DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20183233

Oxygen delivery system in pre-hospital emergency care in india GVK EMRI 108: a review article

Rani Janumpally, Aruna Gimkala, Usha Saie M., Ramana Rao G. V.

Abstract


The goal of an effective emergency medical system should be to provide universal emergency care along with assured quality. Oxygen is often used drug in the pre hospital. Oxygen delivery can be monitored by pulse oximetry, typically with a goal of reversing hypoxemia. This paper describes the importance of oxygen in emergency care and its contribution to reducing avoidable death and disability. It also highlights the oxygen delivery systems and training processes /protocols in ambulance based pre-hospital care. In addition, it also shares the usage rates of oxygen and delivery methods in thermal and electrical burns in 108 GVK EMRI, India ambulances. A descriptive study methodology was adopted for explaining the training and pre-hospital care processes of oxygen delivery. Retrospective study method was adopted to measure the oxygen utilization rates in management of burns cases in 108 ambulances in the year 2015. EMTs consistently assessed vitals and provided oxygen to patients’. When EMTs found that patients’ had oxygen saturation less than 95%, they provided supplemental oxygen 95% of the times. EMTs though adhering to the routine use of oxygen in 9 out of 10 cases “where indicated, refresher training should focus on use of oxygen in special circumstances and the benefit to be closely monitored for favourable clinical outcomes”. There is a need to study such common and important essential pre-hospital interventions in all types of emergencies being served.


Keywords


Emergency ambulance services, Oxygen administration system, Oxygen delivery systems, Pre-hospital setting, Training process

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References


Hopple J. No clue about O2: teaching oxygen therapy to pre-hospital providers. JEMS. 2011;36(12):28-9.

Cornet AD, Kooter AJ, Peters MJ, Smulders YM. Supplemental oxygen therapy in medical emergencies: more harm than benefit? Arch Intern Med. 2012;172(3):289-90.

Metcalfe M. Improving the safety of oxygen therapy in the treatment of acute myocardial infarctions. International Emerg. Nurse 2012;20(2):94-97.

Anderson D. Behind the mask: is oxygen harming your patient? JEMS. 2011;36(7):50-5.

Emergency Medical Technician preparatory text book. Hyderabad: GVK Emergency Management and Research Institute; 2012.

The automotive research association of india. automotive industry standard, Constructional and Functional Requirements for Road Ambulances (National Ambulance Code). 2013. Available from: http://www.nisc.gov.in/PDF/AIS_125.pdf.

O’driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008 Oct 1;63(Suppl 6):vi1-68.

GVK Emergency Management and Research Institute; 2005. Available at: http://www.emri.in.

Manual of Pre hospital Emergency Care Protocols 2nd Edition. October: Stanford Emergency Medicine International USA and GVK Emergency management and research institute India; 2012.

National Health Mission. Specifications of medical equipments for ERS Ambulances under National Health Mission and type of ambulances. 2017. Available from: http://nhm.gov.in/images/pdf/ programmes/ERS/Specification_of_Equipments_for_ERS_Ambulance.pdf.

Tintinalli, Judith E. EMS: A Practical Global Guidebook. PMPH-USA, Ltd. for International Federation for Emergency Medicine, EMS equipment. 2010:266-267.

O’Connor RE, Brady W, Brooks SC, Diercks D, Egan J, Ghaemmaghami C, et al. Part 10: Acute coronary syndromes. 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;2:122(18 Suppl 3):S787-S817.

Jauch EC, Cucchiara B, Adeoye O, Meurer W, Brice J, Chan YY, et al. Part 11: adult stroke: 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S818-S828.

Morrison LJ, Deakin CD, Morley PT, Callaway CW, Kerber RE, Kronick SL, et al. Part 8: Advanced life support: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2010;122(16 Suppl 2):S345-S421.

Kosowsky JM, Stephanides SL, Branson RD, Sayre MR. Prehospital use of continuous positive airway pressure (CPAP) for presumed pulmonary edema: a preliminary case series. Prehosp Emerg Care. 2001;5(2):190-6.

Kirkman E, Watts S, Cooper G. Blast injury research models. Philos Trans R Soc Lond B Biol Sci. 2011;366(1562):144-59.

American Academy of Orthopaedic Surgeons. AEMT: Advanced Emergency Care and Transportation of the Sick and Injured. Jones & Bartlett Publishers; 2011 Mar 30.