Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study

Balikuddembe, Joseph Kimuli; Ardalan, Ali; Khorasani‐Zavareh, Davoud; Nejati, Amir; Kasiima, Stephen

doi:10.1186/s12873-016-0112-3

Cited by 26 publications

(72 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shortage of skilled and qualified mainstream healthcare providers and, in particular, prehospital care providers to provide appropriate life-saving interventions is a key barrier to quality prehospital care. 23 24 40 Overall, lay responders such as the bystanders, policemen, friends, relatives and commercial drivers were the main providers of prehospital emergency rescue services from the injury scene to trauma care facilities. None of the studies examined the association between shortage and type of the providers on any post-trauma outcomes at the prehospital care level.…”

Section: Resultsmentioning

confidence: 99%

“…The trainings were reported to improve quality of first aid interventions in Uganda and Ethiopia. 23 43 In other counties like Tanzania, lay responder training has been suggested as necessity for strengthening capacity for community-based trauma responses. 48 Two studies, one conducted by Edem et al in South Africa and another conducted by Sultan et al in Ethiopia, observed that current prehospital training offered to health professionals in the respective countries was inadequate in meeting the minimum skill and knowledge needs for critical trauma care.…”

Section: Resultsmentioning

confidence: 99%

“…5 In Uganda, there was no national EMS policy or a functionalpostcrash care system across the health system. 23 The study reported that inadequate or lack of health insurance cover and inability of victims of crash to raise ambulance fees were major challenges in provision of responsive EMS care at the prehospital care level. 23 Other barriers to optimal prehospital care outcomes identified among the reviewed studies included miscommunication about where to transfer patients, long patient waiting times in the prehospital settings, and limited intensive care unit ambulances which contributed to an increase in avoidable trauma deaths.…”

Section: Other Contextual Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Health system factors associated with post-trauma mortality at the prehospital care level in Africa: a scoping review

Koome

Atela

Thuita

et al. 2020

Trauma Surg Acute Care Open

View full text Add to dashboard Cite

BackgroundAfrica accounts forabout 90% of the global trauma burden. Mapping evidence on health systemfactors associated with post-trauma mortality is essential in definingpre-hospital care research priorities and mitigation of the burden. The studyaimed to map and synthesize existing evidence and research gaps on healthsystem factors associated with post-trauma mortality at the pre-hospital carelevel in Africa.MethodsA scoping review of published studies and grey literature was conducted. The search strategy utilized electronic databases comprising of Medline, Google Scholar, Pub-Med, Hinari and Cochrane Library. Screening and extraction of eligible studies was done independently and in duplicate.ResultsA total of 782 study titles and or abstracts were screened. Of these, 32 underwent full text review. Out of the 32, 17 met the inclusion criteria for final review. The majority of studies were literature reviews (24%) and retrospective studies (23%). Retrospective and qualitative studies comprised 6% of the included studies, systematic reviews (6%), cross-sectional studies (17%), Delphi studies (6%), panel reviews (6%) and qualitative studies (12%), systematic reviews (6%), cross-sectional studies (17%), Delphi studies (6%), panel reviews (6%) and qualitative studies (12%). Reported post-trauma mortality ranged from 13% in Ghana to 40% in Nigeria. Reported preventable mortality is as high as 70% in South Africa, 60% in Ghana and 40% in Nigeria. Transport mode is the most studied health system factor (reported in 76% of the papers). Only two studies (12%) included access to pre-hospital care interventions aspects, nine studies (53%) included care providers aspects and three studies (18%) included aspects of referral pathways. The types of transport mode and referral pathway are the only factors significantly associated with post-trauma mortality, though the findings were mixed. None of the included studies reported significant associations between pre-hospital care interventions, care providers and post-trauma mortality.DiscussionAlthough research on health system factors and its influence on post-trauma mortality at the pre-hospital care level in Africa are limited, anecdotal evidence suggests that access to pre-hospital care interventions, the level of provider skills and referral pathways are important determinants of mortality outcomes. The strength of their influence will require well designed studies that could incorporate mixed method approaches. Moreover, similar reviews incorporating other LMICs are also warranted. Key Words: Health System Factors, Emergency Medical Services [EMS], Pre-hospital Care, Post-Trauma mortality, Africa.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Other Contextual Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Health system factors associated with post-trauma mortality at the prehospital care level in Africa: a scoping review

Koome

Atela

Thuita

et al. 2020

Trauma Surg Acute Care Open

View full text Add to dashboard Cite

show abstract

“…The topic of decision-making in such settings has previously been sporadically investigated in relation to emergency medical technicians (EMTs) but not in relation to physicians. In EMTs, tiredness has, for instance, indeed been reported to influence decision-making regarding the transportation of patients [ 26 ] and, when approaching the end of a shift, has been reported to be a factor influencing the intensity of the treatment or the decision to treat at the scene or to transport to the hospital [ 27 ]. In a field closely related to prehospital work, it has been shown that the duration of the average emergency medical centre dispatcher call was affected by night work shift, increasing by about 10 s late at night [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Does the “Morning Morality Effect” Apply to Prehospital Anaesthesiologists? An Investigation into Diurnal Changes in Ethical Behaviour

et al. 2020

View full text Add to dashboard Cite

The “morning morality effect”—the alleged phenomenon that people are more likely to act in unethical ways in the afternoon when they are tired and have less self-control than in the morning—may well be expected to influence prehospital anaesthesiologist manning mobile emergency care units (MECUs). The working conditions of these units routinely entail fatigue, hunger, sleep deprivation and other physical or emotional conditions that might make prehospital units predisposed to exhibit the “morning morality effect”. We investigated whether this is in fact the case by looking at the distribution of patient transports to hospital with and without physician escort late at night at the end of the shift as a surrogate marker for changing thresholds in ethical behaviour. All missions over a period of 11 years in the MECU in Odense were reviewed. Physician-escorted transports to hospital were compared with non-physician-escorted transports during daytime, evening, and night-time (which correlates with time on the 24 h shifts). In total, 26,883 patients were transported to hospital following treatment by the MECU. Of these, 27.4% (26.9%–27.9%) were escorted to the hospital. The ratio of patient transports to hospital with and without physician escort during the three periods of the day did not differ (p = 1.00). We found no evidence of changes in admission patterns over the day. Thus, no evidence of the expected “morning morality effect” could be found in a prehospital physician-manned emergency care unit.

show abstract

“…The original article [ 1 ] contained an error whereby the author Davoud Khorasani-Zavareh's name was not presented correctly.…”

Section: Erratummentioning

confidence: 99%

Erratum to: Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study

Balikuddembe¹,

Ardalan²,

Khorasani‐Zavareh³

et al. 2016

BMC Emerg Med

Self Cite

View full text Add to dashboard Cite

Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study

Cited by 26 publications

References 22 publications

Health system factors associated with post-trauma mortality at the prehospital care level in Africa: a scoping review

Health system factors associated with post-trauma mortality at the prehospital care level in Africa: a scoping review

Does the “Morning Morality Effect” Apply to Prehospital Anaesthesiologists? An Investigation into Diurnal Changes in Ethical Behaviour

Erratum to: Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study

Contact Info

Product

Resources

About