Pediatric emergency medical care in Yerevan, Armenia: a knowledge and attitudes survey of out-of-hospital emergency physicians

Baghdassarian, Aline; Donaldson, Ross I.; DePiero, Andrew D.; Chernett, Nancy L.; Sule, Harsh

doi:10.1186/1865-1380-7-11

Cited by 8 publications

(11 citation statements)

References 8 publications

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“…Another strength was the usage of a previously validated EMS-focused KAP survey that successfully assessed the relationship between community members and their EMS system in Baghdad, Iraq. 14,15 This Iraqbased study showcased the reproducibility of the previously outlined WHO study methodology, supporting its usage in our current study in Peru.…”

Section: Strengths and Weaknessessupporting

confidence: 82%

Knowledge, attitude and practice of emergency medical care in Lima, Peru

Adler

Goldstein

Phy

et al. 2019

Int J Community Med Public Health

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Background: This study gauged public need and reception for a community-based first-aid and cardiopulmonary resuscitation (CPR) training program in Lima, Peru, to counteract predicted emergency medical service (EMS) deficits.Methods: The study population consisted of Lima households that were selected with a two-staged 30x7 cluster sampling method. An EMS and first-aid focused knowledge-attitude-practice (KAP) survey was administered by a joint academic-community interview team.Results: The study included 210 households from 30 districts within Lima. Among the participants, 61.4% were unable to provide an EMS number and only 24.8% would call an ambulance in case of a family emergency. Although 37.6% could provide first-aid, 99.5% would feel more comfortable if a neighbor were first-aid trained.Conclusions: The results indicated a lack of confidence in Lima’s EMS systems and awareness of EMS contact numbers, which possibly led community members to trust each other over their local EMS. The creation of a community-based first-aid and CPR training program can potentially take advantage of strong intra-community trust, mitigate first-aid deficits, and alleviate Lima’s injury burden by providing a buffer against barriers to effective EMS responses.

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Section: Strengths and Weaknessessupporting

confidence: 82%

Knowledge, attitude and practice of emergency medical care in Lima, Peru

Adler

Goldstein

Phy

et al. 2019

Int J Community Med Public Health

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“…Acutely ill or injured children pose a considerable challenge to providers worldwide [ 1 – 5 ]. Armenia (29743 km 2 ), with a total population of 3 million is a lower-mid income country (LMIC) that gained independence from the Union of Soviet Socialist Republics in 1991.…”

Section: Introductionmentioning

confidence: 99%

“…The emergency medical services system (EMS), in Armenia follows the Franco-German model whereby ambulances are staffed by physician-nurse dyads. This model results in a lower proportion of patients transported to the hospital [ 1 , 7 , 8 ]. In 1995, a 24-month general emergency medicine (EM) residency program was developed to improve emergency and trauma care in Yerevan [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, in the more remote provinces of Armenia, the ambulances are staffed by frontline physicians who do not necessarily have any EM training and may be general pediatricians, family practitioners, or surgeons. A needs assessment study conducted in 2012 in Yerevan, identified gaps in pediatric-specific rapid assessment and resuscitation knowledge and skills among the OH-EPs [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and integration of an intensive emergency pediatric care curriculum in Armenia

et al. 2021

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Background Emergency pediatric care curriculum (EPCC) was developed to address the need for pediatric rapid assessment and resuscitation skills among out-of-hospital emergency providers in Armenia. This study was designed to evaluate the effectiveness of EPCC in increasing physicians’ knowledge when instruction transitioned to local instructors. We hypothesize that (1) EPCC will have a positive impact on post-test knowledge, (2) this effect will be maintained when local trainers teach the course, and (3) curriculum will satisfy participants. Methods This is a quasi-experimental, pre-test/post-test study over a 4-year period from October 2014‑November 2017. Train-the-trainer model was used. Primary outcomes are immediate knowledge acquisition each year and comparison of knowledge acquisition between two cohorts based on North American vs local instructors. Descriptive statistics was used to summarize results. Pre-post change and differences across years were analyzed using repeated measures mixed models. Results Test scores improved from pretest mean of 51% (95% CI 49.6 to 53.0%) to post-test mean of 78% (95% CI 77.0 to 79.6%, p < 0.001). Average increase from pre- to post-test each year was 27% (95% CI 25.3 to 28.7%). Improvement was sustained when local instructors taught the course (p = 0.74). There was no difference in improvement when experience in critical care, EMS, and other specialties were compared (p = 0.23). Participants reported satisfaction and wanted the course repeated. In 2017, EPCC was integrated within the Emergency Medicine residency program in Armenia. Discussion This program was effective at impacting immediate knowledge as well as participant satisfaction and intentions to change practice. This knowledge acquisition and reported satisfaction remained constant even when the instruction was transitioned to the local instructors after 2 years. Through a partnership between the USA and Armenia, we provided OH-EPs in Armenia with an intensive educational experience to attain knowledge and skills necessary to manage acutely ill or injured children in the out-of-hospital setting. Conclusions EPCC resulted in significant improvement in knowledge and was well received by participants. This is a viable and sustainable model to train providers who have otherwise not had formal education in this field.

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“…Furthermore, there are currently no standards regulating residency educational curricula or residency positions available for different specialties. Knowledge gaps have even been described among some physicians in the country [5].…”

Section: Introductionmentioning

confidence: 99%