OBJECTIVES:The objective of the study was to assess the availability of human and nonhuman resources for emergency medical services (EMSs) at the primary health care (PHC) level.MATERIALS AND METHODS:A cross-sectional study with mixed research methods (quantitative and qualitative) was carried out in governmental PHC centers in Dammam, Eastern Province of Saudi Arabia, between September 2014 and January 2015. Using systematic random sampling technique, 13 out of 26 PHC centers were included in the study. The study consisted of two main parts: The first involved the completion of an observational checklist to assess the availability and adequacy of human and nonhuman resources (workforce, emergency infrastructure, equipment, drugs and supporting facilities). The second part involved face-to-face interviews with key informants of nurses from the emergency room (ER) in the sampled centers.RESULTS:Analysis of the checklist showed that the total number of physicians “actually” present ranged from 2 to 8 per center and nurses actually present were 4–11 whereas the officially assigned number was 3–12 physicians and 8–17 nurses per center. Only 2 out of 13 (15.4%) centers had a place reserved for EMS in each male and female section. Only 4 (30.8%) PHC centers had a male ER located on the ground floor, near the entrance, and with a separate ramp. None of the centers had the emergency drugs such as metergotamine, calcium chloride, and naloxone. Regarding ER equipment, none of the studied centers had cervical collars, mouth gags, or a tracheostomy sets. Only one (7.6%) center had a functioning fully equipped ambulance. Five (38.46%) centers were equipped with electrocardiogram and X-ray machines. In the interviews, the informants confirmed the deficiencies identified in the checklist.CONCLUSION:Resources for EMS at Dammam PHC centers were deficient in infrastructure and supporting facilities.
Background:Being the first in-line care providers, primary health-care (PHC) physicians may encounter all forms of emergencies, ranging from minor complaints to life-threatening events. This wide variation of cases challenges the physicians to be competent in emergency medicine. Informative literature describing and assessing the factors affecting PHC physicians’ emergency medical services (EMS)-related practice is deficient (nationally and internationally). The aim of this study is to assess PHC physicians’ practice related to EMS, the factors affecting it, as well as their learning needs and preferred methods of continuous training in emergency medicine.Methods:All physicians working in the selected centers were invited to complete a self-administered questionnaire addressing their EMS-related practice. Moreover, physicians were invited to participate in face-to-face semi-structured interviews and focus group discussions.Results:The study revealed that 87.3% of physicians had a good diagnostic knowledge score while only 47.6% had a good management score. Nonetheless, 63.5% of physicians had a neutral attitude toward EMS. The most common reported emergencies encountered are bronchial asthma (86.51%), cut wounds (83.33%), and burns (76.19%). About 62% of participants reported that their greatest needs for further training were in cardiovascular and central nervous system emergency management, preferably by practical training in hospital emergency department (80%).Conclusions:Dammam PHC physicians have a good knowledge, neutral attitude, and fair practice concerning the emergency cases encountered. The majority of physicians reported their need for further hands-on training in emergency medicine.Settings and Design:A cross-sectional, mixed methods study was conducted in 13 out of 26 PHC centers of Dammam, Saudi Arabia.
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