EMS at 3600 Meters: Exploring Barriers to Emergency Care and Transport in Rural Andean Perú

2021 ◽  
pp. 1-5
Author(s):  
Alison H. Vasa ◽  
Karen A. Falkenstein ◽  
Wayne A. Centrone
Keyword(s):  
Emergency Care ◽  
Care Delivery ◽  
First Aid ◽  
Care Providers ◽  
Community Members ◽  
Major Barrier ◽  
Structural Problems ◽  
Structured Care ◽  
First Aid Training ◽  
Colca Valley

Abstract Background: Given the demonstrated success of programs that bolster informal Emergency Medical Service (EMS) systems in other low- and middle-income counties (LMICs), this study aimed to explore formal and informal systems, practices, customs, and structures for emergency response and medical transport in Colca Valley, Perú while identifying possible opportunities for future intervention. Methods: Twenty-two interviews with first responders and community members were conducted in three mountain villages throughout rural Andean Colca Valley of Perú. Subjects were recruited based on profession and experience with medical emergencies in the area. Transcripts were entered into Dedoose, coded, and analyzed to identify themes. Results: Providers and community members shared similar perceptions on the most common barriers to emergency care and transport. Challenges experienced equally by both groups were identified as “structural problems,” such as lack of infrastructure, lack of structured care delivery, and unclear protocols. Incongruities of responses between groups emerged with regard to certain barriers to care. Providers perceived baseline health education and use of home remedies as significant barriers to seeking care, which was not proportionally corroborated by community members. In contrast, 86% of community members cited lack of trust in health providers as a major barrier. Community members often noted witnessing a high frequency of emergency events, their personal experiences of helping, and the formal utilization of lay providers. When specifically questioned on their willingness to engage in first aid training, all participants were in agreement. Conclusion: While structural changes such as increased infrastructure would likely be the most durable improvement, future interventions focused on both empowering community members and improving the relationship between the health center and the community would be beneficial in this community. Additionally, these interview data suggest that a layperson first aid training program would be feasible and well-received.

scholarly journals Beliefs and challenges held by medical staff about providing emergency care to migrants: an international systematic review and translation of findings to the UK context

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028748
Author(s):  
Hooi-Ling Harrison ◽  
Gavin Daker-White
Keyword(s):  
Systematic Review ◽  
Emergency Care ◽  
Care Delivery ◽  
Qualitative Studies ◽  
Undocumented Migrants ◽  
Care Providers ◽  
Policy And Practice ◽  
Eligibility Criteria ◽  
Potential Health ◽  
The Uk

ObjectiveMigration has increased globally. Emergency departments (EDs) may be the first and only contact some migrants have with healthcare. Emergency care providers’ (ECPs) views concerning migrant patients were examined to identify potential health disparities and enable recommendations for ED policy and practice.DesignSystematic review and meta-synthesis of published findings from qualitative studies.Data sourcesElectronic databases (Ovid Medline, Embase (via Ovid), PsycINFO (via OVID), CINAHL, Web of Science and PubMed), specialist websites and journals were searched.Eligibility criteriaStudies employing qualitative methods published in English.SettingsEDs in high-income countries.ParticipantsECPs included doctors, nurses and paramedics.Topic of enquiryStaff views on migrant care in ED settings.Data extraction and synthesisData that fit the overarching themes of ‘beliefs’ and ‘challenges’ were extracted and coded into an evolving framework. Lines of argument were drawn from the main themes identified in order to infer implications for UK policy and practice.ResultsEleven qualitative studies from Europe and the USA were included. Three analytical themes were found: challenges in cultural competence; weak system organisation that did not sufficiently support emergency care delivery; and ethical dilemmas over decisions on the rationing of healthcare and reporting of undocumented migrants.ConclusionECPs made cultural and organisational adjustments for migrant patients, however, willingness was dependent on the individual’s clinical autonomy. ECPs did not allow legal status to obstruct delivery of emergency care to migrant patients. Reported decisions to inform the authorities were mixed; potentially leading to uncertainty of outcome for undocumented migrants and deterring those in need of healthcare from seeking treatment. If a charging policy for emergency care in the UK was introduced, it is possible that ECPs would resist this through fears of widening healthcare disparities. Further recommendations for service delivery involve training and organisational support.

scholarly journals (P2-29) Educational Model for Pre-Hospital Disaster Management in Haiti and Beyond

