Practice of Pre-Hospital Emergency Care and Associated Factors in Addis Ababa, Ethiopia: Facility-Based Cross-Sectional Study Design

Abstract

Background

Medical emergencies require quick field interventions and stabilization before transport, while rapid transportation to definitive healthcare with fewer field interventions improves trauma outcomes. Poor prehospital healthcare practices negatively impact patients’ health, and limited studies exist on providers’ practices in resource-limited areas like Ethiopia. This study aimed to assess the practice of pre-hospital emergency care and associated factors at pre-hospital health facilities in Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted 191 pre-hospital healthcare providers, of which 20 randomly selected participants were participated in the observational study from October 2021 to February 2022 in Addis Ababa Ethiopia. Data was collected using a checklist and self-administered questionnaire. Data was cleaned, entered into Epi data version 4.4, and exported to SPSS software for analysis. Binary and multivariable logistic regression analyses were performed, with a P-value of 0.05 considered statistically significant.

Results

The study found that 43% (82) of pre-hospital healthcare providers in Addis Ababa, Ethiopia, had good practice in pre-hospital emergency care. The identified factors that increased the odds of good practice in pre-hospital emergency care were: being able to provide advanced life support (AOR = 88.99; 95% CI: 27.143–291.603); adequate monitoring and defibrillators (AOR = 5.829; 95% CI: 1.430–23.765); having work experience of 4–5 years (AOR = 5.86; 95% CI: 1.424–24.109); and having the opportunity to continue education (AOR = 31.953; 95% 6.479–157.591).

Conclusions and Recommendations

The study found high levels of poor practice among pre-hospital healthcare providers in Addis Ababa, Ethiopia. Factors contributing to good practice include being trained in advanced Life Support, adequate monitoring, defibrillators, work experience, and having the opportunity to continue education. Therefore, policymakers and health planners should establish teaching and training centres based on Ministry of Health and Education guidelines.

Plain Language Summary

Medical emergencies, such as cardiac arrests, benefit more from quick field interventions and stabilization before transport, while rapid transportation to definitive healthcare with fewer field interventions by trained paramedic professionals improves trauma outcomes. A facility-based cross-sectional study was conducted from October 2021 to February 2022, with 191 prehospital healthcare providers working in prehospital healthcare facilities in Addis Ababa. Participant observational study data were collected using a checklist, followed by a self-administered questionnaire administered by trained data collectors at each prehospital health facility. The identified factors increased the odds of good practice of pre-hospital emergency care, including advanced life support, adequate monitoring and defibrillator, and 4–5 years of work experience and opportunities to continue education.

More than half of the prehospital healthcare providers had poor prehospital care practices. Factors that increase the likelihood of good practice include competently performing ALS, adequate monitoring and defibrillation, work experience, and opportunities for continuing education. Policymakers and health planners should establish prehospital healthcare teaching and training centers based on prehospital healthcare guidelines.

Keywords:

• pre-hospital healthcare providers practice

Abbreviations

ALS, Advanced Life Support; AOR, Adjusted Odd Ratio; BLS, Basic Life Support; CI, Confidence Interval; COR, Crude Odd Ratio; CPR, Cardiopulmonary Resuscitation; ED, Emergency Department; EMS, Emergency Medical Services; EMT, Emergency Medical Technician; ERCS, Ethiopian Red Cross society; FEPRA, Fire and Emergency Prevention and Rescue Agency; FMHACA, Food, Medicine and Health Care Administration and Control Authority; FMOH, Federal Ministry of Health; IV, Intravenous; NGO-Nongovernmental organization; PHCP, Pre-hospital Healthcare providers; SPHMMC, Saint Paul’s Hospital Millennium Medical College; WHO, World Health Organization.

Availability of the Data and Materials

Summary data are available in the main document. All data generated or analyzed in this study are included in this published article.

Ethics Approval

Ethical approval was obtained from St. Paul Hospital Millennium Medical College Ethical Review Board Ref. No. Pm27/699, this requirement was not waived by the Institutional Review Board and confirmed that all experimental protocols were approved by St. Paul’s Hospital Millennium Medical College Institutional Ethical Review Board.

Informed Consent

The authors confirmed that written informed consent was obtained from all subjects aged greater than 18 years, and for minor subjects less than 18 years old prior to study initiation and written inform consent was obtained from their parent or legal guardian(s) or legally authorized representatives before the study. Authors had confirmed that all methods were carried out in accordance with relevant guidelines and regulations. Authors had confirmed that all experimental protocols were approved by St. Paul Hospital Millennium Medical College Institutional Review Board/Ethics Committee (Ref. No. Pm27/699.

Acknowledgment

First, we thank God for all things. Second, the authors would like to acknowledge Saint Paul’s Hospital Millennium Medical College for funding, and the SPHMMC School of Nursing and Ethical Review Board for the approval of ethical clearance. The authors would also like to express their gratitude to the pre-hospital facilities in Addis Ababa, Addis Ababa Public Health Research and Emergency Management Directorate, data collectors, supervisors, and study participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

This study was funded by the Saint Paul’s Hospital, Millennium Medical College. However, the funder had no role in the study design, data collection, analysis, preparation of the manuscript, or the decision to publish.