Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-19T01:43:31.319Z Has data issue: false hasContentIssue false

Development of a Prehospital Care Rotation for Emergency Medicine Residents in Haiti

Published online by Cambridge University Press:  22 April 2021

Sean M. Kivlehan*
Affiliation:
Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MassachusettsUSA Department of Emergency Medicine, Harvard Medical School, Boston, MassachusettsUSA
Lourdes Rachelle Faikha Colinet
Affiliation:
Department of Emergency Medicine, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
Cassandre Edmond
Affiliation:
Department of Emergency Medicine, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
Hank Song
Affiliation:
Harvard T. H. Chan School of Public Health, Boston, MassachusettsUSA Department of Emergency Medicine, University of Southern California, Los Angeles, CaliforniaUSA
Chen Wei
Affiliation:
Student; Harvard Medical School, Boston, MassachusettsUSA
Linda Rimpel
Affiliation:
Department of Emergency Medicine, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
Shada A. Rouhani
Affiliation:
Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MassachusettsUSA Department of Emergency Medicine, Harvard Medical School, Boston, MassachusettsUSA Partners In Health, Boston, MassachusettsUSA
Keegan A. Checkett
Affiliation:
Partners In Health, Boston, MassachusettsUSA Department of Emergency Medicine, University of Chicago, Chicago, IllinoisUSA
*
Correspondence: Sean Kivlehan, MD, MPH, Brigham and Women’s Hospital, Department of Emergency Medicine, 75 Frances Street, Neville House, Boston, MassachusettsUSA, E-mail: [email protected]

Abstract

Background:

Prehospital care is a key component of an emergency care system. Prehospital providers initiate patient care in the field and transition it to the emergency department. Emergency Medicine (EM) specialist training programs are growing rapidly in low- and middle-income countries (LMICs), and future emergency physicians will oversee emergency care systems. Despite this, no standardized prehospital care curriculum exists for physicians in these settings. This report describes the development of a prehospital rotation for an EM residency program in Central Haiti.

Methods:

Using a conceptual framework, existing prehospital curricula from high-income countries (HICs) were reviewed and adapted to the Haitian context. Didactics covering prehospital care from LMICs were also reviewed and adapted. Regional stakeholders were identified and engaged in the curriculum development.

Results:

A one-week long, 40-hour curriculum was developed which included didactic, clinical, evaluation, and assessment components. All senior residents completed the rotation in the first year. Feedback was positive from residents, field sites, and students.

Conclusions:

A standardized prehospital rotation for EM residents in Haiti was successfully implemented and well-received. This model of adaptation and local engagement can be applied to other residency programs in low-income countries to increase physician engagement in prehospital care.

Type
Special Report
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Thind, A, Hsia, R, Mabweijano, J, Hicks, ER, Zakariah, A, Mock, CN. Chapter 14. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN, (eds). Essential Surgery: Disease Control Priorities, Third Edition (Volume 1). Washington, DC USA: The International Bank for Reconstruction and Development/The World Bank; 2015.Google Scholar
Reynolds, TA, Sawe, H, Rubiano, AM, Shin, SD, Wallis, L, Mock, CN. Chapter 13. In: Jamison, DT, Gelband, H, Horton, S, etal, (eds). Disease Control Priorities: Improving Health and Reducing Poverty. 3rd edition. Washington, DC USA: The International Bank for Reconstruction and Development/The World Bank; 2017.Google ScholarPubMed
Kobusingye, OC, Hyder, AA, Bishai, D, Hicks, ER, Mock, C, Joshipura, M. Emergency medical systems in low- and middle-income countries: recommendations for action. Bull World Health Organ. 2005;83(8):626631.Google Scholar
Sasser, S, Varghese, M, Kellermann, A, Lormand, JD. Prehospital Trauma Care Systems. Geneva, Switzerland: World Health Organization; 2005.Google Scholar
Kironji, AG, Hodkinson, P, de Ramirez, SS, etal. Identifying barriers for out of hospital emergency care in low and low-middle income countries: a systematic review. BMC Health Serv Res. 2018;18(1):291.CrossRefGoogle ScholarPubMed
Suryanto, Plummer V, Boyle, M. EMS systems in lower-middle income countries: a literature review. Prehosp Disaster Med. 2017;32(1):6470.CrossRefGoogle ScholarPubMed
Nielsen, K, Mock, C, Joshipura, M, Rubiano, AM, Zakariah, A, Rivara, F. Assessment of the status of prehospital care in 13 low- and middle-income countries. Prehosp Emerg Care. 2012;16(3):381389.CrossRefGoogle ScholarPubMed
NAEMSP Position Statement. Physician Oversight of Emergency Medical Services. Prehosp Emerg Care. 2017;21(2):281282.CrossRefGoogle Scholar
Verdile, VP, Krohmer, JR, Swor, RA, Spaite, DW. Model curriculum in emergency medical services for emergency medicine residency programs. SAEM Emergency Medical Services Committee. Acad Emerg Med. 1996;3(7):716722.CrossRefGoogle ScholarPubMed
Rouhani, SA, Eliacin, HC, Edmond, MC, Checkett, KA, Rimpel, L, Marsh, RH. Epidemiology of traumatic injuries presenting to an ED in Central Haiti: a retrospective cohort study. Emerg Med J. 2019;36(7):389394.Google Scholar
ACGME Program Requirements for Graduate Medical Education in Emergency Medicine. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/110_EmergencyMedicine_2019.pdf?ver=2019-06-25-082649-063. Accessed September 21, 2019.Google Scholar
Katzer, R, Cabanas, JG, Martin-Gill, C; SAEM Emergency Medical Services Interest Group. Emergency medical services education in emergency medicine residency programs: a national survey. Acad Emerg Med. 2012;19(2):174179.CrossRefGoogle Scholar
Gottlieb, M, Arno, K, Kuhns, M, Chan, TM. Distribution of clinical rotations among emergency medicine residency programs in the United States. AEM Educ Train. 2018;2(4):288292.CrossRefGoogle ScholarPubMed
ACGME Program Requirements for Graduate Medical Education in Emergency Medical Services (Subspecialty of Emergency Medicine). https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/112_EmergencyMedicalServices_2019.pdf?ver=2019-06-17-151254-920. Accessed September 21, 2019.Google Scholar
African Federation for Emergency Medicine (AFEM). Emergency Care Curriculum. http://afem.co.za/wp-content/uploads/2017/10/AFEM-Curriculum.pdf. Accessed September 21, 2019.Google Scholar
DeGennaro, VJ, Owen, J, Chandler, J, McDaniel, R. Operational implementation and lessons learned from Haiti’s first helicopter air ambulance. Injury. 2016;47(5):10011006.CrossRefGoogle ScholarPubMed
McCullough, C, DeGennaro, V Jr, Bagley, JK, Sharma, J, Saint-Fort, M, Henrys, JH. A national trauma capacity assessment of Haiti. J Surg Research. 2016;201(1):126133.CrossRefGoogle ScholarPubMed
Wallis, L, Reynolds, TA. AFEM Handbook of Acute and Emergency Care. Oxford, England: Oxford University Press: 2014.Google Scholar
World Health Organization (WHO). Emergency Triage Assessment and Treatment (ETAT). Geneva, Switzerland: WHO; 2005.Google Scholar