2011 ◽  
Vol 26 (S1) ◽  
pp. s145-s145
Author(s):  
R. Gore ◽  
C. Bloem ◽  
K. Elbashir ◽  
P. Roblin ◽  
G. Ostrovskiy ◽  
...  
Keyword(s):  
Developing Countries ◽  
Nursing Students ◽  
Emergency Preparedness ◽  
Life Support ◽  
Medical Training ◽  
Health Workers ◽  
Care Delivery ◽  
Training Model ◽  
First Aid ◽  
First Aid Training

IntroductionThere has been increased international awareness and a need to provide accessible and essential emergency preparedness training in developing countries that has resulted in the recognition of new teaching needs and number of new initiatives to meet these needs.MethodsThese teaching methods have been applied in Haiti before and after the 2010 earthquake. They include: - Established a “Train the trainer” model - Established civilian first responder training - Basic Life Support (BLS) and First Aid - Implemented medical training using the Meti Simulator models - Conducted post-training Disaster drill - Conduction of post training assessment - Succession model of training.ResultsA total of 54 people completed a BLS course and 67 completed a First Aid course. 12 participants completed the First Aid and BLS Instructors course. 95 program participants completed an end of course survey. 41 participants had no prior BLS/First Aid training or exposure. The course participants included 2 physicians, 22 students, 8 nursing students, 7 nurses, 20 teachers, 12 health workers, 5 drivers, and 14 laborers. 92 of those surveyed stated they would recommend this course to a friend. 88 participants stated that hands on learning helped them better learn the course material.ConclusionThis training model has been well received in rural Haiti and can be applied in other developing countries. We would like to standardize training protocols that will serve as a foundation for self-sustaining higher-level emergency, pre-hospital, disaster training and management. This will improve the general quality of health care delivery. Our next pilot of this program will be in other parts of Haiti and in Khartoum, Sudan.

scholarly journals Mental Health First Aid Training: A Study of Community Members’ Pre and Post-training Responses to a 17-Item Questionnaire

2020 ◽  
pp. 16-31
Author(s):  
Abdulhameed Abdullah Al-Habeeb ◽  
Haifa Saad Aleshaiwi ◽  
Naseem Akhtar Qureshi
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Knowledge ◽  
First Aid ◽  
Mental Health First Aid ◽  
Community Members ◽  
Item Questionnaire ◽  
First Aid Training ◽  
Post Test ◽  
The Impact

Background: Mental Health First Aid, an important component of metal health educational programs, targets naive community members, public, allied mental health personnel, and mental health experts with specific reference as to how these trained aiders should help people in crisis or with mental health conditions in the community. Objective: This study aimed to describe pre-to-post-test assessment of those who were trained in MHFA program. Setting: National Center for Mental Health Promotion, Riyadh, Saudi Arabia. Methods: Trained mental health professionals organized MHFA courses (n=35) for training self-selected, nonrandomized community members (n=862) who were assessed pre-to-post training by using an adapted 17-item questionnaire for measuring the impact of MHFA course on their mental health knowledge, perception, attitude and practice. Results: The participants’ responses to questionnaire were varied at pre-and post-test evaluation and 65% of them showed mild to significant positive changes in their responses, and the rest were not affected positively after this course, possibly attributed to multiple factors related to naïve community trainees, advanced questionnaire, short timeline and dissimilar instructors. Conclusion: Although all participants well received the MHFA courses, 65% of participants’ pre-to-post-test responses improved positively. The preliminary results of this study are not generalizable to the whole community, need to be cautiously interpreted and this research is calling for more studies especially randomized controlled trials in future.

Pediatrician's Role in Emergency Medical Services for Children

PEDIATRICS ◽  
1988 ◽  
Vol 81 (5) ◽  
pp. 735-735
Author(s):  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Care ◽  
Life Support ◽  
Care Delivery ◽  
Prehospital Care ◽  
Pediatric Emergency ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical ◽  
Pediatric Emergency Care

To reduce the morbidity and mortality of critically ill and injured children, comprehensive care must be provided. This includes effective services and treatment from the onset of the illness or injury through definitive care. Pediatricians should counsel families not only about prevention of disease and injury but also about access to pediatric emergency care resources in their region. If the interval between recognition of illness and delivery of care is to be reduced to a minimum, a prehospital protocol must be established. Parents as well as prehospital care providers must be knowledgeable about their community's prehospital protocol for life-threatening illness or injury. Primary care pediatricians need to establish networks with hospital-based pediatricians, emergency physicians, pediatric surgeons, and other pediatric medical and pediatric surgical specialists so that there is clearly assigned responsibility for provision of pediatric emergency care.1 When available, a pediatric surgeon should take charge of the child with multiple traumatic injuries. Optimally, the pediatric emergency care delivery system will be comprehensive and designed to meet the unique needs of children. The specific objectives of an emergency medical services for children (EMS-C) system should remain constant even though available resources may vary from region to region. For an EMS-C system to be most effective, practitioners need to develop the knowledge, skills, attitudes, and experience necessary to provide essential life support for ill and injured children. Many regions currently have well-developed emergency medical services (EMS) systems with outstanding capability and sophistication but most have been designed to meet the needs of adults.2

