Creaton Anne, Naitini Ilikini, Lenoa Lemecki
Fiji National University, Department of Medicine, Nursing and Health Sciences, Suva, Fiji; Monash University, Department of Public Health and Preventative Medicine, Melbourne, Australia; Royal Flying Doctors Service Queensland, Cairns, Australia.
Fiji National University, Department of Medicine, Nursing and Health Sciences, Suva, Fiji; Assistant Director of Medical Services Aspen Fiji, Ba, Fiji.
Prehosp Disaster Med. 2024 Feb;39(1):106-110. doi: 10.1017/S1049023X24000037. Epub 2024 Jan 29.
The benefits of emergency care systems in low- and middle-income countries are well-described. Passed in the wake of the coronavirus disease 2019 (COVID-19) pandemic, the World Health Assembly (WHA) Resolution 76.2 emphasizes the importance of communication, transportation and referral mechanisms, and the linkages between communities, primary care, and hospital care. Literature describing prehospital care and ambulance system development is scarce, with little data on the effectiveness and cost effectiveness of different options. Prehospital care systems in Pacific Island countries are under-developed. In Fiji, out-of-hospital care is fragmented with an uncoordinated patchwork of ambulance providers. There is no scope of practice or training requirement for providers and no patient care records. There are no data relating to demand, access, and utilization of ambulance services.In response to a surge of COVID-19 cases in 2021, the Fiji government created a Prehospital Emergency Care Coordination Center (PHECCC) in the capital Suva, which was operational from July-October 2021. Access was via a toll-free number, whereby the public could receive a medical consultation followed by phone advice or dispatch of an ambulance for a home assessment, followed by transportation to hospital, if required. The PHECCC also provided coordination of inter-facility transport and retrieval of the critically ill.The system that was created met many of the prehospital care standards set by emergency care leaders in the region and created the first dataset relating to ambulance demand and utilization. This is the first article to document prehospital system development in the Pacific region.
低收入和中等收入国家应急护理系统的益处已有详尽描述。2019年冠状病毒病（COVID-19）大流行之后通过的世界卫生大会（WHA）第76.2号决议强调了沟通、运输和转诊机制以及社区、初级保健和医院护理之间联系的重要性。描述院前护理和救护车系统发展的文献稀缺，关于不同选择的有效性和成本效益的数据很少。太平洋岛国的院前护理系统发展不足。在斐济，院外护理分散，救护车服务提供商拼凑且不协调。对服务提供商没有执业范围或培训要求，也没有患者护理记录。没有与救护车服务需求、可及性和利用率相关的数据。为应对2021年COVID-19病例激增的情况，斐济政府在首都苏瓦设立了院前应急护理协调中心（PHECCC），该中心于2021年7月至10月运营。通过免费电话接入，公众可以接受医疗咨询，随后获得电话建议或派遣救护车进行家庭评估，如有需要再送往医院。PHECCC还提供机构间运输协调和危重症患者的转运。所创建的系统符合该地区应急护理领导者设定的许多院前护理标准，并创建了首个与救护车需求和利用率相关的数据集。这是第一篇记录太平洋地区院前系统发展的文章。
