Understanding of Development Emergency Medical Services in Laos Emergency Medicine Residents

Korakot Apiratwarakul; Ismet Celebi; Somsak Tiamkao; Vajarabhongsa Bhudhisawasdi; Chatkhane Pearkao; Kamonwon  Ienghong

doi:10.3889/oamjms.2021.7333

Authors

Korakot Apiratwarakul Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0000-0002-1984-0865
Ismet Celebi Department of Paramedic, Gazi University, Ankara, Turkey
Somsak Tiamkao Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Vajarabhongsa Bhudhisawasdi Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Chatkhane Pearkao Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
Kamonwon Ienghong Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0000-0003-0328-4128

DOI:

https://doi.org/10.3889/oamjms.2021.7333

Keywords:

Accidents, Appropriate technology, Emergency health services, Health-care policy, National health policy, Pre-hospital emergency care

Abstract

BACKGROUND: Rising death tolls from traffic accidents are quickly becoming an inescapable problem in almost all countries around the world. That being said, the World Health Organization has launched an ambitious campaign aimed at reducing the death rate from traffic accidents by 50% in the next 10 years. Development of emergency medical services (EMSs) was the tool to success the goals, especially in low- to middle-income countries including Laos. However, no studies regard perspective of training EMS in Laos emergency medicine residents.

AIM: The aim of our work is to demonstrate the effect of EMS training for Laos emergency medicine residents to the development of the national policy in Lao’s EMS.

METHODS: A cross-sectional study was conducted in two countries (Laos and Thailand) from January 2020. The project activities were establishment of a command-and-control center, development of EMS support system, and training for emergency care professionals.

RESULTS: The eight Laos emergency medicine residents were enrolled between January and March 2020. After practicing as a dispatcher and emergency medical consultant in Thailand at Khon Kaen University, the participants from Laos found that all personnel gained experience and improved their knowledge of technology in EMS and organization management. This had a direct impact on improving confidence in their return to practice in Laos.

CONCLUSIONS: The human resource development through international collaboration between Thailand and Laos is contributing the effective knowledge and expertise learning in Laos. Moreover, the result of this training may provide the most effective care system resulting in the much-needed drop in the mortality rate of traffic accidents in Laos.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Walugembe F, Levira F, Ganesh B, Lwetoijera DW. A retrospective study on the epidemiology and trends of road traffic accidents, fatalities and injuries in three municipalities of Dar es Salaam region, Tanzania between 2014-2018. Pan Afr Med J. 2020;36:24. https://doi.org/10.11604/pamj.2020.36.24.21754 PMid:32774601 DOI: https://doi.org/10.11604/pamj.2020.36.24.21754

Ziakopoulos A, Yannis G. A review of spatial approaches in road safety. Accid Anal Prev. 2020;135:105323. https://doi.org/10.1016/j.aap.2019.105323 PMid:31648775 DOI: https://doi.org/10.1016/j.aap.2019.105323

Kumar S, Srivastava DK, Kharya P, Sachan N, Kiran K. Analysis of risk factors contributing to road traffic accidents in a tertiary care hospital. A hospital based cross-sectional study. Chin J Traumatol. 2020;23(3):159-62. https://doi.org/10.1016/j.cjtee.2020.04.005 PMid:32381399 DOI: https://doi.org/10.1016/j.cjtee.2020.04.005

Hannachi H, Khiari H, Hsairi M. Burden of road traffic accidents in the Greater Maghreb (1990-2017). Tunis Med. 2020;98(5):355-62. PMid:32548838

Bakhtari Aghdam F, Sadeghi-Bazargani H, Azami-Aghdash S, Esmaeili A, Panahi H, Khazaee-Pool M, et al. Developing a national road traffic safety education program in Iran. BMC Public Health. 2020;20(1):1064. https://doi.org/10.1186/s12889-020-09142-1 PMid:32631276 DOI: https://doi.org/10.1186/s12889-020-09142-1

Asadi-Pooya AA, Bazrafshan M. Driving rate and road traffic accidents in drivers with functional (psychogenic nonepileptic) seizures. Seizure. 2020;79:27-9. https://doi.org/10.1016/j.seizure.2020.04.005 PMid:32408106 DOI: https://doi.org/10.1016/j.seizure.2020.04.005

Chang FR, Huang HL, Schwebel DC, Chan AH, Hu GQ. Global road traffic injury statistics: Challenges, mechanisms and solutions. Chin J Traumatol. 2020;23(4):216-8. https://doi.org/10.1016/j.cjtee.2020.06.001 PMid:32680705 DOI: https://doi.org/10.1016/j.cjtee.2020.06.001

