Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-30T03:31:45.785Z Has data issue: false hasContentIssue false

Knowledge and Attitudes of the Out-Of-Hospital Emergency Care Consumers in Santo Domingo, Dominican Republic

Published online by Cambridge University Press:  28 June 2012

Amado Alejandro Báez*
Affiliation:
Department of Emergency Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA Emergency Medicine, Hospital General Plaza de la Salud, Santo Domingo, Dominican Republic
Ediza Giraldez
Affiliation:
Department of Emergency Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
Peter L. Lane
Affiliation:
Deceased
Charles Pozner
Affiliation:
Department of Emergency Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
Juan Rodriguez
Affiliation:
Dominican Republic's Secretariat of Public Health, Santo Domingo, Dominican Republic
Selwyn Rogers
Affiliation:
Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
*
Department of Emergency Medicine Brigham and Women's Hospital/Harvard Medical School 75 Francis Street, Boston, MA 02115 USA E-mail: [email protected]

Abstract

Introduction:

Prehospital emergency services are a vital public service, and consumer access to the system is an important factor in their use. The Dominican Republic recently experienced “the epidemiological transition” leading to increased morbidity and mortality secondary to traumatic and cardiac conditions—thus, increasing the need for prompt and adequate delivery of emergency medical care.

Methods:

A survey was administered to 90 subjects from diverse backgrounds, all living in Santo Domingo. Survey items included questions on emergency medical services (EMS) systems knowledge (i.e., access numbers), confidence in the system, first-aid education and prior experience with the EMS system. Chi-square was used to measure statistical significance for categorical variables and Student's t-test for continuous variables (JMP 2.0 software was used for statistical processing).

Results:

A total of 90 subjects were surveyed. The average age of respondents was 36 ± 12 years SD. More than one-fifth (22.2%) of respondents did not know the established universal emergency number (9-1-1), and 37.8% responded that they would access a different telephone number in case of a medical emergency.

Conclusions:

Important deficiencies and access-to-care concerns were interpreted from the results. An adequate understanding of the current state of prehospital care could lead to creation of policies by system administrators to further improve the delivery of emergency medical care. This study will assist system administrators in future design and policy issues.

Type
Brief Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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

1.93rd US Congress: Emergency Medical Services System Act of 1973. Public Law 93154 (1973).Google Scholar
2. Dominican National Commission on Emergencies. Available at http://www.comisiondeemergencia.com/CNE/cne.htm. Accessed 25 July 2003.Google Scholar
3.Pan American Health Organization (PAHO): Basic country health profiles for the Americas: Dominican Republic Summaries, 2000. Available at http://www.paho.org/English/SHA/prfldor.htm. Accessed 15 July 2005.Google Scholar
4. Oficina Nacional de Estadisticas (ONE) República Dominicana: [Población censo 2002 Según Provinicas y Municipios]. Available at http://www.one.gov.do. Accessed 15 July 2005.Google Scholar
5. Verizon Dominicana: Directorio Telefonico Comercial. Available at http://www.superpagesdr.com/. Accessed 21 January 2006.Google Scholar
6.Baez, AA: A history of EMS in the Dominican Republic. Emerg Med Serv 2001;30(6):76.Google Scholar
7.Reines, HD, Bartlett, RL, Chudy, NE et al. : Is advanced life support appropriate for victims of motor vehicle accidents: The South Carolina Highway Trauma Project. J Trauma 1998;28(5):563570.Google Scholar
8.Lerner, EB, Moscati, RM: The golden hour: Scientific fact or medical “urban legend”? Acad Emerg Med 2001;8(7):758760.CrossRefGoogle ScholarPubMed
9.University of Maryland Medical Center: Tribute to R. Adams Cowley, MD. Available at http://www.umm.edu/shocktrauma/history.htm. Accessed 16 July 2008.Google Scholar
10.Feero, S, Hedges, JR, Simmons, E, Irwin, L: Does out-of-hospital EMS time affect trauma survival? Am J Emerg Med 1995;13(2);133135.Google Scholar
11.National Committee of Trauma and Committee of Shock: Accidental Death and Disability: The Neglected Disease of Modern Society. Washington DC: National Academy of Science/National Research Council, 1966.Google Scholar
12.Cornwell, EE 3rd, Belzberg, H, Hennigan, K et al. : Emergency medical services (EMS) vs. non-EMS transport of critically injured patients: A prospective evaluation. Arch Surg 2000;135(3):315319.CrossRefGoogle ScholarPubMed
13.Frey, CF: Accidents and trauma care. Surg Annu 1984;16;6989.Google Scholar
14.Ornato, JP, Craren, EJ, Nelson, NM, Kimball, KF: Impact of improved emergency medical services and emergency trauma care on the reduction in mortality from trauma. J Trauma 1985:25(7):575579.CrossRefGoogle ScholarPubMed
15.Stiell, IG, Wells, GA, Field, BJ et al. : Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS study phase II. Ontario Prehospital Advanced Life Support. JAMA 1999;281(13):11751181.CrossRefGoogle ScholarPubMed
16.Cummins, RO: Emergency medical services and sudden cardiac arrest: The “chain of survival” concept. Annu Rev Public Health 1993;14:4345.Google Scholar
17.Cummins, RO: The “chain of survival” concept: How it can save lives. Heart Dis Stroke 1992;1(1):4345.Google Scholar
18.Cummins, RO, Ornato, JP, Thies, WH, Pepe, PE: Improving survival from sudden cardiac arrest: The “chain of survival” concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation 1991;83(5):1832:1847.CrossRefGoogle ScholarPubMed
19.Fedoruk, JC, Currie, WL, Gobet, M: Locations of cardiac arrest: Affirmation for community Public Access Defibrillation (PAD) Program. Prehospital Disast Med 2002;17(4):202205.CrossRefGoogle ScholarPubMed
20.Hajbaghery, MA, Mousavi, G, Akbari, H: Factors influencing survival after inhospital cardiopulmonary resuscitation. Resuscitation 2005;66(3):317321.CrossRefGoogle Scholar
21.Hankins, DGLuke, A: Emergency medical service aspects of emergency cardiac care. Emerg Med Clin N Am 2005;23(4):12191231.CrossRefGoogle ScholarPubMed
22.Roman, MI, de Miguel, AG, Garrido, PC et al. : Epidemiologic intervention framework of a prehospital emergency medical service. Prehosp Emerg Care 2005;9(3):344354.Google Scholar