Working toward Equity in Emergencies (WE) through Stop the Bleed: A pilot collaborative health program with the Somali community in Seattle

Stadeli, Kathryn M.; Abdullahi, Dirir; Ali, Abdifatah Farah; Conrick, Kelsey M.; Paulsen, Michael; Bulger, Eileen M.; Vavilala, Monica S.; Mohamed, Farah; Ali, Ahmed; Ibrahim, Anisa

doi:10.1016/j.amjsurg.2020.03.004

Cited by 15 publications

(7 citation statements)

References 11 publications

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“…As a specific example, findings from this study informed development of the Working for Equity: WE Stop the Bleed program. 38,39 Perhaps the most important finding from our study is that EMS participants described many differences in how they provided care for patients with LEP but explicitly expressed a belief that they provided the same high-quality care to all comers regardless of language, race, or ethnicity. There was a lack of recognition of lower quality of care, particularly in the setting of known disparities.…”

Section: Discussionmentioning

confidence: 79%

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Perceptions of Prehospital Care for Patients With Limited English Proficiency Among Emergency Medical Technicians and Paramedics

et al. 2023

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ImportancePatients with limited English proficiency (LEP) experience disparities in prehospital care. On-scene interactions between patients with LEP and emergency medical services (EMS) providers (ie, firefighters/emergency medical technicians [EMTs] and paramedics) are critical to high-quality care and have been minimally explored.ObjectiveTo identify EMS-perceived barriers and facilitators to providing high-quality prehospital care for patients with LEP.Design, Setting, and ParticipantsIn this qualitative study, semi-structured focus groups were conducted with firefighters/EMTs and paramedics with all levels of experience from urban areas with a high proportion of residents with LEP from July to September 2018. Data were analyzed from July 2018 to May 2019.ExposuresProviding prehospital care for patients with LEP.Main Outcomes and MeasuresThe main outcomes were barriers and facilitators to prehospital care for patients with LEP, assessed using thematic analysis. Four domains of interest were examined: (1) overall impressions of interactions with patients with LEP, (2) barriers and facilitators to communication, (3) barriers and facilitators to providing care, and (4) ideas for improving prehospital care for patients with LEP.ResultsThirty-nine EMS providers participated in 8 focus groups: 26 firefighters/EMTs (66%) and 13 paramedics (33%). The median age of participants was 46 years (range, 23-63 years), and 35 (90%) were male. Participants described barriers to optimal care as ineffective interpretation, cultural differences, high-stress scenarios (eg, violent events), unclear acuity of patient’s condition, provider bias, and distrust of EMS. Perceived facilitators to optimal care included using an on-scene interpreter, high-acuity disease, relying on objective clinical findings, building trust and rapport, and conservative decision-making regarding treatment and transport. Providers reported transporting most patients with LEP to hospitals regardless of illness severity due to concern for miscommunication and unrecognized problems. Better speed and technology for interpretation, education for communities and EMS providers, and community-EMS interactions outside emergencies were cited as potential strategies for improvement.Conclusions and RelevanceIn this study, EMS providers described many barriers to high-quality care during prehospital emergency response for patients with LEP yet were unaware that these barriers impacted quality of care. Barriers including ineffective interpretation, provider bias, distrust of EMS, and cultural differences may contribute to outcome disparities and overutilization of resources. Future work should focus on the development of targeted interventions to improve modifiable barriers to care, such as improving interpretation and cultural humility and increasing trust.

