Meskin S, Huyler F, Gupta S K, Berger L
Department of Emergency Medicine, University of New Mexico, Albuquerque, USA.
Ann Emerg Med. 1997 Mar;29(3):409-14. doi: 10.1016/s0196-0644(97)70355-x.
We describe the delivery of emergency medical services in the developing country of Nepal and identify areas of need and potential collaboration. We conducted interviews with emergency department directors and staff, analyzed ED patient records, and prospectively surveyed a convenience sample of patients visiting three Kathmandu, Nepal, EDs. The three principal EDs in Kathmandu have a collective yearly volume exceeding 100,000 visits. Injury is the reason for more than 30% of all visits; 27% of ED patients are admitted. Equipment and emergency laboratory tests essential to the practice of emergency medicine are often unavailable. Emergency physicians receive no formal training in emergency medicine, and continuing medical educational opportunities are limited. We determined that the three EDs in Kathmandu provide high-volume, high-acuteness care. Emergency physicians lack critical resources to manage the breadth of clinical problems encountered. A substantial emergency medical infrastructure exists in Kathmandu from which to address emerging problems. Injury is currently the single greatest threat to public health and may benefit from a multi-level international collaborative approach.
我们描述了尼泊尔这个发展中国家的紧急医疗服务情况，并确定了需求领域和潜在合作领域。我们采访了急诊科主任和工作人员，分析了急诊患者记录，并对尼泊尔加德满都三家急诊科的就诊患者进行了便利抽样前瞻性调查。加德满都的三家主要急诊科每年就诊总量超过10万次。受伤是所有就诊原因的30%以上；27%的急诊患者需要住院治疗。急诊医学实践所必需的设备和紧急实验室检查常常无法提供。急诊医生没有接受过急诊医学的正规培训，继续医学教育机会有限。我们确定加德满都的三家急诊科提供高流量、高急症护理。急诊医生缺乏处理所遇到的广泛临床问题的关键资源。加德满都存在大量紧急医疗基础设施，可用于解决新出现的问题。伤害目前是对公众健康的最大单一威胁，可能受益于多层次的国际合作方法。
