{"title":"SAJPEC: A new dawn for pre-hospital emergency care in South Africa","authors":"Simpiwe Sobuwa","doi":"10.24213/1-1-4167","DOIUrl":"https://doi.org/10.24213/1-1-4167","url":null,"abstract":"The South African pre-hospital setting has made remarkable progress since the development of emergency care short courses more than three decades ago. The profession has moved from boxtype ambulances staffed with ambulance drivers to well-equipped emergency response vehicles and ambulance aircraft staffed with paramedics with professional degrees.1 Paramedics are now in a position to enroll for a Doctoral degree in emergency medical care or equivalent, a first for the African continent.1 Having paramedics with postgraduate qualifications means that there is an opportunity for research output emanating from their research projects. It is against this backdrop that a working group of the Emergency Care Society of South Africa conceptualized the idea of the South African Journal of Pre-hospital Emergency Care (SAJPEC).","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117299532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Something new, again","authors":"C. Stein","doi":"10.24213/1-1-4171","DOIUrl":"https://doi.org/10.24213/1-1-4171","url":null,"abstract":"In March 2011, I wrote the first editorial for a new publication by the Emergency Care Society of South Africa. The publication, which was not peerreviewed and more in the style of a quarterly magazine, was called Sanguine. In writing that editorial I quoted the Roman author and natural philosopher Pliny the Elder who said ‘ex Africa semper aliquid novi’ – there is always something new out of Africa. The Society continued to publish Sanguine for the next five years, and then made a decision to move in the direction of a peer-reviewed scientific journal as my colleague Simpiwe Sobuwa alludes to on page 2 of this issue. And so, almost a decade after the start of something new, here we are again.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"241 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115589803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Simulated clinical scenarios: The experiences of Emergency Care Practitioner students","authors":"H. Slabber, K. Henrico","doi":"10.24213/3-1-4964","DOIUrl":"https://doi.org/10.24213/3-1-4964","url":null,"abstract":"Background: Simulation education as a strategy is used extensively in Emergency Medical Care Departments. The literature in this field strongly suggests positive effects on patient safety and student-readiness. Simulation education strategies often fail to address the student experiences in the classroom. The aim of this study was to explore how Emergency Care Practitioner (ECP) students experience simulated clinical scenarios. Methods: This study was conducted at a South African University in the Gauteng province. Data was collected through semi-structured interviews. Convenience sampling was used to recruit participation. Data saturation occurred after six interviews. Open coding was used to code the transcripts. Results: ECP students experienced simulated clinical scenarios to be a highly beneficial teaching and learning experience, but experienced simulation as a nerve-racking assessment tool that requires excellent debriefing and feedback to improve its effectiveness. High-fidelity simulation scenarios, that are built on real-life context, are received most favourably by students. Conclusions: ECP Students find simulated clinical scenarios to be valuable in their education. To achieve a favourable simulation experience for ECP students excellent debriefing and feedback protocols need to be implemented. Availability of time to practise in the simulation laboratory is limited and students feel limited by this.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125087960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pre-hospital emergency care research in South Africa: where are we now as a profession?","authors":"Enrico Dippenaar","doi":"10.24213/2-2-4983","DOIUrl":"https://doi.org/10.24213/2-2-4983","url":null,"abstract":"The expansion of knowledge is perhaps one of the greatest achievements of humankind. Through the centuries we have gathered information, both structured and not, that shapes our view of the world and the way we interact with each other and our surroundings. The scientific method came about as a structured approach to help us focus on specific problems and answer unique questions. This has led to our knowledge of medicine greatly increasing over time, allowing us to extend life by caring for the ill and injured. Clinical practice has improved greatly because of persistent knowledge acquisition, which forms the basis of modern evidence-based and informed medicine.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121416092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Lewis, Wayne Jooste, Roderick Campbell, W. Stassen
{"title":"The accuracy of Bloemfontein-based Emergency Medical Services providers in recognising sepsis","authors":"M. Lewis, Wayne Jooste, Roderick Campbell, W. Stassen","doi":"10.24213/2-2-4265","DOIUrl":"https://doi.org/10.24213/2-2-4265","url":null,"abstract":"Background: Sepsis is considered a severe life-threatening medical emergency and globally carries a high mortality. Research suggests early recognition of sepsis can lead to early initiation of treatment and effective communication of this condition to the receiving facility by pre-hospital emergency care (PEC) providers. Depending on system operations, this has been shown to improve patient outcomes. However, sepsis often presents non-specifically, and in the absence of validated pre-hospital sepsis screening tools, less than half of sepsis patients seen by PEC providers are recognised. This study aimed to determine the accuracy with which Bloemfontein-based PEC providers recognise sepsis in a series of patient vignettes. Methods: A series of seven case vignettes were presented to a convenient sample of advanced life support (ALS) and intermediate life support (ILS) PEC providers. The PEC providers were asked to review each vignette and indicate whether the patient described had sepsis or not. The vignettes consisted of a clinical case description with signs and symptoms of patients presenting with or without sepsis, and images were shown where relevant. Elements of the Robson Prehospital Severe Sepsis Screening (RPSS) tool were used to populate the sepsis vignettes. Results: A total of 27 ILS and ALS PEC providers in the Bloemfontein area partook in the research study. Thus, a total of 189 vignettes were evaluated for sepsis. PEC providers, both ILS and ALS, recognised sepsis with a sensitivity of 69.63% and a specificity of 37.04% (PPV 73.44%, NPV 32.79%), indicating an accuracy of 60.32%. Although all participants mentioned some motivations for their answers, none of the participants gave specific cut-off value ranges at which point they would suspect sepsis. Conclusion: This vignette-based study found that PEC providers can recognise sepsis with modest accuracy, echoing previous work on this topic. In addition, the study provides a platform for similar studies, which, in turn, could aid in the development of a validated, pre-hospital sepsis screening tool.