Assessment of the status of prehospital care in 13 low- and middle-income countries.
Assessment of the status of prehospital care in 13 low- and middle-income countries.
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DOI：
10.3109/10903127.2012.664245
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发表时间：
2012-07
影响因子：
2.4
通讯作者：
Rivara F
中科院分区：
文献类型：
--
作者：
Nielsen K;Mock C;Joshipura M;Rubiano AM;Zakariah A;Rivara F
受伤和其他医疗紧急情况在低收入和中等收入国家越来越普遍。这些疾病造成的死亡大多数发生在医院外，因此有必要发展院前护理。大多数中低收入国家的院前能力发展不足，无法满足日益增长的紧急护理需求。为了更好地规划全球院前急救的发展，本研究旨在更好地了解大范围中低收入国家院前急救的现状。对非洲、亚洲和拉丁美洲13个低收入国家的紧急医疗服务（EMS）领导人和其他关键信息提供者进行了调查。问题涉及到的运输到医院的方法，EMS供应商的培训和认证，EMS系统的组织和资金，公众获得院前护理，EMS发展的障碍。院前护理能力差异很大，但一般而言，低收入国家和农村地区的院前护理能力较不发达，正规急诊服务的利用率往往很低。商业司机，志愿者和其他旁观者提供了很大比例的院前运输，偶尔也在许多地方提供急救。虽然税收和强制性机动车辆保险为85%的国家的EMS提供了补充资金，但最常提到的进一步发展院前护理的障碍是资金不足（36%的障碍）。其次最常见的障碍是系统内缺乏领导（18%）和缺乏立法设定标准（18%）。将院前护理扩大到目前服务不足或没有服务的地区，特别是在低收入国家和农村地区，可以利用现有的第一反应者网络，如商业司机和外行人。有必要努力提高其效力，如更广泛的急救培训，并将其努力更好地纳入正规的环管系统。就现有的正规环管系统而言，需要增加和更经常地提供资金，整合和协调现有的服务，并改进组织和领导，这可以通过使环管系统的行政和领导成为更理想的职业道路来实现。
Injury and other medical emergencies are becoming increasingly common in low- and middle-income countries (LMICs). Many to most of the deaths from these conditions occur outside of hospitals, necessitating the development of prehospital care. Prehospital capabilities are inadequately developed to meet the growing needs for emergency care in most LMICs. In order to better plan for development of prehospital care globally, this study sought to better understand the current status of prehospital care in a wide range of LMICs. A survey was conducted of emergency medical services (EMS) leaders and other key informants in 13 LMICs in Africa, Asia, and Latin America. Questions addressed methods of transport to hospital, training and certification of EMS providers, organization and funding of EMS systems, public access to prehospital care, and barriers to EMS development. Prehospital care capabilities varied significantly, but in general, were less developed in low-income countries and in rural areas, where utilization of formal emergency medical services was often very low. Commercial drivers, volunteers, and other bystanders provided a large proportion of prehospital transport and occasionally also provide first aid in many locations. Although taxes and mandatory motor vehicle insurance provided supplemental funds to EMS in 85% of the countries, the most frequently cited barriers to further development of prehospital care was inadequate funding (36% of barriers cited). The next most commonly sited barriers were lack of leadership within the system (18%) and lack of legislation setting standards (18%). Expansion of prehospital care to currently under- or un-served areas, especially in low-income countries and in rural areas, could make use of the already existing networks of first responders, such as commercial drivers and lay persons. Efforts to increase their effectiveness, such as more widespread first aid training, and better encompassing their efforts within formal EMS, are warranted. In terms of existing formal EMS, there is a need for increased and more regular funding, integration and coordination among existing services, and improved organization and leadership, as could be accomplished by making EMS administration and leadership a more desirable career path.
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DOI：
10.1097/00005373-200001000-00020
发表时间：
2000-01-01
影响因子：
--
作者：
Arreola-Risa, C;Mock, CN;Jurkovich, GJ
通讯作者：
Jurkovich, GJ
DOI：
10.1097/01.ta.0000073609.12530.19
发表时间：
2003-06-01
影响因子：
--
作者：
Husum, H;Gilbert, M;Murad, M
通讯作者：
Murad, M
DOI：
10.1097/00005373-199805000-00011
发表时间：
1998-05-01
影响因子：
--
作者：
Mock, CN;Jurkovich, GJ;Maier, RV
通讯作者：
Maier, RV
影响因子：
2.6
作者：
Jayaraman, Sudha;Mabweijano, Jacqueline R;Ozgediz, Doruk
通讯作者：
Ozgediz, Doruk
影响因子：
2.2
作者：
Roy, Nobhojit;Murlidhar, V;Vatkar, Arvind
通讯作者：
Vatkar, Arvind