A First Aid Training Course for Primary Health Care Providers in Nagorno Karabagh: Assessing Knowledge Retention

2012 ◽  
Vol 27 (6) ◽  
pp. 509-514 ◽  
Author(s):  
Michael E. Thompson ◽  
Tsovinar L. Harutyunyan ◽  
Alina H. Dorian
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Knowledge Retention ◽  
First Aid ◽  
Care Providers ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
First Aid Training ◽  
Nagorno Karabagh

AbstractIntroductionConflict in the South Caucasus’ Nagorno Karabagh region has damaged health facilities and disrupted the delivery of services and supplies as well as led to depletion of human and fixed capital and weakened the de facto government's ability to provide training for health care providers.ProblemIn response to documented medical training deficits, the American University of Armenia organized a first aid training course (FATC) for primary health care providers within the scope of the USAID-funded Humanitarian Assistance Project in Nagorno Karabagh. This paper reports the follow-up assessments conducted to inform policy makers regarding FATC knowledge and skill retention and the potential need for periodic refresher training.MethodsFollow-up assessments were conducted six months and 18 months following the FATC to assess the retention of knowledge, attitudes, and self-reported practices. Eighty-four providers participated in the first follow-up and 210 in the second. The assessment tool contained items addressing the use and quality of the first aid skills, trainee's evaluation of the course, and randomly selected test questions to assess knowledge retention.ResultsAt both follow-up points, the participants’ assessment of the course was positive. More than 85% of the trainees self-assessed their skills as “excellent” or “good” and noted that skills were frequently practiced. Scores of approximately 58% on knowledge tests at both the first and second follow-ups indicated no knowledge decay between the first and second survey waves, but substantial decline from the immediate post-test assessment in the classroom.ConclusionThe trainees assessed the FATC as effective, and the skills covered as important and well utilized. Knowledge retention was modest, but stable. Refresher courses are necessary to reverse the decay of technical knowledge and to ensure proper application in the field.ThompsonME, HarutyunyanTL, DorianAH. A first aid training course for primary health care providers in Nagorno Karabagh: assessing knowledge retention. Prehosp Disaster Med. 2012;27(6):1-6.

ASSESSMENT OF KNOWLEDGE, ATTITUDE, AND PRACTICE OF FIRST AID, AND ASSOCIATED FACTORS, AMONG KINDERGARTEN TEACHERS

2018 ◽  
Vol 7 (5) ◽  
Author(s):  
Amsalu Birara Melese ◽  
Alemtsehay Alemu Tesema ◽  
Amare Simegn
Keyword(s):  
Multivariate Logistic Regression Analysis ◽  
First Aid ◽  
Kindergarten Teachers ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Knowledge Question ◽  
First Aid Training ◽  
Knowledge Attitude And Practice ◽  
Structured Questionnaire ◽  
Good Attitude

Abstract Background: Injuries are very common now a day and can occur at any point of time in a day to day life. Among them, injuries in school children rank a major part. The objective of this research to evaluate knowledge, attitude and practice towards first aid and factors associated among kindergarten teachers. Methods: Institutions based cross-sectional quantitative study design was employed. The study was conducted in Bahir dar town, Amhara region, Ethiopia from March to May 2017. A Pre-tested and structured questionnaire was used to collect data. Binary and multivariate logistic regression analysis was used to determine the separate and confounding effect for variables. Result: A total of 173 respondents were interviewed with a response rate of 93%. From the total respondents 97 (56.1%) scored above mean for knowledge question, In particular, subjects lacked knowledge regarding first aid for Human/animal bite (60.1%) was not answered correctly. Regarding practice out of all respondents, 128(74%) had faced the child in need of first aid. About attitude, all respondents (100%) felt good attitude towards giving and learning first aid. Service year (AOR=8.6, 95%CI0.035-0.399) and previous first aid training (AOR=2.5, 95%CI 1.138-5.570) were found to have a significant association with knowledge of first aid. Conclusion: The knowledge of kindergarten teachers towards first aid were found to be low while they have the good attitude towards giving first aid and receiving training on first aid. It remains necessary to increase their actual first aid knowledge and skills.  

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