Sun TJ, Liu SJ, Xie FK, Huang XF, Tao JX, Lu YL, et al. Influence of road types on road traffic accidents in northern Guizhou Province, China. Chin J Traumatol. 2021;24(1):34-8. https://doi.org/10.1016/j.cjtee.2020.11.002 PMid:33309475 DOI: https://doi.org/10.1016/j.cjtee.2020.11.002

Qureshi AI, Huang W, Khan S, Lobanova I, Siddiq F, Gomez CR, et al. Mandated societal lockdown and road traffic accidents. Accid Anal Prev. 2020;146:105747. https://doi.org/10.1016/j.aap.2020.105747 PMid:32911131 DOI: https://doi.org/10.1016/j.aap.2020.105747

Salvagioni DA, Mesas AE, Melanda FN, Dos Santos HG, González AD, Girotto E, et al. Prospective association betwee burnout and road traffic accidents in teachers. Stress Health. 2020;36(5):629-38. https://doi.org/10.1002/smi.2958 PMid:32407605 DOI: https://doi.org/10.1002/smi.2958

Bravo G, Duarte G, Cerda J, Castellucci H. Road traffic accidents of the elderly in Chile between the years 2008-2017: A registerbased descriptive study. Medwave. 2020;20(5):e7923. https://doi.org/10.5867/medwave.2020.05.7923 PMid:32559182 DOI: https://doi.org/10.5867/medwave.2020.05.7923

Shen X, Wei S. Severity analysis of road transport accidents of hazardous materials with machine learning. Traffic Inj Prev. 2021;22(4):324-9. https://doi.org/10.1080/15389588.2021.1900569 PMid:33849325 DOI: https://doi.org/10.1080/15389588.2021.1900569

Yin Y, Wen H, Sun L, Hou W. The influence of road geometry on vehicle rollover and skidding. Int J Environ Res Public Health. 2020;17(5):1648. https://doi.org/10.3390/ijerph17051648 PMid:32138346 DOI: https://doi.org/10.3390/ijerph17051648

Shen Y, Hermans E, Bao Q, Brijs T, Wets G. Towards better road safety management: Lessons learned from inter-national benchmarking. Accid Anal Prev. 2020;138:105484. https://doi.org/10.1016/j.aap.2020.105484 PMid:32105839 DOI: https://doi.org/10.1016/j.aap.2020.105484

de Oliveira RP, Achcar JA. Victims of road accidents with serious injuries and dependence on some individual, climatic and infrastructure factors on federal highways in Brazil. Int J Inj Contr Saf Promot. 2020;27(3):355-61. https://doi.org/10.1080/17457300.2020.1778040 PMid:32529896 DOI: https://doi.org/10.1080/17457300.2020.1778040

Slesak G, Slesak RM, Inthalad S, Somsavad S, Sisouphanh B, Kim JH, et al. A hospital-initiated multisectoral road safety campaign with speed-adapted coconut drop test in Northern Laos. Int J Inj Contr Saf Promot. 2011;18(1):37-43. https://doi.org/10.1080/17457300.2010.503328 PMid:21279870 DOI: https://doi.org/10.1080/17457300.2010.503328

Vogel T, Reinharz D, Gripenberg M, Barennes H. An organizational analysis of road traffic crash prevention to explain the difficulties of a national program in a low income country. BMC Res Notes. 2015;8:486. https://doi.org/10.1186/s13104-015-1472-6 PMid:26415958 DOI: https://doi.org/10.1186/s13104-015-1472-6

Waseela M, Laosee O. Determinants of road traffic injury among adult motorcyclists in Malé, Maldives. Asia Pac J Public Health. 2015;27(3):277-85. https://doi.org/10.1177/1010539514539544 PMid:24958612 DOI: https://doi.org/10.1177/1010539514539544

Essink DR, Ratsavong K, Bally E, Fraser J, Xaypadith S, Vonglokham M, et al. Developing a national health research agenda for Lao PDR: Prioritising the research needs of stakeholders. Glob Health Action. 2020;13:1777000. https://doi.org/10.1080/16549716.2020.1777000 PMid:32741341 DOI: https://doi.org/10.1080/16549716.2020.1777000

