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Managing medical emergencies: Sustainable pre-hospital medical education in Rwanda


A. Shustak
J. M. Uwitonze
J. Kabagema
M. Wojick
B. Asay
A. Louka
L. Wolfe
T. Dushime
S. Jayaraman

Abstract




INTRODUCTION: In Rwanda, non-communicable diseases accounted for 44% of all reported deaths as of 2016. Yet, there is very limited data on pre-hospital management of emergency medical conditions in LMICs. We evaluated the impact of a pre-hospital medical emergencies training course and train-the-trainers program for Service d’Aide Medicale Urgente (SAMU) to address the burden of NCDs.


METHODS: A 100-question baseline assessment was administered to 25 SAMU staff to assess knowledge of basic anatomy, physiology, medicine, obstetrics, pediatrics, trauma, and scene safety. A two-day Emergency Medical Care Course (EMCC) was developed. Two cohorts (one for instructors and another one for staff) from ten district and provincial hospitals. EMCC 1 and a one- day educator course were conducted for the instructor core. They then taught the second cohort of trainees (EMCC 2).


RESULTS: In the baseline assessment of 25 SAMU staff, the median score was 56% overall and 54% in medical. EMCC 1 median scores were 43% vs 86% (pre vs post), p<0.001 using matched pair analysis of 18 participants. EMCC 2 median scores were 45% vs 82% (pre vs post), p<0.001 using matched pair analysis of 16 participants. A one-way ANOVA mean square analysis showed no statistically significant difference between the two cohorts post-training, with similar post- assessment scores.


DISCUSSION: This study showed that the course improved knowledge for an instructor core and staff from district and provincial hospitals, confirming the effectiveness of a train-the-trainers model, which will allow for sustainability in pre-hospital emergency medical training in Rwanda.





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eISSN: 2410-8626