Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto CA, USA.
SUNY Downstate Medical Center, Department of Emergency Medicine, Brooklyn NY, USA.
Ann Glob Health. 2022 Aug 12;88(1):70. doi: 10.5334/aogh.3649. eCollection 2022.
Emergency medical services (EMS) are a critical but often overlooked component of essential public health care delivery in low- and middle-income countries (LMICs). Few countries in Africa have established EMS and there is scant literature to provide guidance for EMS growth.
This study aimed to characterize EMS utilization in Harare, Zimbabwe in order to guide system strengthening efforts.
We performed a retrospective chart review of patient care reports (PCR) generated by the City of Harare ambulance system for patients transported and/or treated in the prehospital setting over a 14-month period (February 2018 - March 2019).
A total of 875 PCRs were reviewed representing approximately 8% of the calls to EMS. The majority of patients were age 15 to 49 (76%) and 61% were female patients. In general, trauma and pregnancy were the most common chief complaints, comprising 56% of all transports. More than half (51%) of transports were for inter-facility transfers (IFTs) and 52% of these IFTs were maternity-related. Transports for trauma were mostly for male patients (63%), and 75% of the trauma patients were age 15-49. EMTs assessed and documented pulse and blood pressure for 72% of patients.
In this study, EMS cared primarily for obstetric and trauma emergencies, which mirrors the leading causes of premature death in LMICs. The predominance of requests for maternity-related IFTs emphasizes the role for EMS as an integral player in peripartum maternal health care. Targeted public health efforts and chief complaint-specific training for EMTs in these priority areas could improve quality of care and patient outcomes. Moreover, a focus on strengthening prehospital data collection and research is critical to advancing EMS development in Zimbabwe and the region through quality improvement and epidemiologic surveillance.
紧急医疗服务（EMS）是中低收入国家（LMICs）基本公共卫生保健服务的一个关键但经常被忽视的组成部分。非洲很少有国家建立了 EMS，也几乎没有文献为 EMS 的发展提供指导。
本研究旨在描述津巴布韦哈拉雷的 EMS 使用情况，以指导系统加强工作。
我们对哈拉雷市救护车系统在 14 个月期间（2018 年 2 月至 2019 年 3 月）在院前环境中运送和/或治疗的患者的患者护理报告（PCR）进行了回顾性图表审查。
共审查了 875 份 PCR，占 EMS 呼叫的约 8%。大多数患者年龄在 15 至 49 岁之间（76%），61%为女性患者。一般来说，创伤和妊娠是最常见的主诉，占所有转运的 56%。超过一半（51%）的转运是为了进行院内转运（IFT），其中 52%的 IFT 与分娩有关。创伤转运主要针对男性患者（63%），75%的创伤患者年龄在 15-49 岁之间。EMT 对 72%的患者评估并记录了脉搏和血压。
在这项研究中，EMS 主要照顾产科和创伤急症，这反映了 LMICs 中导致过早死亡的主要原因。对与分娩相关的 IFT 的需求居多强调了 EMS 在围产期产妇保健中的重要作用。在这些重点领域针对 EMT 进行有针对性的公共卫生努力和特定主诉培训，可以改善护理质量和患者预后。此外，重点加强院前数据收集和研究对于通过质量改进和流行病学监测推进津巴布韦和该地区的 EMS 发展至关重要。
