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Physicians’ Perceptions of Life-Threatening Emergency Management in Guyanese Health Centers

Annales Francaises de Medecine d'Urgence, ISSN: 2108-6591, Vol: 12, Issue: 4, Page: 219-223
2022
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Article Description

Introduction: Life-threatening emergencies are common in remote Guyanese health centers. The medical population is composed of general practitioners with lack of training in emergency medicine. Methods: We conducted a descriptive study using a questionnaire distributed through a mailing list of 310 contacts of physicians who have worked in the remote health centers (RHC) from 2010 to 2019. Results: We obtained 90 responses out of 310 (29%) and analyzed 87 (28%). The majority of physicians were general practitioners (72%) under 40 years of age (69%) without emergency medicine training (76%). The most common emergencies were comas and polytrauma as well as gynecological and obstetrical emergencies. The majority of the physicians reported being uncomfortable during these treatments (67%). The relationship with the emergency medical service (EMS) was judged to be mostly appropriate (93%). The assistance provided by the RHC paramedical team was judged correct in 49% and excellent in 48% of cases. More than one physician out of five (21%) stated that they did not want to renew their RHC contract because of the experience of life-threatening emergencies. In order to improve the management of serious patients, the physicians are in favor of the presence of reflex cards (87%), pre-assignment training on mannequins (75%), short training courses in resuscitation by emergency physicians (67%), alternatives to orotracheal intubation such as supraglottic devices (68%), and telemedicine-guided assistance (30%). Conclusion: This work reveals a significant suffering of physicians facing the difficulties in the management of vital emergencies. In order to respond to the issues raised by this study, the majority of the improvement measures mentioned in this work are being implemented since the end of 2019.

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