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Faculty of Health Sciences

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Subject: search.filters.subject.Emergency management

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    A comparative study of emergency service response intervals in Johannesburg, South Africa and the North West Ambulance Service, United Kingdom
    (2019-09-05) Van Der Net, Wynand; Vincent-Lambert, Craig; Kevin, Govender
    Background: The primary role of an Emergency Medical Service (EMS) is to respond to an emergency incident within the shortest possible time. As a consequence, response times have historically been used as a key indicator of EMS performance. The City of Johannesburg Emergency Management Services (CoJEMS) provides an EMS to the citizens of the greater Johannesburg metropolitan area in South Africa. The CoJEMS are expected to respond to emergency incidents within 15 minutes, which is the national norm. Before this study there was no complete up-to-date data set or literature describing the extent to which the CoJEMS were meeting this target. The absence of accurate data relating to responsetime intervals was seen as problematic as it limits EMS managers’ abilities to make informed decisions concerning quality management, benchmarking and improvement strategies. Aim: The aim of the study was to investigate, document and describe the time taken by the CoJEMS to complete activities routinely associated with the activation of and response to an emergency incident and to compare these with the response times achieved by the North West Ambulance Services (NWAS) in the United Kingdom. Methods: The research methods included a literature review to identify generic activities that occur from the moment an emergency happens until the patient arrives at a medical facility for treatment. Following this a spreadsheet that was designed to capture the time taken to complete each of the identified activities. Data from 784 calls for the CoJEMS and 786 calls for NWAS were recorded onto the spreadsheet and analysed descriptively. Results: The NWAS had a median overall response time of just 10 min 45 seconds. The median overall time for COJEMs was over twice as long, at 23 min 16 seconds. Conclusion: The NWAS outperformed the CoJEMS in the majority of response-time intervals and the CoJEMS median of 23 min 16 seconds exceeded the national norm and standard of 15 min. Many of the extended CoJEMS response times could be linked to delays in communication between the calltaking department and the EMS dispatch, coupled with a lack of availability of EMS vehicles. Further studies are recommended to determine the reason for the lack of available CoJEMS vehicles, as well as ways to encourage a closer relationship between the different departments within the CoJEMS central communications centre
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    Preparedness of emergency care providers to deal with death, dying and bereavement in the prehospital setting
    (2018) Conning, Reon Johnathan; Naidoo, Raveen; Bhagwan, Raisuyah; Ahmad, Sami Mana
    Introduction: Emergency care providers are exposed to events involving suffering and tragedy as part of their routine work in the field. They are accordingly expected to deal with death, dying and bereavement in a safe, sensitive, efficient manner, showing empathy and compassion while managing their own emotions. This can be stressful and lead to trauma symptoms, anxiety and depression. Purpose: To investigate how prepared emergency care providers are to deal with death, dying and bereavement in the prehospital setting in order to recommend strategies that will diminish the emotional strain they experience, as well as decrease the trauma of sudden death and the number of abnormal grief reactions for the bereft. Methods: The study used a quantitative descriptive prospective design. Data was collected using an online self-report questionnaire that was sent to all operational emergency care providers in the Dubai Corporation of Ambulance Services (DCAS). The data from consenting participants (n = 496) was analysed using the IBM Statistical Package for Social Sciences (SPSS) version 25.0. Inferential statistical techniques such as correlations and chi-square test values were used and interpreted using the p-values. Factor analysis was also conducted for the purpose of data reduction. Results: The majority of respondents (n = 316; 64.4%) reported that they had not received any formal education or training on death, dying and bereavement. Those that had received formal education or training reported that this training was conducted mainly by nursing (n = 124; 25.9%) and paramedic (n = 65; 13.6%) instructors. A quarter of the respondents (n = 126; 25.4%) reported experiencing intrusive symptoms such as loss of sleep, missing work and nightmares as a result of a work-related death or dying incident, but only a few (n = 20; 4.1%) had received professional counselling. Conclusion: This study found that emergency care providers are underprepared to deal with death, dying and bereavement and reported discomfort and anxiety associated with this aspect of their job. A comprehensive death education programme that encompasses the diversity of death and the unique challenges that the emergency and prehospital setting presents should be implemented to reduce emotional anxiety, help emergency care providers cope better with death and decrease the number of abnormal grief reactions on the part of the bereft.