68. Emergency Medical Services
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Editors/Authors: Olive C. Kobusingye, Adnan A. Hyder, David Bishai, Manjul Joshipura, Eduardo Romero Hicks, and Charles Mock
Throughout the world, anyone may require emergency medical services, from rural farmers, whose most common form of transportation may be animal–drawn carts, to sophisticated residents of high–income cities and suburbs. Developing strategies to meet the needs posed by such diverse circumstances requires innovation and a reorientation of public health planning.
Defining the burden of disease addressed by emergency medical services is problematic, as those diseases span the spectrum of communicable infections, noncommunicable conditions, obstetric conditions, and injuries. Acute episodes of malaria, for example, result in an estimated 1 million deaths each year, most of which could be averted by effective emergency care. Ninety–five percent of the 500,000 maternal deaths that occur each year happen in low–income countries where emergency obstetrical care is lacking.
Emergency care does not have to be expensive or rely on high–tech interventions to be effective. In Ghana, where transport to a hospital is usually by taxi or bus, commercial drivers have received a six–hour basic first–aid course at a cost of just US$3 per participant. India has developed a two–day trauma management course for health professionals that takes into account local conditions and capabilities and costs only US$50 per trainee.
Improved organization and planning for emergency care can be done at reasonable cost and lead to better outcomes. With sufficient focus, low–income countries could help to define more cost–effective emergency systems than are available in high–income countries.
Click on the links below to read the full text.
- 68.1 The Emergency Medical Care Pyramid
- 68.2 Schematic Illustration of the Burden of Disease Potentially Addressed by EMS
- 68.1 Improving Trauma Care in the Absence of a Formal Ambulance System
- 68.2 Training for Emergency Care in India
- 68.1 Overview of Emergency Medical Services
- 68.2 Burden of Diseases Potentially Addressed by EMS in Low- and Middle-Income Countries (2001, all ages, both sexes)
- 68.3 Cost of Using Trained Lay First Responders Together with Trained Paramedics (local currency converted to 2001 U.S. dollars using exchange rates)
- 68.4 Cost-Effectiveness of Combining Paramedics with Lay Responders (local currency converted to 2001 U.S. dollars using exchange rates)
- 68.5 Cost and Effectiveness of Ambulances (U.S. dollars)
- 68.6 Summary of Cost and Effectiveness (U.S. dollars)
- 68.A Essential Resources for the Delivery of Emergency Care in Hospitals