Integrated Clinical Clerkship in Emergency Medicine AY 2021- 2022

Pre-hospital care encompasses all processes and efforts made towards assessing, treating, and stabilizing the patient prior to arrival at the hospital. It is especially important in patients with acute life-threatening conditions, as these may require on-site assessment and stabilization. There should be a universally accessible dispatch and EMS communication system, wherein patients, family members or bystanders can easily contact a service for EMS dispatch to their area. EMS response should be prompt, with assessment and stabilization occurring upon arrival to the scene. Prior to arrival, there should be open communication between the bystanders and the dispatch, so that pre-arrival instructions may be given and carried out. Once the patient is stable, it is dire that a system of dispatch and transport is available to transfer the patient to a facility capable of definitive care. In the case of the patient in the documentary, his tuberculosis remains untreated because of the distance between his house and that of the healthcare facility. There is no extant dispatch and transfer service that can reach their home in the mountains. Thus, the weakened patient must be carried and brought to the facility on foot in order to be assessed and treated. There is also limited signal in their remote village, limiting the usability of telecommunications. This is far from the ideal. An efficient pre-hospital care system should be capable of reaching patients geographically isolated places. Especially in emergent cases, the lack of an efficient EMS worsens patient outcomes as they do not have access to evaluations and treatments that are time-sensitive.