Factors affecting primary health-care physicians' emergency-related practice; Eastern Province, KSA

Abstract

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.

Preparedness of non-hospital health centers to manage patients with life-threatening emergency conditions: findings from a qualitative study

“…Potential management of LTE patients requires specific knowledge and expertise, which ought to be updated and practiced on a regular basis [ 12 , 27 ]. In reality, this issue is not easy for service providers of NHHCs as they occasionally manage such conditions; hence, they may not know how they should respond appropriately even if they have required expertise as well as they have access to primary equipment [ 12 , 28 ].…”

Acute poisoning as urgent cases and care measures

“…U Etiopiji, sistem Hitne medicinske pomoći ima za cilj smanjenje smrtnosti i invaliditeta licima kojima je život i/ili zdravlje ugroženo u prehospitalnom okruženju. Njihov osnovni zadatak je da pruže hitnu prebolničku Ranđelović N. Simona, Živanović R Slavoljub Transport pacijenata iz ambulante ABC časopis urgentne medicine 2019;19:(2): [8][9][10][11][12][13][14][15][16][17] pluća (HOBP), edem pluća i druga stanja koja nisu ili ne mogu u potpunosti da budu zbrinuta. Moineddin R i sar.…”

“…Pacijenti sa nestabilnom anginom pektoris kao sledećom najčešćom dijagnozom (9,74%), takođe su transportovani isključivo lekarskim transportom. Poremećaji srčanog ritma po tipu komorskih ekstrasistola zauzeli su 5,19%, i to su stanja koja se početno i zbrinjavaju u ambulati primarne zdravstvene zaštite a nastavlja se u bolničkim uslovima [17]. Fibrilacija pretkomora zabeležena je samo jednom (0,65%) kao i bradikardija (0,65%).…”

“…U većem procentu su transportovani i pacijenti sa bolom u abdomenu i karlici (3,90%), moždanim infarktom (3,25%), kongestivnom insuficijencijom srca (3,25%), plućnim edemom (2,60%). Pacijenti sa nekim od ovih stanja se obavezno transportuju na dalju dijagnostiku i lečenje [6]., jedan deo nije mogao da bude zbrinutu ambulanti [17], Ranđelović [17] koji u našoj ambulanti ne postoje. I u našem istraživanju su dalji tretman i transport zahtevali, na primer, ginekološko krvarenje (0,65%) prevezeno transportnom ekipom.…”

“…Ranđelović N. Simona, Živanović R Slavoljub Transport pacijenata iz ambulante ABC časopis urgentne medicine 2019;19:(2):[8][9][10][11][12][13][14][15][16][17] …”