Emergency medical services in Ethiopia: Drivers, challenges and opportunities

Mosadeghrad, Ali Mohammad; Gebru, Addis Adera; Sari, Ali Akbari; Getu, Mikiyas Amare

doi:10.3233/hab-190368

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…Our gure is higher than some ndings from Australia, which used similar prede ned criteria to address the sudden prehospital clinical deterioration in trauma patients (32,33). The difference in the advancement of the EMS system between Australia and Ethiopia could be the reason for the disparity in the ndings, as the EMS system in Ethiopia is a recent phenomenon (30,44). In addition, treatment-seeking delay by the patients or delayed inter-hospital transfer could be another factor as a signi cant proportion of the patients included in this study were critically ill and had unstable vital signs before transportations.…”

Section: Discussionmentioning

confidence: 56%

Prehospital characteristics of COVID-19 patients transported by emergency medical service and the predictors of a prehospital sudden deterioration in Addis Ababa, Ethiopia

Beza

Baru

Alemayehu

et al. 2022

Preprint

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Background: Severally ill COVID- 19 patients may require urgent transport to a specialized facility for advanced care. Prehospital transport is inherently risky; the patient's health may deteriorate, and potentially fatal situations may arise. Hence, early detection of clinically worsening patients in a prehospital setting may enable in selecting the best receiving facility, arranging for swift transportation, and providing the most accurate and timely therapies. The incidence and predictors of abrupt prehospital clinical deterioration among critically ill patients in Ethiopia are relatively limited.Study objectives. It will be useful to show the claims that the researchers are making and to verify that they have achieved their promises in the article's discussion section.Methods. There is no theoretical foundation for this study because no similar study has been conducted in the past. A prospective cohort study of 591 COVID-19 patients transported by a public EMS in Addis Ababa was conducted to determine the incidence of sudden clinical deterioration during prehospital transportation and its predictors. For data entry, Epi data V4.2 and SPSS V 25 was used for analysis. To control the effect of confounders, the candidate variables for multivariable analysis were chosen using a p 0.25 inclusion threshold from bivariate analysis. A statistically significant association was declared at adjusted relative risk (ARR) ≠ 1 with a 95 % confidence interval (CI) and a p-value < 0.05 after adjusting for potential confounders.Results. The incidence of prehospital sudden clinical deterioration in this study was 10.8%. The independent predictors of prehospital sudden clinical deterioration were total prehospital time [ARR 1.03(95%; CI: 1.00-1.06)]; queuing delays [ARR 1.03(95%; CI:1.00-1.06)]; initial prehospital respiratory rate [ARR 1.07(95% CI:1.01-1.13)], and diabetic Mellitus [ARR 1.06(95%; CI: 1.01-1.11)]. Conclusion. In the current study, one in every ten COVID-19 patients experienced a clinical deterioration while an EMS provider was present. The factors that determined rapid deterioration were total prehospital time, queueing delays, the initial respiratory rate, and diabetes mellitus. Queueing delays should be managed in order to find a way to decrease overall prehospital time. According to this finding, more research on prehospital intervention and indicators of prehospital clinical deterioration in Ethiopia is warranted.

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Section: Discussionmentioning

confidence: 56%

Prehospital characteristics of COVID-19 patients transported by emergency medical service and the predictors of a prehospital sudden deterioration in Addis Ababa, Ethiopia

Beza

Baru

Alemayehu

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…This strategy has been increasingly adopted in developed countries such as China and the United States, aiming to reduce overcrowding and the waiting time for care -especially in cases of low complexity -without compromising the quality of care. [10][11][12][13][14][15] A research that evaluated the aggravating factors for nurses' performance in the emergency room identified that situations of daily stress interfere directly in the quality of care. Thus, this theme has been gaining more and more attention in scientific discussions, especially in the approach of coping with negative experiences in the emergency ward and how they affect the professionals in the service.…”

Section: Resultsmentioning

confidence: 99%

Barriers and challenges in nursing’s performance in emergency and emergency services / Entraves e desafios na atuação do enfermeiro nos serviços de urgência e emergência

