Big changes needed to emergency medical response

by Brian JM Joseph

There’s need for some serious changes that to take place within our healthcare system, especially the way we respond to emergencies here in Grenada.

Those individuals in charge of our healthcare services need to be cognisant of the facts that nurses aren’t supposed to be working on ambulances. Ambulances are supposed to be staffed with paramedics and Emergency Medical Technicians (EMTs), and not nurses.

In the medical field, all healthcare professionals have their roles to play, and therefore it requires teamwork and collaborative effort from everyone and it can be considered as networking. It’s time that we stop those irresponsible practices and staff the ambulances with the necessary medical personnel — healthcare professionals who are trained in advanced emergency care, and not just individuals who have been given basic life support (BLS) training. It takes more than just BLS training for someone to administer advanced medical care to individuals who are in urgent need of it.

To administer care it takes a different mindset, and one needs to stay focused on what he/she has to do. I have seen many healthcare professionals panic during emergencies. There’s a number of skills that needed in an emergency, for example, airway management, patient assessment and you have to know how to handle trauma etc. If healthcare professionals cannot stabilise their patients at the scene of an accident before transportation, it will prove detrimental, while trying to transport them in a rush via ambulance because they’re supposed to be stabilised at the scene, and there’s an allotted time for doing so.

The ‘golden hour’ is a term often used in trauma to suggest that an injured patient has 60 minutes from time of injury to receive definitive care, after which morbidity and mortality significantly increase. I have been noticing a lot of errors in judgement as it relates to those in management, because for years they’ve been equipping the ambulances without right personnel especially when responding to emergencies. For example, as it relates to serious airway management, only paramedics and doctors can intubate patients by inserting an endotracheal tube (ET), to assist with breathing. For instances when nurses are sent out on ambulances “they cannot intubate” therefore it will prove detrimental for these victims. The majority of nurses are mostly trained in bedside nursing, unlike others who are looking for alternatives by academically attaining a Bachelor of Science in Nursing (BSN) who will be able to branch out into other areas. Most definitely we have a serious problem on our hands and that issue needs rectifying.

The management team of the Ministry of Health, including hospital administration, you have some serious groundwork to do in terms of providing better ambulance services. We cannot just do things haphazardly anymore, and it’s time to start thinking of new alternatives in providing better emergency services. There’s needs to be coordination between fire service, police officers and medical personnel. We need trained and certified EMRs, and they must be placed under a dispatcher system. An ambulance shouldn’t be the one arriving at the scene of an accident; it should be fire service, police officers and EMRs.

I’m calling on the relevant individuals within the healthcare system to desist from such practices and allow the nurses to carry out their bedside nursing duties and stop stressing them with such responsibilities designated for EMTs, paramedics and EMRs.