Weaknesses and Capacities Affecting the Prehospital Emergency Care for Victims of Road Traffic Incidents in the Greater Kampala Metropolitan Area: A Cross-Sectional Study

Abstract

Introduction:Prehospital emergency care is a vital and integral component of health systems, particularly in resource-constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities, and trauma caused by road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the prehospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA).Methods:A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims’ pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions, respectively. Data were descriptively analyzed, and a principal component analysis was employed to identify the most influential weaknesses and capacities affecting the prehospital emergency care for the victims of RTI in the GKMA.Results:From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 20164. key weaknesses and 5 key capacities were identified to affect the prehospital emergency care for RTI victims in the GKMA. Although some strengths exist, (e.g., ambulance facilitation, EMS structuring, and coordination), the key weaknesses affecting the pre-hospital care for victims were noted to relate to the absence of predefined EMS systems, particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment, insufficient skills/training of the first responders, inadequate EMS resources, and avoidable delays to respond and transport RTI victims to medical facilities.Discussion:Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.

Educational impact of a pilot paediatric simulation-based training course in Botswana

“…Insufficient EMS provider training has been reported as a major weakness in developing EMS systems in other African countries, so the provision of effective training might exert a positive impact in a similar setting. 18 19 In the present study, we specifically assessed the impact of the training programme in Botswana using the first three levels in Kirkpatrick’s model for evaluation of the training programme. 20 The model has four levels to assess the effectiveness of an educational programme by determining the learner’s perception about satisfaction or self-efficacy with respect to the curriculum (level 1), whether they learnt what was taught (level 2), whether their behaviour demonstrated that they can apply what was taught (level 3) and whether changed learner behaviour results in a different real-world outcome after training (level 4).…”

Políticas e intervenciones para reducir lesiones por accidentes de tránsito: De la evidencia a la práctica

“…La literatura científica ha reportado experiencias donde los centros de asistencia y traumatología fueron efectivos en la reducción de las lesiones de AT, basándose en minimizar el tiempo entre la lesión y el tratamiento de reanimación hospitalaria; así, en Francia está basado en el triaje prehospitalario de las víctimas en la escena del accidente a fin de establecer la prioridad en la atención y la inclusión de personal médico entrenado en sus ambulancias para estabilizar al individuo lesionado en el menor tiempo posible 21 . Estudios sobre la atención de emergencias prehospitalarias y AT reportaron barreras que limitan la ejecución de sus intervenciones, las cuales fueron: la ausencia de un sistema integral de servicios médicos de emergencia (SME) entre la capital y el país, la baja calidad en los primeros auxilios brindados, insuficiente entrenamientos sobre respuesta inmediata, recursos inadecuados, demoras en la respuesta de atención y en el traslado a los SME 22 , el involucramiento negativo de ciudadanos, falta de coordinación entre las autoridades, inadecuados servicios prehospitalarios en número y distribución, deficiencias en infraestructura urbana y sistemas de comunicación 23,24,25 . El panel de expertos luego de analizar y contextualizar la evidencia recomendó: establecer una central de emergencia única que pueda derivar la información a las instancias correspondientes, elaborar un protocolo de atención prehospitala-ria con roles definidos para los policías, bomberos, personal de salud, fiscales y ciudadanos, así como la atención en foco con una priorización de víctimas como en accidentes masivos, desarrollar un sistema de educación continua al público que incluya: cómo informar la emergencia (que requisitos mínimos se requiere para poder hacer una llamada útil como, lugar, víctimas, puntos de referencia, y otros datos), concientizar sobre la importancia de la disponibilidad de la vía libre, de despejar esta vía para la circulación de las ambulancias.…”

The state of emergency medical services and acute health facility care in Uganda: findings from a National Cross-Sectional Survey

“…With a well-established EMS system (i.e., with functional prehospital care, transportation, and hospital care) as is found in most high income countries, many emergency medical conditions can be resolved in a few hours or days [6]. While a few studies have been done to assess pre-hospital care in Kampala [7][8][9], to our knowledge, no study has been done to assess the status of EMS and acute health facility care in Uganda at national level. The Ministry of Health (MoH) recognized the need to improve these services, and through this study sought to establish the status of emergency medical services and acute health facility care in the country.…”