Oxygen delivery system in pre-hospital emergency care in india GVK EMRI 108: a review article

The goal of an effective emergency medical system should be to provide universal emergency care along with assured quality. Oxygen is often used drug in the pre hospital. Oxygen delivery can be monitored by pulse oximetry, typically with a goal of reversing hypoxemia. This paper describes the importance of oxygen in emergency care and its contribution to reducing avoidable death and disability. It also highlights the oxygen delivery systems and training processes /protocols in ambulance based pre-hospital care. In addition, it also shares the usage rates of oxygen and delivery methods in thermal and electrical burns in 108 GVK EMRI, India ambulances. A descriptive study methodology was adopted for explaining the training and pre-hospital care processes of oxygen delivery. Retrospective study method was adopted to measure the oxygen utilization rates in management of burns cases in 108 ambulances in the year 2015. EMTs consistently assessed vitals and provided oxygen to patients’. When EMTs found that patients’ had oxygen saturation less than 95%, they provided supplemental oxygen 95% of the times. EMTs though adhering to the routine use of oxygen in 9 out of 10 cases “where indicated, refresher training should focus on use of oxygen in special circumstances and the benefit to be closely monitored for favourable clinical outcomes”. There is a need to study such common and important essential pre-hospital interventions in all types of emergencies being served

Characteristics of Prehospital Heat Illness Cases During the Annual Heat Wave Period in Telangana, India

AbstractObjectives:Global warming and more intense heat wave periods impact health. Heat illness during heat waves has not been studied in the prehospital setting of a low- and middle-income country (LMIC). Early intervention in the community and in the prehospital setting can improve outcomes. Hence, this paper aims to describe the characteristics of heat illness patients utilizing the ambulance service in Telangana state, India with the aim of optimizing public prevention and first aid strategies and prehospital response to this growing problem.Methods:This retrospective observational study reviewed patients presenting to Telangana’s prehospital emergency care system with heat illness symptoms during the heat wave period from March through June in 2018 and 2019. Descriptive analysis was done on the prehospital, dispatch, and environmental data looking at the patients’ characteristics and prehospital intervention.Results:There were 295 cases in 2018 and 230 cases in 2019 from March-June. The overall incidence of calls with heat illness symptoms was 1.5 cases per 100,000 people. The Scheduled Tribes (ST) had the highest incidence of 4.5 per 100,000 people. Over 96% were from the white income group (below poverty line) while two percent were from the pink income group (above poverty line). From geospatial mapping of the cases, the highest incidence of calls came from the rural, tribal areas. However, the time to response in rural areas was longer than that in an urban area. Males with an average age of 47 were more likely to be affected. The three most common symptoms recorded by the first responders were vomiting (44.4%), general weakness (28.7%), and diarrhea (15.9%). The three most common medical interventions on scene were oxygen therapy (35.1%), oral rehydration salt (ORS) solution administration (26.9%), and intravenous fluid administration (27.0%), with cold sponging infrequently mentioned.Conclusion:This descriptive study provides a snapshot of the regions and groups of people most affected by heat illness during heat waves and the heterogeneous symptom presentation and challenges with management in the prehospital setting. These data may aid planning of prehospital resources and preparation of community first responders during heat wave periods.</jats:sec