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First responders are an integral part of the health care system

Apr 06, 2013 Letters

 

 

DEAR EDITOR,
What happened to A Partnership for National Unity (APNU) Member of Parliament Richard Allen, who collapsed in the National Assembly on Thursday, exposed some glaring deficiencies in our emergent health delivery system.
Mr. Allen collapsed on the floor of the house at exactly 1400hrs and it took a full fifteen minutes for an “ambulance” to arrive. He was eventually transported away from the Parliament Complex at 1420 hrs; (a full 20 minutes had elapsed from the time this medical incident started) and even though Mr. Allen was surrounded and assisted by many of his colleagues who are Medical Doctors, even they lacked the basic equipment (sphygmomanometer and stethoscope) to do a primary evaluation (check his vital signs… blood pressure etc). So even though highly trained first responders were present, these professionals were handcuffed by a lack of basic equipment.
The National Assembly, especially when in full session, is a vital point in the Leadership of Guyana and Thursday’s incident exposed many deficiencies and weaknesses that need to be addressed immediately. However, that this happened during the 2013 budget debate should serve to focus the attention of the relevant authorities on much needed priorities in our health delivery system.
As more and more people move from the rural areas and our suburbs extend further and further away from the city and major medical centres. Emergency medical care and the role of First Responders become more critical to the national health delivery system. First Responders are the first medically trained personnel to arrive at a scene. Usually in the First World they are Police Officers, Emergency Medical Technicians, Fire and rescue officers or Para-medics. In Guyana, sadly our ambulance service which has gone through several evolutions, has not kept pace with the technology and the advances of acceptable best practices in emergency medicine.
The Ambulance service in Guyana is a throw-back to a long gone era. It is limited to transporting patients, without the capacity or the capability to provide any emergent medical care. The vehicles that are used as ambulances are not adequately equipped with life-saving equipment, and the fleet is small and not strategically placed geographically to meet the needs of a growing urban and interconnected rural population.
Most times when someone is the victim of some type of trauma they are hustled into a private vehicle and rushed to the nearest hospital or medical clinic. The persons rendering assistance are usually not trained in basic first aid, pay no attention to spinal stabilisation or bone fracture mobilisation or have any training in cardio pulmonary resuscitation (CPR).  The result is that precious time is lost and sometimes more harm is done by moving these patients using such primitive and non-medical methods of transportation.
The time has come for the architects of our health delivery system to build an emergency medical network with coordinated communication centres, well-equipped ambulances and well-trained emergency medical technicians, Para-medics and Fire and Police officers, who are trained in providing basic pre-hospital care for medical emergencies.
This is the type of human service initiative that should be on the front burner of the Government of Guyana. It is an established medical fact that the initial care received by a patient has a profound effect on their overall prognosis and recovery. It is a sad commentary that in 2013, Guyana does not have emergency medical response centres and a modern ambulance service.
The controversial Marriott Hotel, an investment of over $51 million US dollars, will not add to the quality of life or improve the quality of the national health delivery system. However with the same investment dollars (51 Million US), the government would be able to build ten regional 911 centres and purchase and equip over 1000 ambulances and train the Emergency Medical Technicians to man them. This is the type of investment in human development that unfortunately is sadly lacking in Guyana today.
Mark Archer

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