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Preparing for Preparedness Development of Emergency and Disaster Medicine System (EDMS) in Latvia. Maija Busmane, MD Chief of Department of Planning and Cooperation Centre of Emergency and Disaster medicine, Ministry of Health Latvia maija.busmane@kmc.gov.lv Co-authors:

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preparing for preparedness development of emergency and disaster medicine system edms in latvia

Preparing for PreparednessDevelopment of Emergency and Disaster Medicine System(EDMS)in Latvia

Maija Busmane, MD

Chief of Department of Planning and Cooperation

Centre of Emergency and Disaster medicine,

Ministry of Health Latvia

maija.busmane@kmc.gov.lv

Co-authors:

M.Sics, MD; R.Pupele, MD; E.Akitis

Centre of Emergency and Disaster Medicine

slide3

Centre of Emergency and Disaster Medicine

2004 –2005

  • Uncommon nature

outbreaks for Latvia

(storms and black - out,

earthquake)

The world has changed also in Latvia

  • Large flood and

forest fires

  • Technical and traffic

accidents with mass

casualties

  • Real terrorism

threat

slide4

Centre of Emergency and Disaster Medicine

Studyobjectives:

Analysewhat does PREPARADNESSmean for health care stakeholders and how toprovide itin the best possible way and in the context with

  • health care reforms
  • civil military crises management
  • international cooperation
slide5

Centre of Emergency and Disaster Medicine

Methods used

  • Site investigation
  • Data collection
  • Questioning
  • Assessment
  • Comparison
  • Forecasting
slide6

Centre of Emergency and Disaster Medicine

SDR (per 100 000), 2003.

Source: European HFA Datebase, June 2005.

slide7

100

80

60

Survival ( % )

40

20

0

5

10

15

20

25

30

Time till defibrillation ( % )

Centre of Emergency and Disaster Medicine

Possibilities to prevent the Sudden Death

Every minute lost

reduces

survival rate !!!

slide8

Centre of Emergency and Disaster Medicine

Pre-hospital Emergency Medical Services today

  • Dispatching Centreswith

different capacityand

without interconnection

  • Municipality “Border

problems”

  • Unique EMS call problem
  • Costs ineffectiveness
  • Lack of Ambulance Teams

(personnel)

  • Irregular location of

Ambulance Teams

  • Lack of Ambulance

vehicles, technical and

medical equipment

slide9

Centre of Emergency and Disaster Medicine

EMS calls and calls completion

(day average)

slide10

Centre of Emergency and Disaster Medicine

Conclusions

  • There are no facility for effective management of
  • EDMS common resources in circumstances while
  • p-h EMS’s providers management is
  • decentralized;
  • There are unequal possibilities to receive p-h EMS
  • in day-to-day and in case if Disaster occurs;
  • New infrastructure and organization for medical
  • institutions involved to prevent emergency
  • consequences is certainly necessary.
slide11

Centre of Emergency and Disaster Medicine

Several principles and approaches considered for

creating a new scheme of EMC to cover the

patients` needs for equal availability of services

(on time and qualitative)

  • Subsidiarity
  • Coordination
  • Succession
  • Consolidation of resources
  • Intersectoral scope

Essential attention must be paid to all transitions

of Health Care System and HealthProfessionals`

attitude towards Reforms

slide12

Centre of Emergency and Disaster Medicine

Pre-hospital EMS in the foreseeable future

Unified management

system

Three levels:

  • Central Management
  • Unit (CMU)
  • Regional Management
  • and Dispatcher
  • Centres (RMDC)
  • Ambulance Location
  • Points Network
  • and Ambulance teams
slide13

Centre of Emergency and Disaster Medicine

RMDC

Call completion business processes

User Functions

Calltaking

Interview

Decision

about Call

completion

Call

completion

Maintainance

of basic data

Support algoritm for interview

Identification

of competence

Support

for Call

completion

Event

analysis

Decision

delivery

Support

from

Senior

Doctor

I

Call completion

Final Report

Call Card

complition

Call Card

delivery

Call Card

closing

SystemFunctions

slide15

Benefits expected after implementationnew

pre-hospital EMS DispatchSystem I

Centre of Emergency and Disaster Medicine

  • Save more people lives
  • Increase EMS accessibility to meet international standards(response time, unitary call number, quality)
  • Increase EMS management role as a support for

internationalcooperation, for Civil Military Crisis

Management assistance, especially in case of CBRN threats

increase capacities for NATO Crisis ResponseSystem

  • Model can be used as EU co-operation system
  • Support EDMS planning
slide16

Benefits expected after implementationnew

pre-hospital EMS DispatchSystem II

Centre of Emergency and Disaster Medicine

Provide:

  • unitary quality control and statistics system
  • synergy effect and efficient use of available resources
  • better co-operation and co-ordination with other

rescue services,institutionsetc.

  • co-ordination of Specialized Emergency care,

Consultancyservice, Reserves, Hospital services,

Medicaltransportation service and other Health resources

  • capacity for PHC call management (PHC central)

and possibility for call separation

slide17

Centre of Emergency and Disaster Medicine

Matter of Opinion – direct call to EMS

TODAY 112 + 03 (direct Call to EMS)

Statement of EMS development

determines

112 + ”xx3”

(direct Call to EMS)

Overwise – minders

Demands

Only 112

DISCUSSION:

Which of above mentioned two ways is more relevant to save people lives and keep them well ?

slide18

Centre of Emergency and Disaster Medicine

Pyramid of Preparedness

CORNERSTONES:

  • Provision of EDMS Resources
  • Methodological management of EDMS in “peace time”

COORDINATION

  • Education, Training and

International cooperation

MANAGEMENT

  • Monitoring of every day EMS
  • High developed Hospital’s

Admission and Emergency units

  • High developed prehospital EMS –

thebasic Operational Unit of EDMS

MANAGEMENTAND COORDINATION

- the most relevant factor for preparedness,

particularly ifresources are limited

slide19

Centre of Emergency and Disaster Medicine

The Government of Latvia

has adopted

Policy Statement of EMS development

2005 –2010

(12.07. 2005.)

slide20

Centre of Emergency and Disaster Medicine

To be

continued ...

To be continued ...

Thank you

for your attention !