Laosee O, Rattanapan C, Somrongthong R. Physical and cognitive functions affecting road traffic injuries among senior drivers. Arch Gerontol Geriatr. 2018;78:160-4. https://doi.org/10.1016/j.archger.2018.06.015 PMid:29981493 DOI: https://doi.org/10.1016/j.archger.2018.06.015

Fong MC, Measelle JR, Dwyer JL, Taylor YK, Mobasser A, Strong TM, et al. Rates of motorcycle helmet use and reasons for non-use among adults and children in Luang Prabang, Lao People’s democratic republic. BMC Public Health. 2015;15:970. https://doi.org/10.1186/s12889-015-2304-2 PMid:26416386 DOI: https://doi.org/10.1186/s12889-015-2304-2

Slesak G, Inthalath S, Wilder-Smith A, Barennes H. Road traffic injuries in Northern Laos: Trends and risk factors of an underreported public health problem. Trop Med Int Health. 2015;20(11):1578-87. https://doi.org/10.1111/tmi.12562 PMid:26121296 DOI: https://doi.org/10.1111/tmi.12562

Wada T, Nakahara S, Bounta B, Phommahaxay K, Phonelervong V, Phommachanh S, et al. Road traffic injury among child motorcyclists in Vientiane Capital, Laos: A crosssectional study using a hospital-based injury surveillance database. Int J Inj Contr Saf Promot. 2017;24(2):152-7. https://doi.org/10.1080/17457300.2015.1080728 PMid:28452289 DOI: https://doi.org/10.1080/17457300.2015.1080728

Suriyawongpaisal P, Atiksawedparit P, Srithamrongsawad S, Thongtan T. Assessment of nationwide emergency systems in Thailand, a middle-income country setting with UHC. Int J Health Plann Manage. 2019;34(2):e1346-55. https://doi.org/10.1002/hpm.2783 PMid:30945365 DOI: https://doi.org/10.1002/hpm.2783

Pochaisan O, Pattanarattanamolee R, Pongphuttha W, Chadbunchachai W, Nakahara S. Development of an emergency medical services system in Thailand: Roles of the universal health coverage and the national lead agency. Emerg Med Aust. 2021;33(4):756-8. https://doi.org/10.1111/1742-6723.13794 PMid:33977648 DOI: https://doi.org/10.1111/1742-6723.13794

Nakahara S, Hoang BH, Mayxay M, Pattanarattanamolee R, Jayatilleke AU, Ichikawa M, et al. Development of an emergency medical system model for resource-constrained settings. Trop Med Int Health. 2019;24(10):1140-50. https://doi.org/10.1111/tmi.13301 PMid:31390114 DOI: https://doi.org/10.1111/tmi.13301

Tansuwannarat P, Atiksawedparit P, Wibulpolprasert A, Mankasetkit N. Prehospital time of suspected stroke patients treated by emergency medical service: A nationwide study in Thailand. Int J Emerg Med. 2021;14(1):37. https://doi.org/10.1186/s12245-021-00361-w PMid:34281496 DOI: https://doi.org/10.1186/s12245-021-00361-w

von Harbou K, Sawanpanyalert N, Trewin A, Brown R, Prawira J, Bhola AK, et al. Strengthening emergency preparedness through the WHO emergency medical team mentorship and verification process: Experience from Thailand. WHO South East Asia J Public Health. 2020;9(1):32-6. https://doi.org/10.4103/2224-3151.282993 PMid:32341219 DOI: https://doi.org/10.4103/2224-3151.282993

Hart A, Chai PR, Griswold MK, Lai JT, Boyer EW, Broach J. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management. Am J Disaster Med. 2017;12(4):261-5. https://doi.org/10.5055/ajdm.2017.0279 PMid:29468628 DOI: https://doi.org/10.5055/ajdm.2017.0279

Felice J, Coughlin RF, Burns K, Chmura C, Bogucki S, Cone DC, et al. Effects of real-time EMS direction on optimizing EMS turnaround and load-balancing between neighboring hospital campuses. Prehosp Emerg Care. 2019;23(6):788-94. https://doi.org/10.1080/10903127.2019.1587123 PMid:30798628 DOI: https://doi.org/10.1080/10903127.2019.1587123

Williams J, Freeman CL, Goldstein S. EMS incident command system. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2021. Available from: http://www.ncbi.nlm.nih.gov/books/NBK441863. [Last accessed on 2021 Sep 03].

