[accordion] [acc_item title=”General”] Capital – Abu Dhabi
Land Size – 83,600 sq km
Population – 4,975,593
Language(s) – Arabic (official), Persian, English, Hindi, Urdu

[/acc_item] [acc_item title=”Prehospital Care Overview”]
  • “In addition to significant economic and societal changes, remarkable improvements have been made in the provision of health care services” (Sasser, 51)
  • Emergency medicine and EMS “are currently limited, with the UAE best described as being in the ‘developing phase’” (Sasser, 51).
  • Presently no uniform medical control or treatment protocols, communications systems, systems management, training or education, or quality assurance policies” (Sasser, 51)
[/acc_item] [acc_item title=”EMS System Model”]
  • Abu Dhabi (est. pop. 900,000 – 2004)
    • Multiple providers, typically based out of hospital facilities
      • Public providers
        • Ministry Of Health
        • Civil Defense
        • Police Department
      • Private
        • Private hospitals may provide response to private requests for service (e.g., Inter-facility)
    • “Some attempt is made to post units at locations where requests for service may be anticipated; however, there is no developed method of system status management” (Sasser, 53)
    • Transport
      • “Ambulances often proceed directly to their base facility regardless of patient complaint, critical nature, or proximate resources” (Sasser, 54)
      • Long response/transport times
      • Communication between ambulance and hospital exists
        • “No consistent system of protocols that govern utilization” (Sasser, 54)
          • Personnel often depend on personal mobile phones
        • Little advanced notification
[/acc_item] [acc_item title=”Lead Agency”]
  • Ministry of Health
    • Provides majority of oversight for government-related health care services
    • There may be more than one governmental body responsible for provision of health care in individual emirates
[/acc_item] [acc_item title=”Funding”]
  • Public
    • Majority of health-care services provided by government-funded facilities
    • Health care provided free of charge to UAE nationals
    • 2001 – government stopped subsidization of expatriate health care
      • Fines may be given to expatriates visiting public EDs “whose illnesses are deemed to be nonurgent”
  • Private
    • Private sector is increasing significantly
[/acc_item] [acc_item title=”Levels of Care”]
  • Ambulances
    • Type II (vans) – majority
    • Type I (modular) – increasing in number, with some ALS equipment
    • GMC Suburban – several maintained by MOH; operate as fly-cars or for back-up assistance
  • “Equipment available in most ambulances is highly variable, and ranges from [BLS] to [ALS]” (Sasser, 54)
    • Lacking equipment/medication formularies
  • Ambulances staffed by “a variety of providers, depending on the organization involved, and may include physicians, nurses, or paramedics (designated by their countries of origin)” (Sasser, 54)
    • “Based on our experience, some individuals do have an expanded knowledge base for prehospital medicine, but most seem to have little formal medical training” (Sasser, 54)
    • Also staffed by driver, typically lacking medical training “and contributes little to patient care activities” (Sasser, 54)
[/acc_item] [acc_item title=”Education and Training”]
  • “No designations or certification standards for providers within UAE” (Sasser, 54)
    • EMTs are not recognized by MOH
  • Certain organizations staff “paramedics”
    • Typically expatriates trained and formerly employed in native country
[/acc_item] [acc_item title=”Specialty Services”]
  • Air Medical Wing – Abu Dhabi National Police
    • Operates throughout UAE
      • Interfacility transfers, scene response, technical rescue, extrication and dive rescue
    • Minimal call volume
      • “Only in recent years has it expanded beyond VIP transport” (Sasser, 54)
    • Staffed by:
    • Paramedics – Scene responses
      • Physicians (typically general practitioners) – Interfacility
      • Minimal training and continuing education
  • Technical Rescue
    • Civil Defense and PD
      • Limited protocols for heavy, medium, and light technical, high-angle, swift water, and confined space rescue
[/acc_item] [acc_item title=”Dispatch”]
  • No uniform EMS communications/dispatch for Abu Dhabi
    • Individual agencies rely on own systems, typically by direct-telephone to headquarters
    • No designated EMDs; Calls may be answered by personnel with no to little medical training
    • Also lacking:
      • Call screening
      • Interrogation
      • Prioritization
      • Provision of pre-arrival instructions
  • MOH maintains PSAP at Central Hospital ED, staffed by on-duty ambulance personnel
    • “Call-taker decides whether an ambulance is required based on the nature of the complaint”
    • No street addresses in Abu Dhabi
    • No automatic number and location identifiers
      • Personnel rely on landmarks, family/friends/bystanders and patients to located calls
[/acc_item] [acc_item title=”Public Access Numbers”]
  • Abu Dhabi
    • 999 – Police Department
    • 998 – MOH
    • 997 – Civil Defense
[/acc_item] [acc_item title=”Emergency Medicine”]
  • MOH reported [in 2004] increase from 7 to 30 hospitals in Emirates over past 30 years
  • Abu Dhabi – cited by World Health Organization in 1996 as one of best cities for health care in Middle East
  • Emergency Medicine not recognized as distinct specialty
    • EDs (“accident units”) typically staffed by general practitioners with “little to no advanced training in any specialty, let alone EM” (Sasser, 53)
    • Facilities typically have inadequate equipment, documentation, and support services
    • “Board-certified EM expatriate physicians have been practicing within Abu Dhabi in the recent past” (Sasser, 53)
  • Recently opened 16,000 sq. ft. ED in Abu Dhabi
  • “Interest in EM training programs among medical school graduates is increasing with the increasing presence of board-certified practitioners within the country” (Sasser, 56)
[/acc_item] [acc_item title=”Disaster”]
  • Concerns for airport, oil production and refinery disasters/events
  • “It is presumed that the [Civil Defense] Agency will be involved in disasters” (Sasser, 55)
  • Recent indication (2004) by General Authority for Health Services (GAHS) for development of Bio/Radio/Chem management planning at various facilities nationwide (Sasser, 55)
[/acc_item] [acc_item title=”Future Initiatives”]
  • Development of “specialized” emergency services at main health facilities in Abu Dhabi
    • Central Operations Center
      • Oversight
        • Supply Management
        • Interfacility Coordination
      • Abu Dhabi Police (2004):
        • Began efforts to find “ ‘skilled and professional staff of the EMS and rescue operators who will readily offer an array of EMS and rescue operations that are not available in any such organization in the Middle East’ ” (Sasser, 55)
        • 50-page “Safety and Prevention” manual for general public, “addressing injuries, medical complaints, and temporizing measures to be used before the patient receives proper medical care” (Sasser, 55-6)
  • Recommendation by National Consultative Council for development of dedicated traffic lanes for EMS and other emergency vehicles
  • Development of female involvement in operations
  • Sending UAE nationals abroad for training/education
[/acc_item] [acc_item title=”References”] [/acc_item] [/accordion]
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  • Dr Surjya Kmal

    Are medics supposed to enter confined spaces for rescue. OR rescue team will extricate injured person and then medics take over ?

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