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126726580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A number of firsts","authors":"Christopher Stein","doi":"10.24213/3-1-5368","DOIUrl":"https://doi.org/10.24213/3-1-5368","url":null,"abstract":"In this issue of the journal, we publish our first case report which focuses on airway management of a traumatic brain injury case.1 While perhaps not traditionally enjoying the recognition of original research, case reports comprise an important component of the content mix in this journal reminding us that of the all-important link between scholarly activities and clinical practice. The case reported in this issue originates from a clinical context outside of South Africa, but where many South African emergency care providers currently work. We welcome reports of interesting or unique cases from any locale with characteristics similar to those in South Africa (whether this be with regard to burden of disease, scope of practice or qualifications) but we also urge local colleagues to send us their own case reports for consideration.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130658507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Investigation into employees’ motivation during the COVID-19 pandemic, at a single private Emergency Medical Services provider in Gauteng","authors":"Jared McDowall","doi":"10.24213/3-1-5121","DOIUrl":"https://doi.org/10.24213/3-1-5121","url":null,"abstract":"Background: Employee motivation has been identified as pivotal in every organisation, as it assists in the realisation of organisations’ vision and/or mission. The COVID-19 pandemic has had an unprecedented effect across the globe, which extended into personal and professional realms. It may be argued, though, that it had a compounding effect on healthcare providers. Despite healthcare organisations having a COVID-19 disaster response plan in place, the relationship between employees’ motivation and organisational performance has been poorly described. The aim of this research was to investigate and describe factors of motivation amongst emergency operations centre (EOC) employees during the COVID-19 pandemic at a single private emergency medical services (EMS) provider in Gauteng. Methods: The sample included 110 EOC employees, and a probabilistic stratified sampling methodology was utilised. An electronic survey instrument was used to collect data. All recorded data were stored on Google® forms and extracted into an electronic data spreadsheet for analysis (Microsoft® Excel®). Results: A total of 87 participants responded, yielding a 95% confidence interval. The majority of participants were between 25-35 years old (n=53), female (n=53), single (n=43), and had a higher certificate as their highest formal qualification (n=60). It was found that organisational reputation (87.4%), the sense of making a difference (87.4%), and job security (85.1%) were amongst the most prevalent motivational factors amongst EOC employees during the pandemic. Conclusion: The results outline the importance of motivation in a disaster response plan. Employees’ motivation should be prioritised and adequately managed in times of crisis. Based on the link between motivation and organisational performance, a failure to do so may have a negative impact on performance. Organisational reputation, the sense of making a difference, and job security were identified as key motivational factors.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123720271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gangaram Padarath, Rajeev Debipershad Ballaram, Y. Pillay, B. Pillay, Guillaume Alinier
{"title":"Blind bougie first pass success endotracheal intubation process: An out-of-hospital case report","authors":"Gangaram Padarath, Rajeev Debipershad Ballaram, Y. Pillay, B. Pillay, Guillaume Alinier","doi":"10.24213/3-1-4912","DOIUrl":"https://doi.org/10.24213/3-1-4912","url":null,"abstract":"The blind bougie technique is performed when the epiglottis is visible to the intubator, but the vocal cords cannot be seen (Grade III Cormack-Lehane view). The blind bougie technique for endotracheal intubation is not routinely performed by Critical Care Paramedics for a failed intubation in the prehospital setting. However, at Hamad Medical Corporation Ambulance Service in the State of Qatar, the blind bougie technique is included in their failed airway clinical practice guidelines. This case report aims to describe the rapid sequence induction for intubation process and endotracheal tube placement in an adult trauma patient, presenting with a difficult airway, using the blind bougie technique in the out-of-hospital setting. A 35-year-old male patient was ejected from an all-terrain vehicle following a high-speed accident in the desert. The patient sustained an isolated head injury. Based on the patient’s clinical presentation, he required immediate endotracheal intubation for maintenance and protection of his airway prior to rapid transport to definitive care. Predictors of difficult airway were calculated. Using the blind bougie technique, endotracheal intubation was performed with first pass success. It is recommended that emergency medical services include the blind bougie technique of endotracheal intubation among their difficult airway procedures.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"148 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115175811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Emergency care practitioners’ views on the use of ultrasound in pre-hospital acute care settings","authors":"C. Vincent-Lambert, Ernest Marx, B. van Nugteren","doi":"10.24213/3-2-5522","DOIUrl":"https://doi.org/10.24213/3-2-5522","url":null,"abstract":"Background: Ultrasound may assist in the detection of life-threatening conditions and evolving pathologies. South African emergency care practitioners (ECPs) working in pre-hospital contexts have historically not used ultrasound to diagnose and treat patients. However, recently published clinical practice guidelines from the Health Professions Council of South Africa (HPCSA) suggest that ultrasound be considered as an adjunct in the provision of pre-hospital emergency care. Our study investigated ECPs’ views and perceptions of introducing ultrasound to their scope of practice.","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"220 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113984945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pre-hospital POCUS then and now","authors":"Christopher Stein","doi":"10.24213/3-2-5716","DOIUrl":"https://doi.org/10.24213/3-2-5716","url":null,"abstract":"","PeriodicalId":393807,"journal":{"name":"South African Journal of Pre-hospital Emergency Care","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132144339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}