Prehospital Airway Management in Emergency and Trauma Patients: A Cross-sectional Study of Ambulance Service Providers and Staff in a Low- and Middle-income Country

Abstract

Even though ambulances are equipped with basic equipment, due to lack of trained staff, these ambulances only serve the mere purpose of transportation. There is a need to train ambulance staff and increase ambulance to staff ratio to improve prehospital AM and patient survival.

Prehospital Airway Management for Trauma Patients by First Responders in Six Sub‐Saharan African Countries and Five Other Low‐ and Middle‐Income Countries: A Scoping Review

“…Despite this prevalence, training remains limited. A study in Pakistan revealed 64% of ambulance staff interviewed were unfamiliar with AM and had limited awareness of AM in critical situations [34]. Another study found that despite 52% of patients in Iran requiring AM, just 20.8% were managed appropriately, defined by PHTLS guidelines [17].…”

“…With limited research on the state of prehospital AM in resource‐limited settings, the majority of studies included in this scoping review were case–control and retrospective cohort studies (12/17), [13, 14, 17, 27–29, 31, 33, 35, 36, 38, 39] while a limited selection of included studies were observational or qualitative in nature (5/17) [26, 30, 32, 34, 37]. Of the studies meeting inclusion criteria, first responder curricula teaching ABC were most common, found in 11 studies, followed by ET intubation in eight studies.…”

“…Another challenge to AM in LMICs is the lack of trained personnel available and transportation logistics. Many low‐resource EMS programs train bystander LFRs, often focusing on transportation providers proximal to RTIs [34]. If a single first responder witnesses an RTI requiring AM and responds, it may be implausible to expect effective AM and transport simultaneously.…”

How is Ambulance Patient Care and Response Time Data Collected and Reported in Malaysia and Indonesia?

“…Ten years following Hisamuddin's (39) observations, trauma systems remain undeveloped and unorganised in 'most Asian countries', with the exception being high-income countries (41). This statement is reinforced by a description of Indonesian pre- hospital services as having vehicles with only basic equipment (42) and staffed from Puskesmas (the term in Bahasa Indonesian for a community health clinic) with ambulance nurses lacking pre-hospital skills and knowledge (40).…”

Knowledge, Practice, and Associated Factors of Nurses in Pre-Hospital Emergency Care at a Tertiary Care Teaching Hospital

“…11 The evidence revealed that until recent years, there was a little study about knowledge and practice of specific staff called Emergency Medical Team (EMT) and still no organized recruitment guideline or formal training available in most developing countries about pre-hospital emergency care. 12 Less than 10% of all violence that led to death occurred in low-income countries due to delay in the emergency care before the hospital settings. 13 The evidence also suggested that the lack of information or knowledge about prehospital emergency care results in 16% dissatisfaction with the care given to the client.…”