Time to improve pre-hospital care in developing countries

Abstract

Developing countries such as Indonesia do not have well established emergency medical service (EMS) systems like Australia, New Zealand, the United Kingdom and the United States of America. However, a considerable amount of research, development and funding are paving the way for developing countries to enhance and evolve their systems to suit their needs. The Health Ministry in Indonesia recently announced the introduction of a 119 emergency number for Indonesians to activate the response of an ambulance to an emergency medical or trauma situation (1). In spite of this, there is no guarantee that an ambulance will arrive in a timely manner due to a multitude of reasons. There are potential issues with the redirection of the emergency call from the call centre to the appropriate hospital to deal with the emergency situation. Another issue is the lack of infrastructure and resources in which to manage the emergency response. The majority of ambulances in Indonesia are staffed by emergency nurses from the hospital emergency department (ED) or nursing staff from the Puskesmas (a community health clinic). The staffing of the ambulance varies from one non-medical qualified driver and two nurses to one driver and one nurse. These ED and Puskesmas nurses have varying qualifications and skill levels.