Pediatric emergency medical care in Yerevan, Armenia: a knowledge and attitudes survey of out-of-hospital emergency physicians.

BACKGROUND: Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement. METHODS: We distributed an anonymous, self-administered Knowledge and Attitudes survey to a convenience sample of out-of-hospital EPs in the capital, Yerevan, from August to September 2012. RESULTS: With a response rate of 80%, the majority (89.7%) of respondents failed a 10-question knowledge test (with a pre-defined passing score of ≥7) with a mean score of 4.17 ± 1.99 SD. Answers regarding the relationship between pediatric cardiac arrest and respiratory issues, compression-to-ventilation ratio in neonates, definition of hypotension, and recognition of shock were most frequently incorrect. None of the participants had attended pediatric-specific continuing medical education (CME) activities within the preceding 5 years. χ2 analysis demonstrated no statistically significant association between physician age, length of EMS experience, type of ambulance (general vs. resuscitation/critical care), or CME attendance and pass/fail status. The majority of participants agreed that PEC education in Armenia needs improvement (98%), that there is a need for pediatric-specific CME (98%), and that national out-of-hospital PEC guidelines would increase PEC safety, efficiency, and effectiveness (96%). CONCLUSIONS: Out-of-hospital emergency physicians in Yerevan, Armenia are deficient in pediatric-specific emergency assessment and resuscitation knowledge and training, but express a clear desire for improvement. There is a need to support additional PEC training and CME within the EMS system in Armenia

How to Incorporate Global Health into Your Curriculum/Course

Objectives: 1. Understand that education on global health concepts is demanded by the student body, and how it relates to a variety of courses already taught on campus. Relevant concepts include Health \u26 Equity, Role of culture in healthcare, Healthcare delivery systems, Disaster preparedness and response, Communicable and non-communicable diseases, Women’s and children’s health, and Nutrition and mental health. 2. Understand that involvement and improvements in global health require multi-disciplinary involvement and are not limited to international work (the “local” in “glocal”) 3. Identify strategies to incorporate these global health concepts into existing coursework, especially using the upcoming Mobile Interactive Courseware Platform. 4. Identify risks/benefits associated with global health service opportunities such that they may appropriately guide and mentor students interested in such opportunities. 5. Identify strategies to help students structure their global health activities so that they are mindful of ethical issues and maximize their scholarly potential Presentation: 46 minute