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Research Publications (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/216

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    Occupational blood and body fluid exposure among emergency medical service providers in the eThekwini metropole of South Africa
    (Elsevier BV, 2022-06) Chetty, Melvin; Govender, Kevin P.; Sobuwa, Simpiwe
    Emergency Medical Service (EMS) providers in South Africa are among health care workers (HCW) most at risk of contracting infectious diseases due to occupational exposure to blood and body fluids (BBF). While the austere, dynamic, and challenging nature of the prehospital environment appears to be one of the primary drivers to this risk, the growing prevalence of bloodborne infections within the country; particularly Hepatitis B, C and Human Immunodeficiency Virus (HIV), has inevitably compounded the problem. The aim of this study was to investigate the knowledge, practices, and prevalence of BBF exposure among EMS providers in the eThekwini metropole of KwaZulu-Natal, South Africa.

    Methodology

    This cross-sectional questionnaire-based study was completed by 96 randomly selected EMS providers who worked for the state-run ambulance service and were stationed within the eThekwini metropole.

    Results

    A total of 41 (42.7%) of the 96 respondents indicated memorable exposure to BBF at some point in their operational career. Exposure appeared to be mostly as a result of needlestick injuries (NSI) (63.4%), followed by BBF exposure into the eyes (19.5%). At the time of exposure, a total of 40 participants (97.6%) were wearing gloves, 22% (n = 9) were wearing facemasks, and 9.8% (n = 4) were wearing eye protection. Less than half of the respondents (46, 47.9%) were aware of existing EMS espoused BBF exposure policies, and 55 (57.3%) knew about post-exposure prophylaxis for HIV. Majority of the respondents (n = 74; 77.1%) indicated that they always recapped needles, and 46.9% (n = 45) dispose of sharps containers when completely full.

    Conclusion

    The findings suggest that BBF related knowledge and practices among EMS providers working in the eThekwini metropole may be inadequate, and may increase the risk of blood exposure. In order to improve knowledge, immediate provision of EMS-specific BBF exposure training is required.
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    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.
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    Towards a safer and more efficient neonatal transfer system in South Africa : a qualitative inquiry with advanced life support paramedics
    (Faculty of Health, Engineering and Science, Edith Cowan University, 2021-05-18) Bhagwan, Raisuyah; Ashokcoomar, Pradeep
    Introduction The inter-healthcare transfer of the critically ill neonate is a critical aspect of larger neonatal intensive care, as it influences the safe transport of neonates from the receiving to the referring hospital. It is crucial then that the transfer process be safe and efficient so as not to compromise the already fragile condition of the neonate. The aim of the study was to understand the challenges advanced life support (ALS) paramedics face during neonatal transfers and to understand how the process could be made safer and more efficient. The objectives related to understanding the transfer process, the challenges linked to the critically ill neonate and the difficulties associated with the ambulance vehicle and equipment. Methods Using a qualitative research approach we sought the views of ALS paramedics at the forefront of transfers nationally. In-depth interviews were held with eight paramedics in KwaZulu-Natal and four focus group discussions with ALS paramedics in KwaZuluNatal, Gauteng, Free State and the Western Cape in South Africa. A total of 35 ALS paramedics were involved in these group discussions. Results The study uncovered several challenges that paramedics face related to poor organisational preparation for transfer of the critically ill neonate, and other crucial issues that compromise the transfer such as inadequate or defective equipment. Conclusion There is a need for greater scrutiny of the transfer process and a commitment from stakeholders to begin addressing the challenges confronting the safe transfer of critically ill neonates.
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    Reflection : on the use of the ILMA in an entrapped patient
    (BMJ Publishing Group Ltd and the College of Emergency Medicine, 2014-08-30) Castle, Nicholas; Naguran, Sageshin