Skip to main content
×
×
Home

Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority

  • Sierra Debenham (a1), Matthew Fuller (a2), Matthew Stewart (a2) and Raymond R. Price (a3) (a4)
Abstract

By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks.

Debenham S , Fuller M , Stewart M , Price RR . Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority. Prehosp Disaster Med. 2017;32(6):593595.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority
      Available formats
      ×
Copyright
Corresponding author
Correspondence: Sierra Debenham, MSPH 4657 S. Brookwood Circle Salt Lake City, Utah 84115 USA E-mail: sierra.debenham@hsc.utah.edu
Footnotes
Hide All

Conflicts of interest: The authors report no conflicts of interest.

Footnotes
References
Hide All
1. Mock, C, Juillard, C, Joshipura, M, Goosen, J. Strengthening Care for the Injured: Success Stories and Lessons Learned from around the World. Geneva, Switzerland: World Health Organization; 2010.
2. Sasser, S, Kellerman, A, Lormand, J-D. Prehospital Trauma Care Systems. Geneva, Switzerland: World Health Organization; 2005.
3. Mock, CN, Tiska, M, Adu-Ampofo, M, Boakye, G. Improvements in prehospital trauma care in an African country with no formal Emergency Medical Services. J Trauma. 2002;53(1):90-97.
4. Wesson, HKH, Boikhutso, N, Bachani, AM, Hofman, KJ, Hyder, A. The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence. Health Policy Plan. 2014;29(6):795-808.
5. Husum, H, Gilbert, M, Wisborg, T, Van Heng, Y, Murad, M. Rural prehospital trauma systems improve trauma outcome in low-income countries. J Trauma Inj Infect Crit Care. 2003;54(6):1188-1196.
6. Mock, C, Jurkovich, GJ, nii-Amon-Kotei, D, Arreola-Risa, C, Maier, RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma. 1998;44(5):804-812.
7. Callese, TE, Richards, CT, Shaw, P, et al. Trauma system development in low- and middle-income countries: a review. J Surg Res. 2015;193(1):300-307.
8. Hauswald, M, Yeoh, E. Designing a prehospital system for a developing country: estimated cost and benefits. Am J Emerg Med. 1997;15(6):600-603.
9. World Bank Group. Country and Lending Groups. http://data.worldbank.org/about/country-and-lending-groups. Published 2016. Accessed April 5, 2016.
10. Jayaraman, S, Mabweijano, JR, Lipnick, MS, et al. Current patterns of prehospital trauma care in Kampala, Uganda and the feasibility of a lay-first-responder training program. World J Surg. 2009;33(12):2512-2521.
11. Arreola-Risa, C, Mock, CN, Lojero-Wheatly, L, et al. Low-cost improvements in prehospital trauma care in a Latin American city. J Trauma. 2000;48(1):119-124.
12. Bishai, D, Asiimwe, B, Abbas, S, Hyder, AA, Bayezo, W. Cost-effectiveness of traffic enforcement: case study from Uganda. Inj Prev. 2008;14:223-227.
13. Jayaraman, S, Mabweijano, JR, Lipnick, MS, et al. First things first: effectiveness and scalability of a basis prehospital trauma care program for lay first-responders in Kampala, Uganda. PLoS One. 2009;4(9):1-7.
14. Mould-Millman, N-K, Rominski, SD, Bogus, J, et al. Barriers to accessing Emergency Medical Services in Accra, Ghana: development of a survey instrument and initial application in Ghana. Glob Heal Sci Pract. 2015;3(4):577-590.
15. Nielsen, K, Mock, C, Joshipura, M, Rubiano, AM, Zakariah, A, Rivara, F. Assessment of the status of prehospital care in 13 low- and middle-income countries. Prehosp Emerg Care. 2009;16(3):381-389.
16. Roy, N, Murlidhar, V, Chowdhury, R, et al. Where there are no Emergency Medical Services-prehospital care for the injured in Mumbai, India. Prehosp Disaster Med. 2010;25(2):145-151.
17. Geduld, H, Wallis, L. Taxi driver training in Madagascar: the first step in developing a functioning prehospital emergency care system. Emerg Med J. 2011;28(9):794-796.
18. Wisborg, T, Murad, MK, Edvardsen, O, Husum, H. Prehospital trauma system in a low-income country: system maturation and adaptation during 8 years. J Trauma. 2008;64(5):1342-1348.
19. Tiska, MA, Adu-Ampofo, M, Boakye, G, Tuuli, L, Mock, C. A model of prehospital trauma training for lay persons devised in Africa. Emerg Med J. 2004;21(2):237-239.
20. International Telecommunications Union. Statistics. http://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx. Accessed April 5, 2016.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score