Balikuddembe Joseph Kimuli, Ardalan Ali, Khorasani-Zavareh Davoud, Nejati Amir, Raza Owais
Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences-International Campus, Tehran, Iran.
BMC Emerg Med. 2017 Oct 3;17(1):29. doi: 10.1186/s12873-017-0137-2.
Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA).
A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims' pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions respectively. Data was descriptively analyzed, and after the principal component analysis was employed to identify the most influential weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTI in the GKMA.
From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 2016, 4 and 5 key weaknesses and capacities respectively were identified to affect the pre-hospital emergency care for RTI victims in the GKMA. Although some strengths exist like ambulance facilitation, EMS structuring, coordination and others), the key weaknesses affecting the pre-hospital care for victims were noted to relate to absence of predefined EMS systems particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment; insufficient skills/training of the first responders; inadequate EMS resources; and avoidable delays to respond and transport RTI victims to medical facilities.
Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.
院前急救护理是卫生系统的重要组成部分，在乌干达等资源有限的国家尤为如此。它有助于将道路交通事故（RTIs）造成的死亡、伤害、发病、残疾和创伤降至最低。本研究确定了影响大坎帕拉都会区（GKMA）道路交通事故受害者院前急救护理的薄弱环节和能力。
在GKMA进行了一项横断面研究，使用了一份由三部分组成的结构化问卷。分别从3家医院的受害者和5个急救医疗服务（EMS）机构的EMS专家那里收集了与人口统计学、道路交通事故的性质以及受害者的院前经历和现有急救医疗服务相关的数据。对数据进行了描述性分析，并在主成分分析后，确定了影响GKMA道路交通事故受害者院前急救护理的最具影响力的薄弱环节和能力。
在2016年5月至6月参与研究的459名道路交通事故受害者（男性占74.7%，女性占25.3%）和23名EMS专家（男性占91.3%，女性占8.7%）中，分别确定了4个和5个关键的薄弱环节和能力，这些因素影响了GKMA道路交通事故受害者的院前急救护理。尽管存在一些优势，如救护车便利、EMS结构、协调等，但影响受害者院前护理的关键薄弱环节被指出与缺乏预定义的EMS系统有关，特别是在GKMA乃至整个乌干达。这些薄弱环节包括急救质量差；急救人员技能/培训不足；EMS资源不足；以及将道路交通事故受害者送往医疗机构时可避免的响应和运输延误。
尽管存在一些优势，但影响道路交通事故受害者院前护理的薄弱环节主要源于GKMA乃至整个乌干达缺乏预定义和组织良好的EMS系统。
