Department of Emergency Medicine, College of Medicine and Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
Prehosp Disaster Med. 2013 Apr;28(2):179-83. doi: 10.1017/S1049023X12001859. Epub 2013 Jan 17.
Emergency medical care in Pakistan has not been a priority of medical education and training because of the country's need to address its lack of primary care. Resources and trained personnel are scarce. Despite these challenges, the value of emergency medical care is gaining attention. The objective of this study was to explore the breadth of Emergency Medicine training in Pakistan through an analysis of an Emergency Medicine residency in a teaching hospital. The Aga Khan University Hospital in Karachi is a teaching institution with the only Emergency Medicine residency program in the region. It was started in 2000, led by US-trained physicians, and it laid the foundation for Emergency Medicine in the country.
The study was conducted over a four-week period in January of 2009. Data collection consisted of three components: (1) a survey of the Emergency Department and hospital services; (2) a survey of the Emergency Medicine training curriculum; and (3) a retrospective chart review of every tenth patient seen in the Aga Khan Emergency Department from December 1-14, 2008.
The training program is similar to that of the US models. Of the 153 patients selected for the chart review, the majority presented with GI complaints. Of these, 51 (33%) were admitted to the hospital; 20% (n = 15) left against medical advice; the remaining 57% (n = 87) were discharged.
DISCUSSION/CONCLUSION: The hospital admitted patients with complaints that were expected in the region. Although Aga Khan University Hospital is a pioneer in establishing Emergency Medicine as an official medical discipline in the region, the hospital's obstetrics and gynecology, trauma, toxicology and prehospital services training do not meet current curriculum standards set forth by the Society of Academic Emergency Medicine and the Council of Emergency Medicine Residency Directors. Nevertheless, the review provides a snapshot of the development of Emergency Medical Services in a developing nation. This information may assist other nations that are interested in developing such programs.
由于巴基斯坦缺乏初级保健，因此医学教育和培训并未将紧急医疗护理作为优先事项。资源和训练有素的人员稀缺。尽管存在这些挑战，但紧急医疗护理的价值正受到关注。本研究的目的是通过分析教学医院的急诊医学住院医师培训来探讨巴基斯坦急诊医学培训的广度。卡拉奇的阿迦汗大学医院是一所教学机构，是该地区唯一的急诊医学住院医师培训计划。它成立于 2000 年，由受过美国培训的医生领导，为该国的急诊医学奠定了基础。
这项研究是在 2009 年 1 月的四周内进行的。数据收集包括三个部分：（1）对急诊部和医院服务的调查；（2）对急诊医学培训课程的调查；（3）对 2008 年 12 月 1 日至 14 日在阿迦汗急诊部就诊的每第十位患者的病历回顾。
培训计划与美国模式相似。在选择进行病历回顾的 153 名患者中，大多数患者表现出胃肠道投诉。在这些患者中，有 51 名（33％）被收治入院；20％（n = 15）未经医疗建议离开；其余 57％（n = 87）出院。
讨论/结论：该医院收治了该地区预期会出现投诉的患者。尽管阿迦汗大学医院是该地区率先将急诊医学作为正式医学学科建立的先驱，但该医院的妇产科，创伤，毒理学和院前服务培训不符合学术急诊医学协会和急诊医学住院医师主任理事会规定的当前课程标准。尽管如此，该综述提供了发展中国家紧急医疗服务发展的快照。此信息可能有助于其他有兴趣开发此类程序的国家。