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Section: Discussionmentioning

confidence: 79%

“…Participants also suggested EMS-community interactions outside emergencies to build trust, cultural familiarity, and relationships. As a specific example, findings from this study informed development of the Working for Equity: WE Stop the Bleed program …”

Section: Discussionmentioning

confidence: 83%

Perceptions of Prehospital Care for Patients With Limited English Proficiency Among Emergency Medical Technicians and Paramedics

et al. 2023

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“…Similar to WE Stop the Bleed, we found that cultural and linguistic adaptation of STB training is a feasible, cost-effective, and successful method for disseminating life-saving information and trauma education to immigrant populations with LEP. 8 Despite its success, STB has still not been widely translated into non-Spanish languages even though studies show that certain immigrant populations are at a higher risk for unintentional and intentional firearm injuries. 13 Immigrants face a myriad of challenges upon resettlement in the US including barriers to medical aid.…”

Section: Discussionmentioning

confidence: 99%

Cultural and Linguistic Adaptations of Stop the Bleed in Multi-Ethnic Refugee Communities

Abdullahi

Zeidan

Koganti

et al. 2023

The American Surgeon™

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Introduction Stop the Bleed (STB), and other trainings that promote health education in basic trauma management techniques, is offered mostly in English and Spanish in the United States. Limited access to injury prevention training may contribute to inequities in health outcomes for individuals with limited English proficiency (LEP). Our study aims to determine the feasibility and effectiveness of STB training in 4 languages spoken in a super diverse refugee settlement community, Clarkston, GA. Methods Written STB educational materials were culturally adapted, translated, and back translated into 4 languages: Arabic, Burmese, Somali, and Swahili. Four 90-minute in-person STB trainings were conducted by medical personnel with community-based interpreters at a central and familiar location in the Clarkston community. Pre- and post-tests were administered in participant’s preferred language to evaluate change in knowledge and beliefs as well as the effectiveness of the training method. Results A total of 46 community members were trained in STB, the majority of which were women (63%). Participants demonstrated improvement in their knowledge, confidence, and comfort using STB techniques. Participants reported that 2 aspects of the training were particularly beneficial: the presence of language concordant interpreters from the community and small group hands on sessions that allowed for practicing STB techniques. Conclusion Cultural and linguistic adaptation of STB training is a feasible, cost-effective, and effective method for disseminating life-saving information and trauma education to immigrant populations who have LEP. Expansion of community training and partnerships to support the needs of diverse communities is both necessary and urgent.

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“…( 2020 ) and Stadeli et al. ( 2020 ) Geduld and Wallis ( 2011 ), Curran et al. ( 2018 ) and Lamote et al.…”

Section: Pre-ems Servicesmentioning

confidence: 97%

A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services

Matinrad

Reuter-Oppermann

2021

Cent Eur J Oper Res

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Emergency services worldwide face increasing cost pressure that potentially limits their existing resources. In many countries, emergency services also face the issues of staff shortage–creating extra challenges and constraints, especially during crisis times such as the COVID-19 pandemic–as well as long distances to sparsely populated areas resulting in longer response times. To overcome these issues and potentially reduce consequences of daily (medical) emergencies, several countries, such as Sweden, Germany, and the Netherlands, have started initiatives using new types of human resources as well as equipment, which have not been part of the existing emergency systems before. These resources are employed in response to medical emergency cases if they can arrive earlier than emergency medical services (EMS). A good number of studies have investigated the use of these new types of resources in EMS systems, from medical, technical, and logistical perspectives as their study domains. Several review papers in the literature exist that focus on one or several of these new types of resources. However, to the best of our knowledge, no review paper that comprehensively considers all new types of resources in emergency medical response systems exists. We try to fill this gap by presenting a broad literature review of the studies focused on the different new types of resources, which are used prior to the arrival of EMS. Our objective is to present an application-based and methodological overview of these papers, to provide insights to this important field and to bring it to the attention of researchers as well as emergency managers and administrators.

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Working toward Equity in Emergencies (WE) through Stop the Bleed: A pilot collaborative health program with the Somali community in Seattle

Cited by 15 publications

References 11 publications

Perceptions of Prehospital Care for Patients With Limited English Proficiency Among Emergency Medical Technicians and Paramedics

Perceptions of Prehospital Care for Patients With Limited English Proficiency Among Emergency Medical Technicians and Paramedics

Cultural and Linguistic Adaptations of Stop the Bleed in Multi-Ethnic Refugee Communities

A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services

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