The 130th Annual Meeting of APHA

Abstract #48454

Bobby Girish Kapur, MD and Junaid A Razzak, MD. School of Medicine, Section of Emergency Medicine, Yale University, 464 Congress Avenue, New Haven, CT 06519, 203 773 1781, bgkapur@hotmail.com

Purpose: This paper investigates evidence-based research applicable to major causes of morbidity in developing nations and defines the priorities for pre-hospital care in these regions. Methods: Using data from the Global Burden of Disease study, which the World Health Organization uses for morbidity statistics, the projected top ten causes of Disability Adjusted Life Years (DALY's) in 2020 for developing nations were documented. Then a Medline search of articles from 1966 to August 2001 with no language restriction was conducted seeking studies that provide evidence of pre-hospital management of these diseases. Results: The ten most significant DALY's projected for developing nations in 2020 are: major depression, road traffic accidents, ischemic heart disease, COPD, cerebrovascular disease, tuberculosis, lower respiratory infections, war injuries, diarrheal diseases, HIV. When "emergency medical services" was combined with the following subject headings, these number of articles were retrieved: "depression" 12; "accidents, traffic" 472; "angina pectoris" 33; "chest pain" 78; "heart arrest" 776; "coronary disease" 144; "lung diseases, obstructive" 22, "tuberculosis" 8; "respiratory tract infections" 5; "diarrhea" 9; "blast injuries" 36; "wounds, gunshot" 51; "wounds, penetrating" 79, "HIV" 1. Trials exist for pre-hospital management of road traffic accidents, ischemic heart disease, COPD, cerebrovascular disease, and war injuries. However, limited information occurs in the literature for pre-hospital management of depression, TB, respiratory infections, diarrheal diseases, or HIV. Conclusions: Developing nations can maximize utilization of scarce resources by creating EMS systems that address the ten most significant causes of DALY’s projected for 2020.

Learning Objectives:

• At the conclusion of the session, the participants will be able to identify EMS systems that address the needs of developing nations.

Keywords: EMS/Trauma, International Systems

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.