A survey of usar healthcare practitioners' requirements in order to operate effectively in the collapsed structure environment

Glass, Trevor Brian
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Background: An Urban Search and Rescue (USAR) Healthcare Practitioner (UHP) is a medical professional (doctor, nurse or paramedic) that works as part of a USAR team. UHPs are essential for effective USAR operations and are required to function as an integral component of the USAR team. The purpose of a UHP is to 1) provide for the medical requirements of their team; 2) the team’s search dogs and 3) provide emergency medical care to victims entrapped in collapsed structures. The International Search and Rescue Advisory Group (INSARAG) Guidelines require that a USAR team have a medical component, however, there is currently no international consensus or standardisation regarding the requirements of UHP’s. This research set out to survey members of the UHP community to gain insight into the demographics and experience of current UHP’s and to determine their opinions regarding UHP selection processes and USAR specific training for UHP’s. Methods: This study was a prospective, descriptive, transverse study comprised of closed and open-ended questions conducted using an online questionnaire. Requests for participation, which included a link to the online questionnaire, were emailed to the researcher’s personal contacts in twenty countries. These UHP’s were requested to send the request for participation in the study to their respective UHP networks. This resulted in a total of 136 study respondents from nineteen countries. Results: Of the UHP’s that participated in this survey, 82% were 36 years or older, with the largest group (44%) being older than 44. Males accounted for 83.7% of the respondents. Paramedics make up the majority (43.2%) of the UHP community that participated in the survey. The largest number of respondents (35%) have been v medically qualified as a doctor, nurse or paramedic for > 20 years. The majority of respondents (30%) have been involved in USAR for 3-5 years. The experience of respondents in responding to actual USAR incidents is low, 47% had never responded internationally and a further 42% had deployed on 1-3 international USAR responses. The vast majority of survey respondents (94.3%) are of the opinion that there is a need for a selection process for prospective UHP’s and 93% are of the opinion there is a need for UHP’s to undergo a USAR-specific training program after being selected as a UHP. There was unanimous agreement to the need for an ongoing USAR training program that includes the practical aspects of USAR medical care, USAR rescue techniques and USAR simulation exercises at some point between 6 months and two years. Conclusion: Participants completing the online survey questionnaire supported the need for a UHP selection process to become part of a UHP team and the need to undergo a USAR-specific training course prior to becoming an operational member of the team. They also supported the requirement to undergo continuous professional development training, which includes practical aspects of USAR medical care, USAR rescue techniques and USAR simulation exercises.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the degree of Master of Science in Medicine in Emergency Medicine Cape Town, May 2016