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Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal
BACKGROUND: Low- and middle-income countries (LMICs) often face significant challenges related to providing effective pre-hospital care services. Barriers to providing care include lack of financial resources, poor road infrastructure, lack of trained first responders and ambulance staff, and issues...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100927/ https://www.ncbi.nlm.nih.gov/pubmed/33957859 http://dx.doi.org/10.1186/s12245-021-00355-8 |
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author | Jacobson, Claire L. Basnet, Samjhana Bhatt, Ajay Parajuli, Shreejesh Shrestha, Sanu Krishna |
author_facet | Jacobson, Claire L. Basnet, Samjhana Bhatt, Ajay Parajuli, Shreejesh Shrestha, Sanu Krishna |
author_sort | Jacobson, Claire L. |
collection | PubMed |
description | BACKGROUND: Low- and middle-income countries (LMICs) often face significant challenges related to providing effective pre-hospital care services. Barriers to providing care include lack of financial resources, poor road infrastructure, lack of trained first responders and ambulance staff, and issues regarding coordination/communication between different entities involved in Emergency Medical Services. Prior initiatives to characterize and improve the state of pre-hospital care in LMICs have largely focused on improving access to high-quality ambulance services by providing training programs to community first responders and ambulance staff on how to recognize and manage key emergency conditions. In this article, we discuss an alternative strategy for improving pre-hospital care: the creation of a context-specific Emergency Medical Dispatcher (EMD) training curriculum and program. METHODS: We describe the current pre-hospital care setting in Nepal, the process of creating and piloting the Nepal-specific EMD training manual, and the early impact of its implementation. RESULTS: The 30-h EMD training was designed, piloted, and revised in collaboration with the three largest EMS organizations in Nepal. The training is now required for all dispatchers at the Dhulikhel Hospital Dispatch Center, one of the largest ambulance dispatch networks in Nepal. Dispatchers are trained in the following knowledge and skill areas: telecommunication guidelines, triaging and documentation procedures, delivery of Basic Life Support instructions to callers, other medical and trauma-condition specific instructions, and limited resource management. The short-term positive impacts of the training’s implementation include improved documentation procedures, better prioritization of ambulance resources, delivery of Basic Life Support instructions to callers, and improved communication between dispatch, responders, and healthcare facilities. CONCLUSIONS: Context-specific Emergency Medical Dispatch training programs, which aim to optimize the emergency resources available in resource-limited settings, present a promising low-cost, high-impact interventional strategy to strengthen the pre-hospital care systems in low- and middle-income countries. |
format | Online Article Text |
id | pubmed-8100927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-81009272021-05-06 Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal Jacobson, Claire L. Basnet, Samjhana Bhatt, Ajay Parajuli, Shreejesh Shrestha, Sanu Krishna Int J Emerg Med Educational Advances in Emergency Medicine BACKGROUND: Low- and middle-income countries (LMICs) often face significant challenges related to providing effective pre-hospital care services. Barriers to providing care include lack of financial resources, poor road infrastructure, lack of trained first responders and ambulance staff, and issues regarding coordination/communication between different entities involved in Emergency Medical Services. Prior initiatives to characterize and improve the state of pre-hospital care in LMICs have largely focused on improving access to high-quality ambulance services by providing training programs to community first responders and ambulance staff on how to recognize and manage key emergency conditions. In this article, we discuss an alternative strategy for improving pre-hospital care: the creation of a context-specific Emergency Medical Dispatcher (EMD) training curriculum and program. METHODS: We describe the current pre-hospital care setting in Nepal, the process of creating and piloting the Nepal-specific EMD training manual, and the early impact of its implementation. RESULTS: The 30-h EMD training was designed, piloted, and revised in collaboration with the three largest EMS organizations in Nepal. The training is now required for all dispatchers at the Dhulikhel Hospital Dispatch Center, one of the largest ambulance dispatch networks in Nepal. Dispatchers are trained in the following knowledge and skill areas: telecommunication guidelines, triaging and documentation procedures, delivery of Basic Life Support instructions to callers, other medical and trauma-condition specific instructions, and limited resource management. The short-term positive impacts of the training’s implementation include improved documentation procedures, better prioritization of ambulance resources, delivery of Basic Life Support instructions to callers, and improved communication between dispatch, responders, and healthcare facilities. CONCLUSIONS: Context-specific Emergency Medical Dispatch training programs, which aim to optimize the emergency resources available in resource-limited settings, present a promising low-cost, high-impact interventional strategy to strengthen the pre-hospital care systems in low- and middle-income countries. Springer Berlin Heidelberg 2021-05-06 /pmc/articles/PMC8100927/ /pubmed/33957859 http://dx.doi.org/10.1186/s12245-021-00355-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Educational Advances in Emergency Medicine Jacobson, Claire L. Basnet, Samjhana Bhatt, Ajay Parajuli, Shreejesh Shrestha, Sanu Krishna Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal |
title | Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal |
title_full | Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal |
title_fullStr | Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal |
title_full_unstemmed | Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal |
title_short | Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal |
title_sort | emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of nepal |
topic | Educational Advances in Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100927/ https://www.ncbi.nlm.nih.gov/pubmed/33957859 http://dx.doi.org/10.1186/s12245-021-00355-8 |
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