Medical and prehospital care training in UK fire and rescue services

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

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.

Knowledge and practices related to burn first aid among Majmaah community, Saudi Arabia

Background:

Burns in developing countries account for significant morbidity and mortality which have been shown by increasing burn first aid awareness. In general, flames, scalds, and contact burns are the most common causes, but in children scalds are the most common.

Objectives:

This study aims to assess the general knowledge and practices related to burn first aid among Majmaah community.

Methods:

This study is a cross-sectional study. Data were collected in 2018 using convenience sampling technique. Saudi men and women age 18 years and older living in Majmaah were included in the study. Data were collected from 390 males and females. The sample size was collected using precision formula. Data were encoded into Microsoft Excel worksheets and imported to Statistical Package for the Social Sciences (SPSS^®) software for analysis.

Results:

A total of 390 individuals responded to the survey. Regarding the demographic data of the study participants, 49.2% were between 30 and 49 years old. Most of them were females (71.8%). Regarding burn first aid knowledge, 82.6% of the study participants knew that the first thing is to stop, drop, and roll when your clothes catch fire, 43.8% knew to apply cold water if hot oil spills on the hands, 41.0% knew that all burn injuries must be treated at hospital, whereas most of them 78.5% knew never to apply raw eggs or herbs to burn wounds.

Conclusion:

The knowledge of Majmaah community toward first aid is found to be low in spite of most of the respondents having a positive attitude toward first aid. The majority of the study participants (73.8%) were well-educated and had a bachelor's degree.

Inter-disciplinary cooperation in a physician-staffed emergency medical system

BACKGROUND

On-scene management of pre-hospital emergencies is often inter-disciplinary, involving ground-emergency medical services (EMS), police- and fire services, and in Norway general practitioners on-call. This can also be supplemented by physician-staffed EMS (P-EMS), utilizing helicopters or rapid response vehicles. We hypothesized that P-EMS cooperates extensively with other emergency services, and therefore the primary aim of this study was to investigate the fraction of inter-disciplinary cooperation between P-EMS and other emergency services.

METHODS

Retrospective, observational study of primary pre-hospital missions with patient contact performed at a Norwegian P-EMS base from 01.01.06 to 31.12.15. Descriptive statistics, comparisons using Student`s t-test, and chi-squared test for trend were applied.

RESULTS

Inter-disciplinary cooperation occurred in 94.3% of the 8580 missions, of which physician-staffed EMS cooperated with ground EMS in 92.4%, general practitioner 32.9%, police service 11.6% and fire service 11.8%. Trauma constituted 34.4 and cardiac arrest 14.1% of missions. The mean National Advisory Committee for Aeronautics score was 4.21 (95% Confidence Interval 4.18-4.24). There was an overall decrease in cooperation with general practitioners and the police service (P < 0.001). During helicopter missions, we reported a decrease in general practitioner cooperation compared to an increase during rapid response car missions (P < 0.001). In cardiac arrest cases, cooperation with both general practitioners and the fire service increased (P < 0.001).

CONCLUSION

Physician-staffed EMS cooperates extensively with other professional emergency services, especially ground-EMS. On-scene cooperation with general practitioners decreased, whereas there was an increased cooperation with the fire service in a "first-responder" role during cardiac arrest missions.