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. 2018 Feb 4;15(2):267.
doi: 10.3390/ijerph15020267.

Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada

Jeffrey Curran  1 , Stephen D Ritchie  2 , Jackson Beardy  3 , David VanderBurgh  4 , Karen Born  5 , John Lewko  6 , Aaron M Orkin  7   8   9
Affiliations

Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada

Jeffrey Curran et al. Int J Environ Res Public Health. .

Abstract

(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help.

Keywords: Indigenous health; community-based emergency care; emergency; pre-hospital care.

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Conflict of interest statement

The authors declare no conflict of interest. Aaron M. Orkin receives salary support from the Canadian Institutes of Health Research, the Schwartz/Reisman Emergency Medicine Institute, and the University of Toronto Department of Family and Community Medicine.

Figures

Figure 1
Figure 1
Map of Nishinawbe Aski Nation member communities, road access, community hospitals, and emergency care referral centers in northern Ontario.
Figure 2
Figure 2
Framework for local perception of an emergency.
See this image and copyright information in PMC

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