When it comes to traumatic injuries, a person’s first thought in America is call 9-1-1. We have absolute trust in the pre-hospital medical system and rely on EMS providers who are always ready at a moment’s notice to render care. However, what happens in areas where providers, resources and training are not as readily available? Calling an ambulance may be costly and place the caller at risk of financial hardship. Transportation to a capable receiving hospital may be hours away. Hospitals may not even have the capability or resources to diagnose and treat the injured patient. According to the World Health Organization, more than 90% of injury related deaths occur in low- and middle-income countries and injury-related deaths outnumber the mortality of HIV/AIDS, tuberculosis and malaria combined. Researching the burden of injuries on the population of Vietnam is paramount in helping support prevention efforts and the further development of the EMS system.
The data collection phase of my research study consisted of a six-week, in-country window. Basically, this means I survived on an I.V. drip of coffee and learned to quickly adapt to the suggestions from my local research team. Each morning consisted of identifying potential patients from HMU’s digital database and randomizing selection for the paper charts review. The student team and I would then meet to train on research protocol, collection methods and patient confidentiality. Next, for four hours we read over patient charts and extracted necessary data. After collection, I treated the students to lunch and spent the rest of my day disseminating the results into an excel file for later analysis. Collection was not a glamorous job, but the students and I developed a friendship in between the rows of files. We shared stories about our childhoods, mutual love of science and medicine, and goals for the future.
Outside of collecting data, I was able to utilize my EMT license and experience in training international EMS providers to partner with the ED at HMU Hospital and the National 115 Ambulance system. I asked to be on call 24/7 in the event traumatic patients were received at hospital. The medical team functioned as a well-tuned orchestra, with the ED physician conducting and nurses as the instruments of care. As with any hospital, there is always room for improvement, so with each case I took notes and reviewed the observations with the staff. The culture of constantly training and improving practice is at the center of every great hospital and the director of HMU Hospital’s ED shared the same vision with his staff.
Building upon local connections in Vietnam, I was able to connect with the 115 national ambulance system. Under the supervision of the director and ambulance medical team, I had the opportunity to perform a ride-along shift to better understand Hanoi’s EMS system. It felt like I was right back in the jump seat of the ambulances at home. There were some differences in field training and resources, however the dedication of the providers to serve their community was as vibrant as ever. With continued research, provider training, advocacy and financial support the EMS system in Vietnam will continue to grow and better protect the population against unnecessary morbidity and mortality.