Experiences of Free State emergency medical care practitioners regarding paediatric pre-hospital care

English: In this research project an in-depth study was done with a view to investigating the experiences of the Free State emergency medical care practitioners regarding paediatric pre-hospital care. The purpose of the study was to render a contribution to the improvement of the operational readiness for paediatric emergency medical care and transportation. It is trusted that this will ensue in a lower mortality and morbidity rate within the Free State Emergency Medical Services (FSEMS). This study thus can serve as a directive for the development of high quality care for paediatric patients in the pre-hospital environment. It can also help solve deficiencies in this medical care environment. The problem that was addressed in the study was the limited data and population-based information available in the pre-hospital environment with regard to paediatric patients, which might suggest that paediatric patients are underserved by the emergency medical care services. This can be contributed to or interpreted as due to a lack of proper size equipment and the limited ability, skills and knowledge of emergency medical personnel for dealing with paediatric patients. To address this problem it was endeavoured to determine what the experiences of emergency medical care practitioners in the Free State were with regard to paediatric pre-hospital care. In order to address the problem stated, the following research questions were asked: 1. How can emergency medical care practitioners’ experiences regarding paediatric prehospital care be conceptualised and contextualised? 2. What are the Free State emergency medical practitioners’ experiences and views regarding paediatric pre-hospital care? 3. What are the factors that influence the Free State emergency medical practitioners’ experiences and views regarding paediatric pre-hospital care and how do these factors influence emergency medical care practitioners’ experiences? 4. Can paediatric pre-hospital emergency medical care within the Free State emergency medical services be improved? The aim of the study was to explore the experiences of Free State emergency medical care practitioners regarding paediatric pre-hospital care. By doing this, deficiencies that may hamper effective paediatric pre-hospital care might be identified and reduced and/or eliminated. A quantitative study was done with elements of qualitative feedback included in the questionnaire. The methods that were used to collect data and which formed the basis of the study comprised a literature review, followed by a questionnaire survey as empirical study. The purpose of the literature review was to gain a background and information on the experiences of emergency care medical practitioners working with paediatrics. The bulk of the literature comprised international sources as very little research has been done in South Africa on this ramification of medical care. The questionnaire for the collection of empirical data was based on the findings of the literature review. The aim of the questionnaire was the investigation of the experiences of EMC personnel’s experiences with paediatric patients. The population comprised EMC practitioners working in the Free State province, and a sample of 197 practitioners, selected by means of stratified random sampling, participated in the survey. The quantitative data were analysed by a statistician, using frequencies and percentages, and the researcher analysed the qualitative data by reading the responses, summarising findings and categorising the findings in themes. These findings were compared with the findings of the literature review and used to make recommendations in an endeavour to improve the experiences of EMC practitioners in the Free State, and improve the mortality and morbidity rates of paediatric patients making use of emergency medical care facilities. The recommendations of the study have a bearing on the following: 1. Standardisation of training for EMC practitioners to ensure that all practitioners are adequately trained. 2. More paediatric education and training initiatives should be taken to ensure that EMC practitioners understand the differences between paediatric patients and adult patients. 3. Practitioners who infrequently practise paediatric skills in the pre-hospital environment must be retrained and assessed regularly for safe practice (CPD). 4. Specialised paediatric equipment is the ideal, but not always affordable, therefore it is important to ensure that basic medical equipment are available and in a working condition. Creating quality service standards within the EMC services through consultation with patients and employees to understand each set of priorities better. 5. Improvement in the working conditions and remuneration of EMC practitioners to improve the standard, attitude and morale of personnel. 6. Retention of qualified EMC practitioners to enhance service and to improve the professional image of the emergency services. 7. Creating a forum where practitioners can articulate their feelings and challenges.. 8. Educating the community about the emergency services available including paediatric care. 9. Creating interdisciplinary training opportunities for EMC practitioners and hospital personnel. 10. Creating interdisciplinary training opportunities for EMC practitioners and hospital personnel to learn effective communication skills and to highlight the importance of effective communication for quality patient care. It is trusted that this research report and the recommendations will make a meaningful difference to paediatric care by EMC practitioners in the Free State.