No abstract

Diabetes is rising at an alarming rate, as 1 in 10 adults worldwide now lives with the disease. In Qatar, a middle eastern Arab country, diabetes prevalence is equally concerning and is predicted to increase from 17% to 24% among individuals aged 45 and 54 years by 2050. While most healthcare strategies focus on preventative and improvement of in-hospital care of patients with diabetes, a notable paucity exists concerning diabetes in the prehospital setting should ideally be provided. This quality improvement study was conducted in a middle eastern ambulance service and aimed to reduce ambulance callbacks of patients with diabetes-related emergencies after refusing transport to the hospital at the first time. We used iterative four-stage problem-solving models. It focused on the education and training of both paramedics and patients. The study showed that while it was possible to reduce the rate of ambulance callbacks of patients with diabetes, this was short-lived and numbers increased again. The study demonstrated that improvements could be effective. Hence, changes that impacted policy, systems of care and ambulance protocols directed at managing and caring for patients with diabetes-related prehospital emergencies may be required to reify them.

Background Hazardous Material—Chemical, Biological, Radiological, and Nuclear (HazMat‐CBRN) incidents, though infrequent, are environmentally precarious and perilous to living beings. They can be deliberate or accidental or follow the re‐emergence of highly contagious diseases. Successful management of such incidents in pre‐hospital settings requires having well‐trained and prepared healthcare workers. Aims This study aimed to explore the reliability and validity of a satisfaction survey, answered by Specialized Emergency Management (SEM) personnel from a national Middle Eastern ambulance service, with a “Hazardous Material Incident Management” course offered to them as a continuing professional development activity and seek their opinion regarding Hamad Medical Corporation Ambulance Service personnel needs for other HazMat‐CBRN related training topics. Method In the cross‐sectional study, we conducted an online satisfaction survey for this group of course participants to obtain their feedback as subject matter experts. Aiken's content validity coefficient (CVC) was calculated to assess the content validity. Cronbach's α coefficient was determined to explore the survey's reliability. IBM®‐SPSS® version 26 was utilized to explore the data. Results The SEM satisfaction survey demonstrated important satisfaction with the implemented training with its robust reliability and content validity (Cronbach's α = 0.922 and CVC = 0.952). The participants also recommended additional related topics. Conclusion Sustaining and reinforcing the HazMat‐CBRN Incident Management course was strongly recommended, considering the increase of HazMat‐CBRN threats worldwide.

Background: Pre-hospital emergency calls do not always result in the patient being transported to the hospital. Such decisions can jeopardize healthcare outcomes and lead to wasting resources. Objectives and Methods: The purpose of this review was to summarize the various theories reported in the literature regarding patient non-conveyance to healthcare facilities in the pre-hospital emergency setting. Studies published between January 2012 and August 2022 were identified from PubMed and Google Scholar. These studies were subsequently screened using the AL-Rayyan® software. Results and Discussion: Twenty-nine articles that summarized patient non-transport theories were identified. Patient non-transport is a crucial health issue. The factors related to the non-transport were: patient-initiated refusals (PIR), clinical-initiated decisions (CID), and dispatcher-initiated decisions (DID). Conclusions: Patient non-transport to hospitals remains a serious challenge for emergency care systems. Hence, it requires greater attention from different healthcare systems. Further analysis is necessary to understand pre-hospital non-transport events and identify improvement areas. This approach helps prevent the wastage of resources while ensuring that patients receive the appropriate and definitive care they require.