scholarly journals Emergency medical services responders’ perceptions of the effect of stress and anxiety on patient safety in the out-of-hospital emergency care of children: a qualitative study

BMJ Open ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. e014057 ◽  
Author(s):  
Jeanne-Marie Guise ◽  
Matthew Hansen ◽  
Kerth O'Brien ◽  
Caitlin Dickinson ◽  
Garth Meckler ◽  
...  
Keyword(s):  
Patient Safety ◽  
Qualitative Study ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Medical Services ◽  
Hospital Emergency ◽  
Emergency Medical

scholarly journals “Dying due to poverty and lack of easy transport”: A qualitative study on access and availability of pre-hospital emergency medical services in Kampala, Uganda

2019 ◽  
Author(s):  
Amber Mehmood ◽  
Shirin Wadhwaniya ◽  
Esther Bayiga Zziwa ◽  
Olive C Kobusingye
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Poor Quality ◽  
Medical Services ◽  
Community Members ◽  
Hospital Emergency ◽  
Care Services ◽  
Emergency Medical

Abstract Background Emergency care services in low-and middle-income countries (LMICs) have traditionally received less attention in the dominant culture favouring vertical health programs. The unmet needs of pre-hospital and hospital-based emergency services are high but the barriers to accessing safe and quality emergency medical services (EMS) remain largely unaddressed. Few studies in Sub-Saharan Africa have qualitatively investigated barriers to EMS use, and quality of pre-hospital services from the providers and community perspective. We conducted a qualitative study to describe the patient-centred approach to emergency care in Kampala, Uganda, with specific attention to access to EMS.Methods The data collection was comprised of Key Informant Interviews (KII) and Focus Group Discussions (FGDs) with the community members. KII participants were selected using maximum purposive sampling based on expert knowledge of emergency care systems, and service delivery. FGDs were conducted to understand perceptions and experiences towards access to pre-hospital care, and to explore barriers to utilization of EMS. The respondents of ten KII and seven FGDs included pre-hospital EMS (PEMS) administrators, policy makers, police, health workers and community members. We conducted a directed content analysis to identify key themes and triangulate findings across different informant groups.Results Key themes emerged across interviews and discussions concerning: (1) lack of funds, (2) lack of standards, (3) need for upfront payments for emergency transport and care, 4) corruption, 5) poor quality pre-hospital emergency service, 6) poor quality hospital emergency care, and 7) delay in seeking treatment.Conclusions Patient-centred emergency care should be an integral part of comprehensive health care services. As Uganda and other LMICs continue to strive for universal health coverage, it is critical to prioritize and integrate emergency care within health systems owing to its cross-cutting nature. Community perceptions around access and quality of PEMS should be addressed in national policies covering affordable and safe EMS.

scholarly journals Barriers to utilization of pre-hospital emergency medical services among residents in Libreville, Gabon: A qualitative study

2013 ◽  
Vol 3 (4) ◽  
pp. 172-177 ◽  
Author(s):  
Nichole Bosson ◽  
Michael A. Redlener ◽  
George L. Foltin ◽  
Maria C. Raven ◽  
Mark P Foran ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Hospital Emergency ◽  
Emergency Medical

scholarly journals Management of COVID-19-related challenges faced by EMS personnel: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fateme Mohammadi ◽  
Banafsheh Tehranineshat ◽  
Mostafa Bijani ◽  
Ali Asghar Khaleghi
Keyword(s):  
Emergency Medical Services ◽  
Emergency Care ◽  
Healthcare Services ◽  
Medical Services ◽  
Hospital Emergency ◽  
Current Crisis ◽  
Professional Performance ◽  
Professional Challenges ◽  
Emergency Medical ◽  
Emergency Medical Services Personnel

