The Bolivian trauma patient's experience: A qualitative needs assessment.

Bolivia / epidemiology Emergency Medical Services First Aid Hospitals Humans Needs Assessment
Emergency medical services (EMS) Global health Interview Low- and middle-income country (LMIC) Qualitative Trauma

Journal

Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 04 09 2020
revised: 16 11 2020
accepted: 02 12 2020
pubmed: 3 1 2021
medline: 22 6 2021
entrez: 2 1 2021
Statut: ppublish

Résumé

Despite a significant burden of injury-related deaths, the Plurinational State of Bolivia (Bolivia), a lower- middle-income country in South America, lacks a formalized trauma system. This study sought to examine Bolivian trauma care from the patient perspective in order to determine barriers to care and targets for improvement. Investigators conducted 15 semi-structured interviews with trauma patients admitted at four hospitals in Santa Cruz de la Sierra, Bolivia in June and July of 2016. Interviews were transcribed, translated, and analyzed through content and discourse analysis to identify key themes and perceptions of trauma care. Participants primarily presented with orthopedic injuries due to road traffic incidents and falls. Only one participant reported receiving first aid from a layperson at the scene of injury. Of the 15 participants, 12 did not know any number to contact emergency medical services (EMS). Participants expressed negative views of EMS as well as concerns for slow response times and inadequate personnel and training. Two thirds of participants were initially brought to a hospital without adequate resources to care for their injuries. Participants generally expressed positive views regarding healthcare workers involved in their hospital-based medical care. This region of Bolivia has a disorganized, underutilized, and distrusted trauma system. In order to increase survival, interventions should focus on improving prehospital trauma care. Potential interventions include the implementation of layperson trauma first responder courses, the establishment of a medical emergency hotline, the unification of EMS, the implementation of basic training requirements for EMS personnel, and public education campaigns to increase trust in EMS.

Sections du résumé

BACKGROUND BACKGROUND
Despite a significant burden of injury-related deaths, the Plurinational State of Bolivia (Bolivia), a lower- middle-income country in South America, lacks a formalized trauma system. This study sought to examine Bolivian trauma care from the patient perspective in order to determine barriers to care and targets for improvement.
METHODS METHODS
Investigators conducted 15 semi-structured interviews with trauma patients admitted at four hospitals in Santa Cruz de la Sierra, Bolivia in June and July of 2016. Interviews were transcribed, translated, and analyzed through content and discourse analysis to identify key themes and perceptions of trauma care.
RESULTS RESULTS
Participants primarily presented with orthopedic injuries due to road traffic incidents and falls. Only one participant reported receiving first aid from a layperson at the scene of injury. Of the 15 participants, 12 did not know any number to contact emergency medical services (EMS). Participants expressed negative views of EMS as well as concerns for slow response times and inadequate personnel and training. Two thirds of participants were initially brought to a hospital without adequate resources to care for their injuries. Participants generally expressed positive views regarding healthcare workers involved in their hospital-based medical care.
CONCLUSIONS CONCLUSIONS
This region of Bolivia has a disorganized, underutilized, and distrusted trauma system. In order to increase survival, interventions should focus on improving prehospital trauma care. Potential interventions include the implementation of layperson trauma first responder courses, the establishment of a medical emergency hotline, the unification of EMS, the implementation of basic training requirements for EMS personnel, and public education campaigns to increase trust in EMS.

Identifiants

DOI: 10.1016/j.injury.2020.12.014 PMID: 33386153
pubmed: 33386153
pii: S0020-1383(20)31044-5
doi: 10.1016/j.injury.2020.12.014
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

167-174

Informations de copyright

Copyright © 2020. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest We have no conflicts of interest to disclose.

Auteurs

Jordan M Rook (JM)

Northwestern University Feinberg School of Medicine, Department of Surgery, Division of Trauma and Critical Care, Chicago, IL, USA; David Geffen School of Medicine at the University of California Los Angeles, Department of Surgery, Los Angeles, CA, USA. Electronic address: jrook@mednet.ucla.edu.

Ethan Wood (E)

Northwestern University Feinberg School of Medicine, Department of Surgery, Division of Trauma and Critical Care, Chicago, IL, USA; Icahn School of Medicine at Mount Sinai, New York City, NY, USA.

Marissa A Boeck (MA)

Northwestern University Feinberg School of Medicine, Department of Surgery, Division of Trauma and Critical Care, Chicago, IL, USA; Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, MA, USA; New York Presbyterian Hospital/Columbia University, Department of Surgery, New York City, NY, USA; University of California San Francisco School of Medicine, Department of Surgery, San Francisco, CA, USA.

Kevin J Blair (KJ)

Northwestern University Feinberg School of Medicine, Department of Surgery, Division of Trauma and Critical Care, Chicago, IL, USA; David Geffen School of Medicine at the University of California Los Angeles, Department of Surgery, Los Angeles, CA, USA.

Alexa Monroy (A)

Northwestern University Feinberg School of Medicine, Department of Surgery, Division of Trauma and Critical Care, Chicago, IL, USA; Children's Hospital Los Angeles, Department of Pediatrics, Los Angeles, CA, USA.

Erica Ludi (E)

Emory University School of Medicine, Department of Surgery, Atlanta, GA, USA.

Eric J Keller (EJ)

Stanford University School of Medicine, Department of Interventional Radiology, Palo Alto, CA, USA.

David Victorson (D)

Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL, USA.

Esteban Foíanini (E)

Clínica Foíanini, Department of Surgery, Santa Cruz de la Sierra, Bolivia.

Mamta Swaroop (M)

Northwestern University Feinberg School of Medicine, Department of Surgery, Division of Trauma and Critical Care, Chicago, IL, USA.

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Classifications MeSH

questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Sud › Bolivie › The Bolivian trauma patient's experience: A...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services des urgences médicales › The Bolivian trauma patient's experience: A...
questionsmedicales.fr › Thérapeutique › Traitement d'urgence › Premiers secours › The Bolivian trauma patient's experience: A...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Hôpitaux › The Bolivian trauma patient's experience: A...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The Bolivian trauma patient's experience: A...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Évaluation des besoins › The Bolivian trauma patient's experience: A...