Portoviejo EMS Development Project
Portoviejo, Ecuador (Aug. 2009)
The Portoviejo EMS Development program is an effort to improve access to quality emergency care in the community of Portoviejo, Ecuador, and surrounding communities. Begun in 2004 by George Contreras, a NYC paramedic, Trek Medics became involved in the program in 2009, when we joined George in Ecuador to provide emergency response training and donated equipment, including LifePak10 EKG monitors, AEDs, and trauma care supplies, to be used on a recently donated ambulance from New York Downtown Hospital in New York City. The trip consisted of training and meetings with local agencies to improve coordination among prehospital and clinical stakeholders.
Emergency Medical Response Symposium
The emergency medical response symposium took place over four days and was attended by first responders from several different agencies. The classes were focused on building upon the basic emergency response training that the attendees had already learned, including patient assessment, practical skills and simulations. The 30-hour symposium also received support from the Ecuadorian Ministry of Public Health who validated and credentialed the training for all participants.
The first three days of training were dedicated to classroom lecture and skills stations, covering topics such as airway management and CPR; trauma care (bleeding control, splinting and spinal stabilization); and environmental and HAZMAT emergencies. Students were provided with an abbreviated Emergency Medical Response text, courtesy of La Fundación Escuela Argentina de Soccorrismo y Primeros Auxilios (EASPA) (The Argentine Foundation School for Rescue and First Aid). Over 40 students attended, representing members of various first responder organizations, including:
- La Fundación 9-1-1 (The 9-1-1 Foundation of Portoviejo)
- La Cruz Roja Portoviejo (Portoviejo Red Cross)
- Cuerpo de Bomberos de Portoviejo (Portoviejo Fire Department)
- Cuerpo de Bomberos de Manta (Manta Fire Department)
- La Defensa Civil (Civil Defense)
- Doctors and nurses from La Cárcel del Rodeo (El Rodeo Prison)
- Current Students in 3-yr Paramedic Program at the Technical University of Manabi
Mass Casualty Incident Drill
On the final day of our symposium, the group met at the Technical University of Manabí to participate in a Mass Casualty Incident drill. The drill consisted of a 12-patient traffic collision, including two automobiles and one motorcycle, and was set up to focus on the specific skills that had been reviewed in the classroom. Students were also able to practice the application of Scene Survey and START Triage principles in the field setting. For most of the group our program was the first time they had been exposed to START Triage, allowing them to experience first-hand how basic guidelines and simple coordination can drastically improve performance, safety and patient outcomes.
Interagency Cooperation Agreement
As part of our trip, a new mutual aid agreement was also drafted and signed between la Cruz Roja de Manabí and La Fundación 9-1-1 in an effort to enhance and streamline interagency operations and improve coordination. Such an agreement was well-received by all parties as there was a shared understanding of the need for better resource sharing. As a result, the two agencies found ways to improve training for responders, to maximize the effectiveness of limited resources, and to better coordinate the utilization of the new equipment provided. One area where immediate results were seen was in the establishment of shared protocols for interfacility transfers from Portoviejo to Guayaquil, where the major regional hospitals are located, several hours away.
As part of our community outreach efforts, 12 staff members from the local Hotel Ejecutivo, also received first aid and CPR/AED training along with an AED and CPR/First Aid kit donated to the hotel for medical emergencies. The hotel routinely hosts several special events and receives international tourists throughout the year, and also has a large restaurant which is frequented by its guests as well as many community residents. The owner of the hotel was very supportive of the EMS Development Portoviejo Project during this trip, and even arranged for a live interview on the nightly news to raise awareness about the work being done to improve medical emergency care in Portoviejo and surrounding communities.