GLOBAL EM
EMS Development in Low- and MiddleIncome Countries: Considerations for Improving Education Internationally
SAEM PULSE | MARCH-APRIL 2023
By Mel Ebeling, Ellen Schenk, PhD, MPH, and Nee-Kofi Mould-Millman, MD, PhD, MSCS, on behalf of the SAEM Global Emergency Medicine Academy
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In the United States, a call to 911 for a medical emergency normally results in an ambulance promptly arriving at the scene. This ambulance is usually stocked with equipment for a variety of chief complaints and, perhaps most importantly, staffed with at least one trained emergency medical technician (EMT) or paramedic with the skills to stabilize the patient. In several areas of the country, a fire truck and/or police officer, depending on the nature of the call, may also have been dispatched and available at the scene to provide additional support to the emergency response.
“Lack of skilled personnel has specifically been documented as a barrier to out-of-hospital emergency care in 61% of studies included in a review of prehospital care in LMICs.” While the emergency medical services (EMS) systems across the U.S. have their own challenges and inadequacies, reports consistently indicate that
many EMS systems in low- and middle-income countries (LMICs) are underdeveloped to adequately respond to out-of-hospital medical emergencies.