Hardy S, Fattah S, Wisborg T, Raatiniemi L, Staff T, Rehn M. Systematic reporting to improve the emergency medical response to major incidents: A pilot study. BMC Emerg Med. 2018;18(1):4. https://doi.org/10.1186/s12873-018-0153-x PMid:29368642 DOI: https://doi.org/10.1186/s12873-018-0153-x

Troyer L, Brady W. Barriers to effective EMS to emergency department information transfer at patient handover: A systematic review. Am J Emerg Med. 2020;38(7):1494-503. https://doi.org/10.1016/j.ajem.2020.04.036 PMid:32321683 DOI: https://doi.org/10.1016/j.ajem.2020.04.036

Haslam NR, Bouamra O, Lawrence T, Moran CG, Lockey DJ. Time to definitive care within major trauma networks in England. BJS Open. 2020;4(5):963-9. https://doi.org/10.1002/bjs5.50316 PMid:32644299 DOI: https://doi.org/10.1002/bjs5.50316

Taylor MA, Hewes HA, Bolinger CD, Fenton SJ, Russell KW. Established time goals can increase the efficiency of trauma resuscitation. Cureus. 2020;12(8):e9524. https://doi.org/10.7759/cureus.9524 PMid:32905069 DOI: https://doi.org/10.7759/cureus.9524

Geri G, Scales DC, Koh M, Wijeysundera HC, Lin S, Feldman M, et al. Healthcare costs and resource utilization associated with treatment of out-of-hospital cardiac arrest. Resuscitation. 2020;153:234-42. https://doi.org/10.1016/j.resuscitation.2020.04.032 PMid:32422247 DOI: https://doi.org/10.1016/j.resuscitation.2020.04.032

Grunau B, Kime N, Leroux B, Rea T, Van Belle G, Menegazzi JJ, et al. Association of intra-arrest transport vs continued on-scene resuscitation with survival to hospital discharge among patients with out-of-hospital cardiac arrest. JAMA. 2020;324(11):1058-67. https://doi.org/10.1001/jama.2020.14185 PMid:32930759 DOI: https://doi.org/10.1001/jama.2020.14185

Kłosiewicz T, Puślecki M, Zalewski R, Sip M, Perek B. Impact of automatic chest compression devices in out-of-hospital cardiac arrest. J Thorac Dis. 2020;12(5):2220-7. https://doi.org/10.21037/jtd.2020.04.25 PMid:32642127 DOI: https://doi.org/10.21037/jtd.2020.04.25

Wagner P, Schloesser S, Braun J, Arntz HR, Breckwoldt J. In out-of-hospital cardiac arrest, is the positioning of victims by bystanders adequate for CPR? A cohort study. BMJ Open. 2020;10(9):e037676. https://doi.org/10.1136/bmjopen-2020-037676 PMid:32967879 DOI: https://doi.org/10.1136/bmjopen-2020-037676

Jung E, Park JH, Lee SY, Ro YS, Hong KJ, Song KJ, et al. Mechanical chest compression device for out-ofhospital cardiac arrest: A nationwide observational study. J Emerg Med. 2020;58(3):424-31. https://doi.org/10.1016/j.jemermed.2019.11.022 PMid:32178958 DOI: https://doi.org/10.1016/j.jemermed.2019.11.022

Lakomek F, Lukas RP, Brinkrolf P, Mennewisch A, Steinsiek N, Gutendorf P, et al. Real-time feedback improves chest compression quality in out-of-hospital cardiac arrest: A prospective cohort study. PLoS One. 2020;15(2):e0229431. https://doi.org/10.1371/journal.pone.0229431 PMid:32092113 DOI: https://doi.org/10.1371/journal.pone.0229431

Tomokawa S, Miyake K, Asakura T. Sustainable human resource training system for promoting school health in Japan. Pediatr Int. 2020;62(8):891-8. https://doi.org/10.1111/ped.14292 PMid:32374493 DOI: https://doi.org/10.1111/ped.14292

Gunawan J, Aungsuroch Y, Fisher ML, McDaniel AM, Liu Y. Competence-based human resource management to improve managerial competence of first-line nurse managers: A scale development. Int J Nurs Pract. 2021;27:e12936. https://doi.org/10.1111/ijn.12936 PMid:33817904 DOI: https://doi.org/10.1111/ijn.12936

Tan H, Zhao F, Hao H, Liu Z. Estimate of safety impact of lane keeping assistant system on fatalities and injuries reduction for China: Scenarios through 2030. Traffic Inj Prev. 2020;21(2):156-62. https://doi.org/10.1080/15389588.2020.1711518 PMid:32023126 DOI: https://doi.org/10.1080/15389588.2020.1711518