Abstract Background As the first link in the chain of providing healthcare services in the frontline of the battle against COVID-19, emergency medical services (EMS) personnel are faced with various challenges, which affect their professional performance. The present study aimed to identify some strategies to manage the COVID-19-related challenges faced by the pre-hospital emergency care personnel in the south of Iran. Methods In this qualitative descriptive study, 27 pre-hospital emergency care personnel who were selected through the purposeful sampling method. Data were collected through 27 semi-structured, in-depth, individual interviews. The collected data were then analyzed based on the Granheim and Lundman’s method. Results Analysis of the data resulted in the identification of 3 main themes and eight sub-themes. These three main themes were as follows: comprehensive and systematic planning, provision of medical equipment, and reduction of professional challenges. Conclusion The findings of the present study showed that, during the COVID-19 crisis, emergency medical services personnel should be provided with a comprehensive and systematic protocol to provide pre-hospital care and their performance should be assessed in terms of a set of scientific standards. Due to lack of equipment and work overload in the current crisis, emergency medical services personnel are faced with many psychological challenges, which adversely affect their quality of pre-hospital emergency care. Furthermore, emergency care senior managers should develop comprehensive protocols, provide more equipment, and eliminate professional challenges to pave the ground for improving the quality and safety of the healthcare services in pre-hospital emergency care during the current COVID-19 crisis.

scholarly journals Barriers and facilitators to cardiopulmonary resuscitation within pre-hospital emergency medical services: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nahid Dehghan-Nayeri ◽  
Hassan Nouri-Sari ◽  
Fatemeh Bahramnezhad ◽  
Fatemeh Hajibabaee ◽  
Mojtaba Senmar
Keyword(s):  
Qualitative Study ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Human Resource ◽  
Organizational Factors ◽  
Medical Services ◽  
Hospital Emergency ◽  
Human Resource Policy ◽  
Emergency Medical ◽  
Resource Policy

Abstract Background Out-of-hospital cardiopulmonary arrest is a common and fatal problem. Rescuing patients with this problem by pre-hospital emergency medical services is associated with various barriers and facilitators. Identifying these barriers as well as the facilitators in a qualitative and an information-rich way will help to improve the quality of performing the maneuver and to increase the patients’ survival. Therefore, the current study was qualitatively conducted with the aim of identifying the factors affecting the cardiopulmonary resuscitation within the pre-hospital emergency medical services. Methods This qualitative study was conducted using a content analysis approach in Iran in 2021. The participants were 16 Iranian emergency medical technicians who were selected through a purposive sampling method. For data collection, in-depth and semi-structured interviews were conducted. For data analysis, the Elo and Kyngäs method was applied. Results The mean participants’ age was 33.06 ± 7.85 years, and their mean work experience was 10.62 ± 6.63 years. The collected information was categorized into one main category called “complex context of the cardiopulmonary resuscitation” and 5 general categories with 17 subcategories. These categories and subcategories include patient condition (patient’s underlying diseases, age, high weight, number of children, and place of living), dominant atmosphere in companions at home (companions’ feeling of agitation, companions doing harm, and companions helping), policy (educational policy, human resource policy, up-to-date equipment and technology, and do-not-resuscitate policy), performance of the out-of-organizational system (disorganization in the patient handover process, and cooperation of the support organizations), and conditions related to the treatment team (conscience, cultural dominance, and shift burden). Conclusions The results showed that the conditions related to the patient and his/her companions, as well as the organizational factors such as the policies and the out-of-organizational factors act as the barriers and the facilitators to the cardiopulmonary resuscitation within pre-hospital emergency medical services. Therefore, the barriers can be modified and the facilitators can be enhanced by taking various measures such as educating, human resource policy-making, upgrading the equipment, and considering appropriate management policies.

scholarly journals Emergency care education in South Africa: past, present and future

2019 ◽  
Vol 16 ◽  
Author(s):  
Simpiwe Sobuwa ◽  
Lloyd Denzil Christopher
Keyword(s):  
South Africa ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Education And Training ◽  
Medical Services ◽  
Hospital Emergency ◽  
Care Education ◽  
Emergency Medical ◽  
The Many ◽  
And Training

There have been major changes in pre-hospital emergency care training and education in South African over the past 30 years. This has culminated in the publication of a regulation that brings an end to an era of short courses in emergency care and paves the way for the implementation of the National Emergency Care Education and Training (NECET) policy. The policy envisions a 1-year higher certificate, a 2-year diploma and the 4-year professional degree in emergency medical care. This paper aims to describe the history of emergency care education and training in South Africa that culminated in the NECET policy. The lessons in the professional development of pre-hospital emergency care education and training may have application for emergency medical services in other countries.The migration of existing emergency medical services personnel to the new higher education qualification structure is a major challenge. The transition to the new framework will take time due to the many challenges that must be overcome before the vision of the policy is realised. Ongoing engagement with all stakeholders is necessary for the benefits envisioned in the NECET policy to be realised.  