Moreira

Lira

et al. 2022

RPCF

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Objetivo: identificar os principais entraves e desafios enfrentados pelo enfermeiro atuante nos serviços de urgência e emergência. Método: trata-se de uma revisão narrativa. Utilizou-se artigos publicados nos últimos cinco anos, disponíveis nas principais bases de dados, em três idiomas, contemplando a temática em seu título, resumo ou assunto. Inicialmente encontrou-se 12.370 arquivos, que ao passarem pelos critérios de exclusão e leitura simplificada culminou na abordagem de 28 artigos. Resultados: dentre os principais achados destacam-se: a grande demanda do serviço, carga horária exaustiva, baixos salários, situações de estresse, eventos adversos, além da falha na comunicação e relação interprofissional. Conclusão: há a prevalência dos entraves nos diversos serviços de urgência e emergência, contudo, são apontadas diversas soluções com potencial de aplicabilidade, na tentativa de gerir os entraves e sanar os desafios identificados.

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“…Our figure is higher than some findings from Australia, which used similar predefined criteria to address the sudden prehospital clinical deterioration in trauma patients [ 32 , 33 ]. The difference in the advancement of the EMS system between Australia and Ethiopia could be the reason for the disparity in the findings, as the EMS system in Ethiopia is a recent phenomenon [ 30 , 44 ]. In addition, treatment-seeking delay by the patients or delayed inter-hospital transfer could be another factor as a significant proportion of the patients included in this study were critically ill and had unstable vital signs before transportations.…”

Section: Discussionmentioning

confidence: 99%

Prehospital characteristics of COVID-19 patients transported by emergency medical service and the predictors of a prehospital sudden deterioration in Addis Ababa, Ethiopia

et al. 2022

View full text Add to dashboard Cite

Background Severally ill COVID-19 patients may require urgent transport to a specialized facility for advanced care. Prehospital transport is inherently risky; the patient’s health may deteriorate, and potentially fatal situations may arise. Hence, early detection of clinically worsening patients in a prehospital setting may enable selecting the best receiving facility, arranging for swift transportation, and providing the most accurate and timely therapies. The incidence and predictors of abrupt prehospital clinical deterioration among critically ill patients in Ethiopia are relatively limited. Study objectives This study was conducted to determine the incidence of sudden clinical deterioration during prehospital transportation and its predictors. Methods A prospective cohort study of 591 COVID-19 patients transported by a public EMS in Addis Ababa. For data entry, Epi data V4.2 and SPSS V 25 were used for analysis. To control the effect of confounders, the candidate variables for multivariable analysis were chosen using a p 0.25 inclusion threshold from the bivariate analysis. A statistically significant association was declared at adjusted relative risk (ARR) ≠ 1 with a 95 % confidence interval (CI) and a p value < 0.05 after adjusting for potential confounders. Results The incidence of prehospital sudden clinical deterioration in this study was 10.8%. The independent predictors of prehospital sudden clinical deterioration were total prehospital time [ARR 1.03 (95%; CI 1.00–1.06)], queuing delays [ARR 1.03 (95%; CI 1.00–1.06)], initial prehospital respiratory rate [ARR 1.07 (95% CI 1.01–1.13)], and diabetic mellitus [ARR 1.06 (95%; CI 1.01–1.11)]. Conclusion In the current study, one in every ten COVID-19 patients experienced a clinical deterioration while an EMS provider was present. The factors that determined rapid deterioration were total prehospital time, queueing delays, the initial respiratory rate, and diabetes mellitus. Queueing delays should be managed in order to find a way to decrease overall prehospital time. According to this finding, more research on prehospital intervention and indicators of prehospital clinical deterioration in Ethiopia is warranted.

show abstract

Emergency medical services in Ethiopia: Drivers, challenges and opportunities

Cited by 8 publications

References 18 publications

Prehospital characteristics of COVID-19 patients transported by emergency medical service and the predictors of a prehospital sudden deterioration in Addis Ababa, Ethiopia

Prehospital characteristics of COVID-19 patients transported by emergency medical service and the predictors of a prehospital sudden deterioration in Addis Ababa, Ethiopia

Barriers and challenges in nursing’s performance in emergency and emergency services / Entraves e desafios na atuação do enfermeiro nos serviços de urgência e emergência

Prehospital characteristics of COVID-19 patients transported by emergency medical service and the predictors of a prehospital sudden deterioration in Addis Ababa, Ethiopia

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