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JIS News

It is dinnertime and a family gathers around the table to eat together as they usually do. But, midway through the evening meal, the father suddenly clutches his chest. His panicked voice strains to utter his alarm while his suddenly weak legs collapse beneath him as he tries to stand. As his teenaged children and wife rush to his side, a grief-stricken spouse shouts for help. Her husband, lying helplessly on the ground, is in the midst of a heart attack. “Call for help,” she yells.
Help for the family in such a situation, can now come by dialling the emergency medical service (EMS) team at the nearest fire station and while the service is not yet available nation-wide, the Ministry of Health is working towards extending it to all parishes across the island.
Already, four fire stations located in the western region of the island – Ironshore in St. James, Negril and Savanna-la-mar in Westmoreland, and Lucea in Hanover – have fire fighters in their employ, who are trained as emergency medical technicians to respond to emergency scenarios.
Director of Emergency Disaster Management and Special Services in the Ministry of Health, Dr. Marion Bullock Ducasse, tells JIS News that the Ministry’s long-term plan is to expand the EMS to hospitals and fire stations spread across the entire island. The goal, she says, is to have such services available in each of the major townships within another three years.
Also referred to as pre-hospital emergency medical services, EMS include “those services utilised in response to an injury or illness in persons, who need to seek medical attention,” Dr. Bullock Ducasse explains.
“Persons will make a call or somebody will call on their behalf to the service and then trained persons with equipped ambulances will respond to ensure that they are assessed wherever they are, and they are stabilised and then transferred to a health facility or a higher level of care,” she says.
EMS technicians are trained to respond to emergencies caused as a result of medical conditions as well as injuries such as motor vehicle accidents or a fall. The technicians offer basic, intermediate and paramedic care and Dr. Bullock Ducasse notes that the care offered is dependent on the level of training. Only a few technicians provide paramedic care as the training is not provided locally.
However, all technicians, she stresses, execute their duties “using protocols, which have been developed for each common condition and with guidance from the doctors at the hospitals”.
As it presently obtains, Dr. Bullock Ducasee says, basic and intermediate-level technicians are trained at the University Hospital of the West Indies’ Department of Community Health and Psychiatry.
“There is a section there,” she tells JIS News, “that does the pre-hospital emergency medical service training for us for the emergency medical technicians at the basic and intermediate levels.they also offer courses for operation of emergency medical vehicles because it is a vast difference from driving a vehicle and driving an ambulance at high speed with injured patients and staff on board”.
“So, as the training continues, we recognise that there are many modalities, so while we train persons to see the patient and care for them, we have to make sure that they arrive at the health facility safely as well,” Dr. Bullock Ducasse adds.
Speaking further, she tells JIS that, “we are strengthening the Ministry of Health’s EMS directorship so that whatever is encountered in terms of a medical emergency, they [EMS technicians] have the capacity for stabilisation to ensure adequate transfer to the hospital and for guidance en route, that is provided by the medical team at the hospital”.
The EMS service was introduced in Jamaica in 1996 and the Health Ministry, in its role as implementing agency, is responsible for all medical aspects of the programme such as setting norms and standards, training emergency medical technicians, and providing ambulances.
“Through our medical directorship, we ensure that there is ongoing certification and training,” Dr. Bullock Ducasse emphasises, adding, “we also make contact with the hospitals prior to arrivals to ensure that the hospital emergency departments are prepared for the patients, who are coming in to their facilities”.
Besides the four fire stations currently offering EMS services, the Linstead fire station is being equipped as a service provider, while the Waterford fire station in Portmore, St. Catherine is slated to come on stream within another two months. Furthermore, the Spanish Town Hospital is under consideration to become a service provider and the Falmouth fire station, which is presently being constructed, will also provide EMS services.
“The other developments are that we are also developing a model where the service would be based at the emergency departments of the hospital so persons, who call the service soon, will have a response from the fire brigade-based service.we are looking at May Pen and St. Ann’s Bay for the hospital-based service,” Dr. Bullock Ducasse discloses.
In addition, she informs that 60 ambulances will be added to the health care service over the next two years, which will be utilised in the regular hospital service and as part of the EMS response.
Turning to the upcoming hurricane season, which begins next month, and the capacity of the EMS to respond to a wide-scale disaster, Dr. Bullock Ducasse informs that the Ministry of Health has an ongoing disaster management programme, which is activated should a disaster such as a hurricane strike the island.
“Through this programme. there is an ongoing level of preparedness,” the Director tells JIS News. “We respond to emergencies on a daily basis, and we activate our emergency operation centres for any large [scale] emergency or disaster under the guidance of the Office of the Disaster Preparedness and Emergency Management (ODPEM), and this is something that we do in an ongoing way,” she further notes.
Last year, the EMS programme responded to calls for assistance during Hurricanes Dennis, Emily and Wilma.
Detailing the EMS’ response in the event of a disaster, Dr. Bullock Ducasse tells JIS News that, “for the alert phase, we verify whatever information we get. if it is something such as a hurricane or an event that is being managed by ODPEM, we immediately collaborate with them to determine the magnitude or the scale of the event, then we contact the relevant facilities, the closest hospital and health department”.
She explains that in each parish, the Medical Officer of Health, who is based at the health department, has the responsibility to ensure that the response in their parish is well directed and coordinated. If necessary, she points out, emergency operation centres are activated with critical staff in place to determine the level of damage or the extent of the event, to determine the response.
“The coordination is all managed at parish level, whether in the region or nationally, to ensure that it is comprehensive and also to ensure that it is appropriate,” Dr. Bullock Ducasse says.
She cites the recent cruise ship fire that occurred off the coast of Montego Bay, as an example of the responsiveness of the Ministry’s EMS. “I can commend the entire health team, because the response from the Cornwall Regional Hospital and those surrounding.they started by preparing their emergency departments to accept larger numbers of patients, discharging patients to make space available, preparing their operating theatres, and having additional supplies in place,” she explains.
In terms of preparations for the ICC Cricket World Cup next year, Dr. Bullock Ducasse informs JIS News that the Pan American Health Organisation and ODPEM, are collaborating in organising training sessions in mass casualty management, incident command system, and emergency care and treatment.
“This is multi-sectoral training,” she says of the training sessions, “where there are representatives from the Ministry of Health, Jamaica Fire Brigade, Jamaica Constabulary Force, Jamaica Defence Force, and ODPEM”.
She says the training sessions are underway, with courses scheduled this month for emergency care and treatment, mass casualty management and incident command system.
“There will also be more training in those three categories in June and in October, we hope to do a major simulation exercise looking at a mass casualty situation based on a scenario for cricket, so that we can plan and rehearse how we will respond for the event next year,” Dr. Bullock Ducasse says.