Countrywide Emergency Medical Service (EMS) coverage may become a reality by 2020 as efforts will be made to expand the service annually, National Medical Director of the EMS Dr Zulfikar Bux has said.
Offering insight into the operations of the two-month-old EMS, the establishment of which was described as the “turning point of EMS development in Guyana,” he said, “We are basically merging everything now so that when you do get medical stabilisation and transport, you have specialist trained in emergency medicine to handle the situation.”
A collaborative effort by Ministry of Public Health, the Ministry of Public Security and the Guyana Fire Service (GFS), the EMS was launched on November 16, 2016 with the aim of providing medical care and medical transport for members of the public.
Persons faced with medical emergencies and desirous of assistance would be able to access the EMS by dialing 912 and speaking with trained dispatchers; these dispatchers, would in turn triage the level of emergency before sending out an ambulance with trained Emergency Medical Technicians (EMTs) to respond to the emergency. The EMTs would be able to stabilise patients before transporting them to the hospital, where the emergency physicians would take over.
Of equal significance is the role of the EMS in enhancing the preparedness of medical staff attached to emergency departments to better handle emergency situations that may require their attention, since communication between the EMTs and medical staff at the hospitals is a key component in the EMS.
“There was no service before November and it was a challenge making sure that patients are brought there in a stable manner. There was no communication and we were not prepared for it and that’s what the EMT has done for us,” Bux added.
So far, the EMS has dispatched EMTs to over 400 medical emergencies between November, 2016 and mid- January, 2017.
“We have delivered babies en route to the hospital; three babies have been delivered by EMTs. Imagine what would have happened if they weren’t there. We have also had a lot of heart attack victims and motor vehicle crash victims who have been saved because of the EMS,” Bux said.
Training
Before EMTs are allowed in the field, they are required to undergo six weeks “rigorous” training, Chief EMT Ron Morris said.
Morris and Bux, with assistance from the Vanderbilt Medical Center in the US are responsible for the training of all EMTs, through the EMS office at Project Dawn Liliendaal, East Coast Demerara.
So far, they have been able to train over 50 persons including several members of the Special Forces, dating back to its pilot stage in 2014.
According to the Chief EMT, the current level of training offered to individuals is basic. However, there are hopes to introduce other levels of training to the EMTs in the not too distant future.
“We are starting at the basics but will eventually get these guys up to standard… As we progress we will be looking to add the additional levels,” Morris related.
As regards recruitment, he stated that once an applicant has the requisite five CSEC passes inclusive of Math, English and a Science subject, an interview is conducted.
Successful applicants would then be subjected to six weeks of theoretical and practical training relating to EMS including how to respond to different types of emergencies.
“These people are trained to recognise emergencies whether its trauma emergencies, basic stabilization, CPR, recognise cardiac and respiratory emergencies, more or less to provide that prehospital care to the patient and communicating that to health facility,” Morris explained.
He further underscored the importance of the pre-hospital care administered by EMTs as it has in the past saved several lives. “One of the things we find in emergency medicine, is that transportation is not efficient; patients are transferred badly or they do not arrive at the hospital fast enough and when they do come to us, we realize that they would have been better off if they had medical intervention at an earlier stage,” Morris related.
Meanwhile, Operations Manager of the Guyana Fire Service Compton Sparman emphasised the importance of cross training between the EMTs and members of the GFS.
“The GFS Training School is not yet equipped to do such training, however, because the EMTs are under the GFS, they must have some cross training, so when they complete this medical course, the GFS takes you and gives you basic training on how to operate under the laws of the GFS,” Sparman explained. “We want to go as far as having the firefighters trained as EMTs… because the EMTs are not trained firefighters.”
Whenever the situation demanded it, he added, “We would be able to depend on firefighters who have cross training… Those are things to come but we have to start somewhere.”
Nationwide coverage
But even as the EMS is still in its “teething stage,” both Bux and Morris anticipate nationwide EMS coverage one day becoming a reality in Guyana.
At present, there are three locations that are equipped with the ambulances and EMTs, namely Alberttown Fire Station, the Central Fire Station at Stabroek Market and Project Dawn at Liliendaal.
From these three locations, the EMS is able to service from as far as Agriculture Road at Mon Repos on the East Coast Demerara, to the Diamond Public Road on the East Bank Demerara.
It is their hope however, that the EMS will receive an additional four ambulances this year, in order to offer coverage for the entire Region 4. This is expected to be complemented with an additional 50-60 EMTs being trained in 2017.
Looking at long-term goals, Bux estimated that coverage can be expanded to service the entire coastland. “We should be able to cover Corriverton to Linden with 20 to 25 ambulances. Our projection is that we should be able to meet this by 2020,” he said.
Not forgetting Guyana’s hinterland, the Director related that work is also being done to ensure the availability of air medivacs and they are even looking at the introduction of water ambulances for riverine areas.
“One of the challenges we are working on is training persons in the hinterland to become EMTs, so they can start this process while we work to get the equipment needed,” Bux related.
However, the EMS is not without its challenges, some of which include the absence of GPS locating system in Guyana and motorists’ response to ambulances on the roadways.
“When someone calls and says they are at this pink house and we do not have a numbering system, a lot of our time is taken up trying to locate where people live,” he said regarding the absence of GPS tracking in Guyana.
Meanwhile, Sparman is imploring motorists to adhere to the sirens and flashing lights and pull over to allow ambulances and fire tenders to pass.
“Sometimes we have vehicles not responding to you and we are asking the public when they hear the ambulance to please pull in the corner,” Sparman said.