James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, et al. Global injury morbidity and mortality from 1990 to 2017: Results from the global burden of disease study 2017. Inj Prev. 2020;26(1):i96-114. https://doi.org/10.1136/injuryprev-2019-043494 PMid:32332142 DOI: https://doi.org/10.1136/injuryprev-2019-043494corr1

Silva TC, Laiz MT, Tabak BM. Traffic campaigns and overconfidence: An experimental approach. Accid Anal Prev. 2020;146:105694. https://doi.org/10.1016/j.aap.2020.105694 PMid:32980658 DOI: https://doi.org/10.1016/j.aap.2020.105694

Jing L, Shan W, Zhang Y. Why the government should be blamed for road safety. Int J Occup Saf Ergon. 2020;26:1-14. https://doi.org/10.1080/10803548.2020.1835234 PMid:33048021 DOI: https://doi.org/10.1080/10803548.2020.1835234

Bodhisane S, Pongpanich S. The accessibility and probability of encountering catastrophic health expenditure by Lao patients in Thai hospitals. J Public Health (Oxf). 2021;43:fdab043. https://doi.org/10.1093/pubmed/fdab043 PMid:33895842 DOI: https://doi.org/10.1093/pubmed/fdab043

Kang S, Ho TT, Lee NJ. Comparative studies on patient safety culture to strengthen health systems among Southeast Asian countries. Front Public Health. 2020;8:600216. https://doi.org/10.3389/fpubh.2020.600216 PMid:33511097 DOI: https://doi.org/10.3389/fpubh.2020.600216

Kutanan W, Kampuansai J, Brunelli A, Ghirotto S, Pittayaporn P, Ruangchai S, et al. New insights from Thailand into the maternal genetic history of Mainland Southeast Asia. Eur J Hum Genet. 2018;26(6):898-911. https://doi.org/10.1038/s41431-018-0113-7 PMid:29483671 DOI: https://doi.org/10.1038/s41431-018-0113-7

Rybarczyk MM, Ludmer N, Broccoli MC, Kivlehan SM, Niescierenko M, Bisanzo M, et al. Emergency medicine training programs in low- and middle-income countries: A systematic review. Ann Glob Health. 2020;86(1):60. https://doi.org/10.5334/aogh.2681 PMid:32587810 DOI: https://doi.org/10.5334/aogh.2681

Douglass K, Pousson A, Gidwani S, Smith J. Postgraduate emergency medicine training in India: An educational partnership with the private sector. J Emerg Med. 2015;49(5):746-54. https://doi.org/10.1016/j.jemermed.2015.03.010 PMid:26095219 DOI: https://doi.org/10.1016/j.jemermed.2015.03.010

Apiratwarakul K, Suzuki T, Phengsavanh A, Wangsri K. Learning outcomes of an international training course on mechanical cardiopulmonary resuscitation device use for emergency medicine residents. J Med Assoc Thai. 2021;104:12-5. DOI: https://doi.org/10.35755/jmedassocthai.2021.S01.12134

Apiratwarakul K, Ienghong K, Mitsungnern T, Kotruchin P, Phungoen P, Bhudhisawasdi V. Use of a motorlance to deliver emergency medical services; a prospective cross sectional study. Arch Acad Emerg Med. 2019;7(1):e48. PMid:31602431

Bashiri A, Alizadeh Savareh B, Ghazisaeedi M. Promotion of prehospital emergency care through clinical decision support systems: Opportunities and challenges. Clin Exp Emerg Med. 2019;6(4):288-96. https://doi.org/10.15441/ceem.18.032 PMid:31910499 DOI: https://doi.org/10.15441/ceem.18.032

Christen OM, Mösching Y, Müller P, Denecke K, Nüssli S. Dashboard visualization of information for emergency medical services. Stud Health Technol Inform. 2020;275:27-31. https://doi.org/10.3233/SHTI200688 PMid:33227734 DOI: https://doi.org/10.3233/SHTI200688

Mears G, Ornato JP, Dawson DE. Emergency medical services information systems and a future EMS national database. Prehosp Emerg Care. 2002;6(1):123-30. https://doi.org/10.1080/10903120290938931 PMid:11789641 DOI: https://doi.org/10.1080/10903120290938931

Short M, Goldstein S. EMS documentation. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2021. Available from: http://www.ncbi.nlm.nih.gov/books/NBK448107. [Last accessed on 2021 Sep 03].