Prehospital care is integral an important part of emergency care. It is at times, more important and compliments the emergency care as it makes the care delivery more timely and lets the treatment start early.
Prehospital care has its own dynamics and competencies. It is very challenging as it is the first contact of healthcare system to any potential infection or disaster or disease and steps taken by paramedics and medics and so it can have far-reaching effects. The prehospital care starts from where the problem actually arises. So a person at home developed chest pain or weakness and requires immediate attention it’s not to wait till he reaches the hospital and his treatment starts from home. The same goes for all trauma and accidents. All of this shows that the role of paramedics and ambulances is crucial and it is important part of our healthcare system. It is well integrated as things that they initiate on ground needs to continue in the hospital.
Healthcare in Pakistan has to catch up with the world and upgrade on both emergency care and prehospital care. It is a must also because of COVID-19 pandemic. Patients who need care regardless of the severity of their COVID illness always find it difficult to contact the doctors or healthcare persons. They are left with either no choice and go to the emergency departments or hide their illness and see the doctor and expose others. The telemedicine has rescued us in this regard and has provided safety and care at the same time to plenty of patients and doctors. Still those patients who don’t have access to any doctor or clinic finds no where to go. For those patients the pre-hospital care is the best way.
With a good and integrated prehospital service, a patient will be able to call the paramedics and they will come and evaluate the patients at home. If the patient requires the evaluation and is quite sick, without exposing unnecessary people this patient can be transported to the hospital. With the integration at work, the ambulance will know exactly where the patient can be adequately treated and the ambulance will serve more than just a transport system. The hospital who has no beds will be bypassed and the hospital who has the bed available will cater to this patients needs. This will serve as an instrument to provide better care more efficiently will most safety and satisfaction to the patients.
People who are decision makers need to understand what steps can provide them with better outcome and with minimal expense. Being a resource poor country, we can not just copy paste western system for it being the successful model. It will backfire as the necessary ingredients for the best functioning needs to be present before we can implement the western system. The first step would be to work on creating standards on what is already in place and start with basics. I would propose a few steps to help people understand the concept.
- Ambulances should be graded as basic or advanced.
- All ambulances should have mandatory inspection every year.
- All drivers should have valid BLS certification.
If we just go by these basic and implementable standards and make sure we achieve that in next two years all across Pakistan, then I would say it will be a great success. Plenty of other things can be said, but rather than making it complicated and not doable, let us start with baby steps but the most important ones.
Will continue the writing on this and similar topics. Also as our Virtual conference is approaching we will present the ideas to people in key position to implement.