model as it operates in rural settings. Methods Soft Systems Methodology (SSM) was used to describe and critically appraise an abstract prehospital community-volunteer model within the context of rural Australia. The philosophical starting point was that local prehospital services should be self-reliant and autonomous. SSM was used to structure the elements of prehospital systems and the relationships between them into metaphors and pictures for analysis. Results The major characteristic of the prehospital community-volunteer model is the relatively uncomplicated processes used to deliver services. Key elements are a knowledgeable and empowered community, a dispatch system with local knowledge, adequate physical resources to meet community expectations, a volunteer-based staffing system, and direct communication with local health professionals. Culturally, the community-volunteer model has a very strong rural character, with opportunity for health professional, emergency worker and local community member involvement. This may be as a volunteer ambulance officer or as a participant in the local governance of the service. Conclusion The prehospital community-volunteer model is a strong and resilient model in communities where the relationship between the ambulance service and the community is based on a socially constructed framework. Advanced technology, rules, systems, procedures and policies are unable to sustain a community-volunteer ambulance service. In contrast to other models, it is held together through stories of the past, rituals and myths. Prehospital community-volunteer models will continue to be important providers of prehospital services in rural Australia. Successful community-volunteer ambulance services need to be integrated into a local urgent care system.

Pre-Hospital Care Quality Program

1985 ◽  
Vol 1 (S1) ◽  
pp. 48-51
Author(s):  
Emil Pascarelli ◽  
Anthony Ciorciari
Keyword(s):  
Cognitive Abilities ◽  
Prehospital Care ◽  
Public Awareness ◽  
Care Quality ◽  
Emergency Medical Technician ◽  
Mass Public ◽  
Emergency Medical ◽  
Quality Program ◽  
The Usa ◽  
Clinical Changes

Paramedic units have awakened a new concept in prehospital care in the USA. New emergency medical services (EMS) administrations, better educated personnel, and mass public awareness through media events have all contributed to the change.Operational changes designed to tighten control of the emergency medical technician (EMT) and paramedic came about through deployment of ambulances and categorization and designation of emergency hospitals. Clinical changes have given the EMS responder, particularly the paramedic, a great deal of freedom in the care given to patients. The paramedic, who uses subjective criteria, can administer care ranging from Standard First Aid to advanced cardiology. Subjective control should be rigid for the EMT or paramedic, when cognitive abilities include only knowledge, comprehension and application, but not for those who have had a chance to exercise analytic and synthetic skills in pre-hospital training programs.

scholarly journals Major Incidents in Kenya: the Case for Emergency Services Development and Training

2013 ◽  
Vol 28 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Benjamin W. Wachira ◽  
Wayne Smith
Keyword(s):  
Emergency Services ◽  
Emergency Operation ◽  
Major Incident ◽  
Transport Sector ◽  
Incident Management ◽  
Local Health ◽  
Publication Type ◽  
Rescue Service ◽  
Major Incidents ◽  
And Training

AbstractKenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality.This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.WachiraB, SmithW. Major incidents in Kenya: the case for emergency services development and training. Prehosp Disaster Med. 2013;28(2):1-4.

scholarly journals (A315) Improvement of the Prehospital Healthcare System in Iran

2011 ◽  
Vol 26 (S1) ◽  
pp. s88-s89
Author(s):  
H.R. Khankeh ◽  
A.R. Jallali ◽  
G.R. Masoomi
Keyword(s):  
Response Time ◽  
Prehospital Care ◽  
National Standard ◽  
Care Process ◽  
Time Interval ◽  
Middle Income ◽  
Mean Response Time ◽  
Time Period ◽  
The Mean ◽  
Retrospective Comparative Study

BackgroundThe prehospital time delay in acute health problem still is a problem in most low- and middle-income countries, like Iran. It often is possible to minimize adverse consequences by promptly providing effective prehospital servicesAimThis study was designed to compare the response time interval occurring during the prehospital care process in Tehran during the last decade.MethodsA retrospective, comparative study was designed, and the mean response time intervals in relation to prehospital care were identified from September 1999 until September 2000 were compared with data from September 2009 until September 2010. Data were collected from Tehran emergency medical services (EMS) center registries.ResultsThe EMS center of Tehran dispatched 213 ambulances every day in 1999–2000 compared with 1,200 in 2009–2010. During the 2009–2010 period, the mean response time for city locations was 14.18(+ /−4) minutes, compared with 1999–2000 the mean response time for city location was 16(+ /− 8). The mean response time from the time period of 1999–2000 also was longer than for 2009–2010 (14.18 vs. 16.58 minutes).ConclusionsDespite the prominent increase in the number of ambulance dispatching everyday, the mean response time in Tehran decreased during last decade. This improvement can be due to the improvement of the prehospital system in Tehran, including the number of: ambulances, trained staff, EMS stations, etc. However, it still is far from a national standard (eight minutes for city).

Development and Implementation of a Novel Prehospital Care System in the State of Kerala, India

2016 ◽  
Vol 31 (6) ◽  
pp. 663-666 ◽  
Author(s):  
Heather A. Brown ◽  
Katherine A. Douglass ◽  
Shafi Ejas ◽  
Venugopalan Poovathumparambil
Keyword(s):  
Prehospital Care ◽  
Public Awareness ◽  
Public Private Partnership ◽  
The State ◽  
Western World ◽  
College Hospital ◽  
Private Partnership ◽  
Awareness Campaigns ◽  
Emergency Medical ◽  
Care System

AbstractMost low- and middle-income countries (LMICs) have struggled to find a system for prehospital care that can provide adequate patient care and geographical coverage while maintaining a feasible price tag. The emergency medical systems of the Western world are not necessarily relevant in developing economic systems, given the lack of strict legislation, the scarcity of resources, and the limited number of trained personnel. Meanwhile, most efforts to provide prehospital care in India have taken the form of adapting Western models to the Indian context with limited success. Described here is a novel approach to prehospital care designed for and implemented in the State of Kerala, India. The Active Network Group of Emergency Life Savers (ANGELS) was launched in 2011 in Calicut City, the third largest city in the Indian State of Kerala. The ANGELS integrated an existing fleet of private and state-owned ambulances into a single network utilizing Global Positioning System (GPS) technology and a single statewide call number. A total of 85 volunteer emergency medical certified technicians (EMCTs) were trained in basic first aid and trauma care principles. Public awareness campaigns accompanied all activities to raise awareness amongst community members. Funding was provided via public-private partnership, aimed to minimize costs to patients for service utilization. Over a two-year period from March 2011 to April 2013, 8,336 calls were recorded, of which 54.8% (4,569) were converted into actual ambulance run sheets. The majority of calls were for medical emergencies and most patients were transported to Medical College Hospital in Calicut. This unique public-private partnership has been responsive to the needs of the population while sustaining low operational costs. This system may provide a relevant template for Emergency Medical Services (EMS) development in other resource-limited settings.BrownHA, DouglassKA, EjasS, PoovathumparambilV. Development and implementation of a novel prehospital care system in the State of Kerala, India. Prehosp Disaster Med. 2016;31(6):663–666.

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