Guidelines for Pediatric Emergency Care Facilities

PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 526-537
Author(s):  
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Pediatric Emergency ◽  
Medical Services ◽  
Emergency Medical ◽  
Care Facilities ◽  
Trained Personnel ◽  
Pediatric Emergency Care

Emergency care for life-threatening pediatric illness and injury requires specialized resources including equipment, drugs, trained personnel, and facilities. The American Medical Association Commission on Emergency Medical Services has provided guidelines for the categorization of hospital pediatric emergency facilities that have been endorsed by the American Academy of Pediatrics (AAP).1 This document was used as the basis for these revised guidelines, which define: 1. The desirable characteristics of a system of Emergency Medical Services for Children (EMSC) that may help achieve a reduction in mortality and morbidity, including long-term disability. 2. The role of health care facilities in identifying and organizing the resources necessary to provide the best possible pediatric emergency care within a region. 3. An integrated system of facilities that provides timely access and appropriate levels of care for all critically ill or injured children. 4. The responsibility of the health cane facility for support of medical control of pre-hospital activities and the pediatric emergency care and education of pre-hospital providers, nurses, and physicians. 5. The role of pediatric centers in providing outreach education and consultation to community facilities. 6. The role of health cane facilities for maintaining communication with the medical home of the patient. Children have their emergency care needs met in a variety of settings, from small community hospitals to large medical centers. Resources available to these health care sites vary, and they may not always have the necessary equipment, supplies, and trained personnel required to meet the special needs of pediatric patients during emergency situations.

Abstract WP261: Non-English-preferring Patients Have No Differences in Stroke Symptom Recognition or Emergency Care Time Metrics

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Shaw Natsui ◽  
Khawja A Siddiqui ◽  
Betty L Erfe ◽  
Nicte I Mejia ◽  
Lee H Schwamm ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Care ◽  
Medical Services ◽  
Similar Response ◽  
Language Preference ◽  
Emergency Department Care ◽  
Hospital Arrival ◽  
Stroke Symptom ◽  
Emergency Medical ◽  
Significant Difference

Introduction: The influence of patients’ language preference on the delivery of acute ischemic stroke (AIS) care in the pre-hospital and in-hospital emergency care settings is scarcely known. We hypothesize that stroke knowledge differences may be associated with non-English preferring (NEP) patients having slower time from symptom discovery to hospital presentation and less engagement of emergency medical services (EMS) than English preferring (EP) patients. Language barriers may also interfere with the delivery of time-sensitive emergency department care. Objectives: To identify whether language preference is associated with differences in patients’ time from stroke symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DIT), and door-to-needle (DTN) time. Methods: We identified consecutive AIS patients presenting to a single urban, tertiary, academic center between 01/2003-04/2014. Data was abstracted from the institution’s Research Patient Data Registry and Get with the Guidelines-Stroke Registry. Bivariate and regression models evaluated the relationship between language preference and: 1) time from symptom onset to hospital arrival, 2) use of EMS, 3) DIT, and 4) DTN time. Results: Of 3,190 AIS patients who met inclusion/exclusion criteria, 9.4% were NEP (n=300). Time from symptom discovery to arrival, and EMS utilization were not significantly different between NEP and EP patients in unadjusted or adjusted analyses (overall median time 157 minutes, IQR 55-420; EMS utilization: 65% vs. 61.3% p=0.21). There was no significant difference between NEP and EP patients in DIT or in likelihood of DIT ≤ 25 minutes in unadjusted or adjusted analyses (overall median 59 minutes, IQR 29-127; DIT ≤ 25 minutes 24.3% vs. 21.3% p=0.29). There was also no significant different in DTN time or in likelihood of DTN ≤ 60 minutes in unadjusted or adjusted analyses (overall median 53 minutes, IQR 36-73; DTN ≤ 60 minutes 62.5% vs. 58.2% p=0.60). Conclusion: Non-English-preferring patients have similar response to stroke symptoms as reflected by EMS utilization and time from symptom discovery to hospital arrival. Similarly, NEP patients have no differences in in-hospital AIS care metrics of DIT and DTN time.

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