Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal.
International Journal of Emergency Medicine · 2021-05-06 · Implementation & quality improvement
Abstract
BACKGROUND: Low- and middle-income countries (LMICs) often face significant challenges related to providing effective pre-hospital care services. Barriers to providing care include lack of financial resources, poor road infrastructure, lack of trained first responders and ambulance staff, and issues regarding coordination/communication between different entities involved in Emergency Medical Services. Prior initiatives to characterize and improve the state of pre-hospital care in LMICs have largely focused on improving access to high-quality ambulance services by providing training programs to community first responders and ambulance staff on how to recognize and manage key emergency conditions. In this article, we discuss an alternative strategy for improving pre-hospital care: the creation of a context-specific Emergency Medical Dispatcher (EMD) training curriculum and program. METHODS: We describe the current pre-hospital care setting in Nepal, the process of creating and piloting the Nepal-specific EMD training manual, and the early impact of its implementation. RESULTS: The 30-h EMD training was designed, piloted, and revised in collaboration with the three largest EMS organizations in Nepal. The training is now required for all dispatchers at the Dhulikhel Hospital Dispatch Center, one of the largest ambulance dispatch networks in Nepal. Dispatchers are trained in the following knowledge and skill areas: telecommunication guidelines, triaging and documentation procedures, delivery of Basic Life Support instructions to callers, other medical and trauma-condition specific instructions, and limited resource management. The short-term positive impacts of the training's implementation include improved documentation procedures, better prioritization of ambulance resources, delivery of Basic Life Support instructions to callers, and improved communication between dispatch, responders, and healthcare facilities. CONCLUSIONS: Context-specific Emergency Medical Dispatch training programs, which aim to optimize the emergency resources available in resource-limited settings, present a promising low-cost, high-impact interventional strategy to strengthen the pre-hospital care systems in low- and middle-income countries.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Communication & handover · Dispatchers & call takers · Implementation · Low- and middle-income settings
Related articles
- The barriers and facilitators to initiation of telephone-assisted bystander cardiopulmonary resuscitation for patients experiencing out-of-hospital cardiac arrest in a private emergency dispatch centre in South Africa. (Resusc Plus, 2024)
- Strengthening Kampala's Urban Referral System for Maternal and Newborn Care Through Establishment of an Emergency Call and Dispatch Center. (Glob Health Sci Pract, 2023)
- The competency requirements for emergency medical services call takers and dispatchers - a scoping review. (Afr J Emerg Med, 2026)
- Live video from bystanders' smartphones to medical dispatchers in real emergencies. (BMC Emerg Med, 2021)
- Challenges Locating the Scene of Emergency: A Qualitative Study of the EMS System in Rwanda. (Prehosp Emerg Care, 2024)
- [Degree of implementation of structured answering of emergency calls in German emergency dispatch centers and effects of the introduction in daily practice]. (Anaesthesist, 2019)