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Int. J. Environ. Res. Public Health 2018, 15(2), 267; https://doi.org/10.3390/ijerph15020267

Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada

1
Northern Ontario School of Medicine, Thunder Bay, ON P7B 5E1, Canada
2
Centre for Rural and Northern Health Research, Laurentian University, Sudbury, ON P3E 2C6, Canada
3
Sachigo Lake First Nation, Unorganized Kenora District, ON P0V 2P0, Canada
4
Institute for Health Policy, Management & Evaluation, Faculty of Medicine, University of Toronto, Toronto, ON M5T 3M6, Canada
5
School of Rural and Northern Health, Laurentian University, Sudbury, ON P3E 2C6, Canada
6
Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
7
Schwartz/Reisman Emergency Medicine Institute, Mt. Sinai Hospital, Toronto, ON M5G 1X5, Canada
*
Author to whom correspondence should be addressed.
Received: 8 December 2017 / Revised: 18 January 2018 / Accepted: 29 January 2018 / Published: 4 February 2018
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
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Abstract

(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help. View Full-Text
Keywords: Indigenous health; pre-hospital care; emergency; community-based emergency care Indigenous health; pre-hospital care; emergency; community-based emergency care
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Curran, J.; Ritchie, S.D.; Beardy, J.; VanderBurgh, D.; Born, K.; Lewko, J.; Orkin, A.M. Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada. Int. J. Environ. Res. Public Health 2018, 15, 267.

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