GPHC’s A&E Dept – Transforming Emergency Care in Guyana

Jun 21, 2015 News

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By Dr Zulfikar Bux

Assistant Professor of Emergency Medicine

The Accident & Emergency (A&E) Department of the Georgetown Public Hospital Corporation

(GPHC) provides services to the entire Guyana. This department has the unique responsibility of accepting complicated patient cases from all institutions in the country, but also has to deliver emergency care to the general population according to the daily demands.

Achieving this takes meticulous coordination of services and continuous development of resources. Over the past five years there has been significant transformation of the services provided and patient care has benefited tremendously. We will focus on the major developments during this period which have served to improve patient care.

SPECIALIST TRAINING FOR DOCTORS

Similar to having surgeons to do surgery and pediatricians to take care of children, emergency medicine specialists coordinate and deliver emergency medical care for patients of all description and presentation. The GPHC A&E currently has three of these specialists and has 14 others in training to supply the needs of our country.

This high quality training is provided by the prestigious Vanderbilt University and Medical Center of the USA. Our goal is to have trained emergency medicine specialists in every Emergency Room of hospitals in the country. We will then develop the emergency medical services of these hospitals so that patients can access efficient specialist emergency medical care at every regional hospital.

SPECIALIST TRAINING FOR NURSES

While our initial focus was on training specialist doctors, we are aware that efficient emergency medical care is team-based and our focus has broadened to ensure emergency medicine training is also delivered to our Nurses. Over the past two years, ongoing emergency nursing training has been delivered and has so far been well received. This training has been broad-based and has taken collaboration from the Vanderbilt emergency nursing training, the Atlantic EMS training partners and local faculties. Emergency Nursing care has been transformed and our patients have benefited tremendously from this initiative. Our goal is to begin a formal specialist emergency medicine training programme for our nurses. This will be done by the Vanderbilt Medical Center and will be an equivalent specialist training programme, similar to what is being done for the doctors. Having specialty-trained emergency nurses is a key concept in emergency patient care. Support will be needed from all if we are to strive together to develop emergency patient care.

AMBULANCE SERVICE (EMERGENCY MEDICAL SERVICES)

Currently our country does not have an established Ambulance Service to respond to public emergencies as needed. The GPHC A&E started a pilot Ambulance service 18 months ago and we currently have 20 trained Emergency Medical Technicians with two Ambulances to respond to Public Emergencies. This project was started in collaboration with the Vanderbilt Medical Center and the Morris Foundation of the USA. This small unit has so far successfully completed over 4000 patient transfers. Three babies were delivered en route to the Hospital and many accident and heart attack patients have benefitted from this efficient response mechanism. Our plans are to gradually expand to a National Ambulance Authority where every Guyanese can have access to emergency transport to a hospital when the needs arise.

REGIONAL COLLABORATION

We have benefitted from collaboration with our emergency medicine counterparts in Trinidad and our doctors rotate there to gain a regional perspective of Emergency medicine. Our Physicians have also contributed by teaching and sharing knowledge with our emergency counterparts there.

We have also trained the first Emergency Medicine Specialist for Antigua and that Physician is now developing the emergency services on that island. Other Caribbean territories have recognized our work and have made requests for our assistance in developing Emergency medical care in their country.

I have mentioned concepts based on systems development for Emergency medicine, but there are other developments in this specialty at the GPHC A&E which are too numerous to mention in this article.

We have our challenges like every other system. The staffers of this department have worked consistently to ensure that their decisions, actions, and goals do not affect patient care. I encourage them to preserve and continue to work in the best interest of our patients and that we always strive for the goal that we have formulated; “In times of disparity, err on the side of the patient”.

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