Pre-hospital Emergency Medical Services, Phase I: Role of the Department of Community Health and Psychiatry

The Department of Community Health and Psychiatry was contracted by the Ministry of Health to assist with the implementation of a pilot programme in the Western Health Region to train fire fighters as basic level Emergency Medical Technicians (EMTs), and was responsible for its design, implementation and monitoring for first 18 months. The course was covered in 440 hours over a 10 week period, and included training in emergency medical response, driving an emergency medical vehicle, emergency medical despatching and inventory control. Of 76 fire fighters selected for training, 62 graduated, receiving Certificate of Merit from the Ministry of Health, Jamaica and were deployed into service on 17th April 1996. During the period 17 April to 31 December, 1996, the newly trained EMT's responded to 1,299 calls. Medical and surgical cases represented approximately 55 percent of all calls, followed by trauma (19 percent), motor vehicle accident (9 percent) and obstetric emergencies (8 percent). Between 15 percent and 20 percent of calls in Montego Bay and Negril involved tourists. This first group of EMT's has performed well and was well received by the communities and the persons who used the service.(AU)

Pre-hospital care in Barbados - abstract

Pre-hospital care in Barbados was completely re-organised in 1984 with international assistance. Training included a three-month course for 45 emergency medical technicians (EMTs) to the basic EMT level. The aim of this study was to review the operations of the Emergency Ambulance Service (EAS), now in its seventh year of operation. During the three-month period July - September 1991, the following information was taken from each call: time and allocation, time of arrival at the scene and the chief complaint. The EAS responded monthly to 1,142 calls from the various parishes. Distribution of calls closely followed that of the population. The majority of calls (66.4 percent) were genuine emergencies, with only 1.2 percent being crank calls. Emergency included asthmatics (12.5 percent), accidents (9.3 percent), violent injuries (6.1 percent), comatose patients (7.3 percent), seizures (5.1 percent) and 14 (0.4 percent) patients with cardiac arrest. The average response time for all calls was 20 minutes. This ranged from 13 minutes in the central parish of St. Michael, to 39 minutes in the northern district of St. Lucy, and 30 minutes in the eastern area of St. Philip. These findings highlight the need for satellite stations in the northern and eastern sides of the island. The wide range of emergencies identified also provides a useful base for reviewing the curriculum and introducing new protocols for pre-hospital care (AU)

Development of the Emergency Medical Services in Barbados - abstract

Pre-hospital and emergency department care have improved immensely over the past 15 years in Barbados. In 1976, a medical unit was formed by the Barbados Regiment to assist primarily as responders in a mass casualty/disaster situation. Within 3 weeks of its existence, it was tested during the Air Cubana crash. Today, if requested, the unit is capable of responding urgently to disasters in neighbouring OECS islands. Previous responses include hurricane David in Dominica - 1979, Hugo in Montserrat - 1988, and the volcanic erruption in St, Vincent - 1980. In 1984, the Emergency Ambulance Service was completely reorganized. Among the staff are 45 EMTs trained to the basic level in pre-hospital care. The service deals with about 1,100 cases monthly, 60 per cent of which originate in the St. Michael area. Response times range from about 10 minutes in St. Michael to about 30 minutes in the most distant Parish of St. Lucy. Improved service offered by the Accident and Emergency Department of the Queen Elizabeth has been the most recent development. In July 1990, a modern 22-bed unit was opened, coinciding with the introduction of a post-graduate course in Accident and Emergency Medicine at the Cave Hill Campus of the UWI. The department is equipped with an X-ray unit and modern commuication devices. A computer tracking system will asist in monitoring patient flow and provide, on a regular basis, statistics necessary for Quality Assurance exercises (AU)

Curriculum design and implementation for Jamaican ambulance personnel

A training programme for Jamaican ambulance personnel is described. The factors relevant to development of the curriculum are discussed, and the need for training this category of personnel is emphasised. The programme deals with first-aid along with basic life support measures. Its role in preparing the ambulance attendants for advanced training is noted (AU)