Research Publications (Health Sciences)
Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/216
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Item The preparedness of emergency care providers to deal with death, dying and bereavement in the pre-hospital setting in Dubai(Paramedics Australasia, 2019-09-02) Conning, Reon; Naidoo, Raveen; Bhagwan, Raisuyah; Naidoo, R.; Bhagwan, R.; Mana Bin Ahmad, S.Introduction This study sought to investigate how prepared emergency care providers are to deal with death, dying and bereavement in the pre-hospital setting in Dubai, and to make recommendations related to such events. Methods A quantitative descriptive prospective design was utilised. Data was collected using an online self-report questionnaire sent to all operational emergency care providers in the Dubai Corporation of Ambulance Services. The data was analysed using the IBM Statistical Package for Social Sciences version 25.0. Results Nearly 65% of participants (n=316) reported that they had not received any formal education or training on death, dying and bereavement. Those that did, reported that the training was conducted mainly by nursing (25.9%; n=124) and paramedic (13.6%; n=65) instructors. One-quarter of participants (25.4%; n=126) reported experiencing intrusive symptoms such as sleep loss, nightmares and missing work as a result of a work-related death or dying incident, but only 4.1% (n=20) had received professional counselling. Conclusion This study found that emergency care providers are underprepared to deal with death, dying and bereavement. A comprehensive death education program encompassing the unique challenges that emergency and pre-hospital setting presents should be implemented to reduce emotional anxiety and help emergency care providers cope better with death, and decrease abnormal grief reactions of the bereft. Abnormal grief reactions can include restlessness, searching for the lost person and disrupted autonomic nervous system functions.Item An analysis of patients transported by a private helicopter emergency medical service in South Africa(SAMJ, 2016) Muhlbauer, Dagmar; Naidoo, Raveen; Hardcastle, T.C.Background. A helicopter emergency medical service (HEMS) is a specialist flying emergency service where on-board medical personnel have both the knowledge and equipment to perform complicated medical procedures. The paucity of literature describing the types of patients flown by HEMS in South Africa (SA) and their clinical outcome poses a challenge for current aeromedical services, as there is no baseline information on which to base flight criteria, staffing and policy documents. This has the potential to hamper the advancement of HEMS in SA. Objectives. To undertake a descriptive analysis of patients flown by the Netcare 911 HEMS over a 12-month period in Gauteng and KwaZulu-Natal (KZN) provinces, SA, and to assess patient outcomes. The clinical demographics of patients transported by the HEMS were analysed, time frames from dispatch of the helicopter to delivery of the patient to the receiving hospital determined, and patient outcomes at 24 hours and 72 hours analysed. Methods. The study utilised a retrospective quantitative, descriptive design to analyse patients transported by a private HEMS in SA. All complete records of patients transported by the Netcare 911 HEMS between 1 January and 31 December 2011 were included. Results. The final study population comprised 537 cases, as 10 cases had to be excluded owing to incomplete documentation. Of the 537 cases, 82 (15.3%) were managed by the KZN HEMS and 455 (84.7%) by the Gauteng HEMS. Adult males were the patients most commonly flown in both Gauteng and KZN (350/455 patients (76.9%) in Gauteng and 48/82 (58.5%) in KZN were males, and 364/455 patients (80.0%) in Gauteng and 73/82 (89.0%) in KZN were adults). Motor vehicle collisions were the most common incidents necessitating transport by HEMS in both operations (n=193, 35.9%). At the 24-hour follow-up, 339 patients (63.1%) were alive and stable, and at the 72-hour follow-up, 404 (75.3%) were alive and stable. Conclusions. The study findings provided valuable information that may have an impact on the current staffing and authorisation criteria of SA HEMS operations.Item The pending loss of advanced life support paramedics in South Africa(African Federation for Emergency Medicine, 2012) Govender, Kevin; Grainger, Linda; Naidoo, Raveen; MacDonald, RussellBackground: In 2008 South Africa (SA) had 1631 registered advanced life support (ALS) paramedics to provide pre-hospital advanced life support care to a population of approxi-mately 50 million. Compared to globally accepted ratios, the number of ALS paramedics in South Africa can be considered as grossly inadequate. This current shortage may be ascribed to migration. However, the extent and nature of this migration, the factors that have contributed to them leaving the country and the existence or effectiveness of implemented strategies that attempt to manage migration of SA ALS paramedic is not known for sure. Methods: The study consisted of a two-phase mixed method descriptive survey. A subset of SA ALS paramedics made up the study population. Quantitative data (Phase One) was obtained from a web-based survey distributed to the accessible population (N = 97). Thereafter, qualitative data (Phase Two) was gathered through in-depth interviews with selected information rich participants (n = 10) also from within the accessible population. Through methodological triangulation, data from Phase One and Phase Two were integrated to obtain an in-depth understanding of South African ALS paramedic migration. In addition, the study investigated whether strategies that attempted to manage migration of SA ALS paramedics existed, and if they did, how effective have they been. Result: Fifty-one of 97 (53%) ALS paramedics responded to the questionnaire in Phase One. Of those, 24 (47.1%) were found to be working inside South Africa, while 27 (52.9%) were working outside South Africa. Working conditions, physical security, and economic considerations were ranked as the top three major factors contributing to the decision or intended decision to migrate. Initiatives to manage the shortage of ALS paramedics in the public sector EMS do exist; however, it appears to be inadequate at its current rate of progress. Conclusion: This study suggests that ALS paramedics in SA are leaving to find work outside the country because of working conditions, physical security, and economic considerations. The current measures to manage migration appear to be ineffective, indicating that new or additional strategies to manage migration of ALS paramedics in SA may be required.