Publications by authors named "Eduardo Romero Hicks"

5 Publications

  • Page 1 of 1

Prehospital and Emergency Care: Updates from the Disease Control Priorities, Version 3.

World J Surg 2015 Sep;39(9):2161-7

UCSF Department of Emergency Medicine, San Francisco General Hospital, 1001 Potrero Avenue, 1E21, San Francisco, CA, 94110, USA,

Background: It is increasingly understood that emergency care systems can be cost-effective in low- and middle-income countries (LMICs). The development of such systems, however, is still a work in progress. This article updates previous work in providing the most recent estimates of the burden of disease sensitive to emergency care, the current state of knowledge on the feasibility of emergency care, effect on outcomes, and cost-effectiveness in LMICs, and future directions for research, policy, and implementation.

Methods: We calculated the potential impact of prehospital and emergency care systems using updated and revised data based on the global burden of disease study. We then assessed the state of current knowledge and potential future directions for research and policy by conducting a review of the literature on current systems in LMICs.

Results: According to these newest updates, 24 million deaths related to emergency medical conditions occur in LMICs annually, accounting for an estimated 932 million years of life lost. Evidence shows that multiple emergency care models can function in different local settings, depending on resources and urbanicity. Emergency care can significantly improve mortality rates from emergent conditions and be highly cost-effective. Further research is needed on implementation of emergency care systems as they become a necessary reality in developing nations worldwide.

Conclusions: Emergency care implementation in LMICs presents both challenges and opportunities. Investment in evidence-based emergency care, research on implementation, and system coordination in LMICs could lead to a more cost- and outcome-effective emergency care system than exists in advanced economies.
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September 2015

Evaluating trauma care capabilities in Mexico with the World Health Organization's Guidelines for Essential Trauma Care publication.

Rev Panam Salud Publica 2006 Feb;19(2):94-103

Secretaría de Salud, Sistema Estatal de Atención de Emergencias Médicas, Monterrey, Nuevo León, Mexico.

Objective: To identify affordable, sustainable methods to strengthen trauma care capabilities in Mexico, using the standards in the Guidelines for Essential Trauma Care, a publication that was developed by the World Health Organization and the International Society of Surgery to provide recommendations on elements of trauma care that should be in place in the various levels of health facilities in all countries.

Methods: The Guidelines publication was used as a basis for needs assessments conducted in 2003 and 2004 in three Mexican states. The states were selected to represent the range of geographic and economic conditions in the country: Oaxaca (south, lower economic status), Puebla (center, middle economic status), and Nuevo León (north, higher economic status). The sixteen facilities that were assessed included rural clinics, small hospitals, and large hospitals. Site visits incorporated direct inspection of physical resources as well as interviews with key administrative and clinical staff.

Results: Human and physical resources for trauma care were adequate in the hospitals, especially the larger ones. The survey did identify some deficiencies, such as shortages of stiff suction tips, pulse oximetry equipment, and some trauma-related medications. All of the clinics had difficulties with basic supplies for resuscitation, even though some received substantial numbers of trauma patients. In all levels of facilities there was room for improvement in administrative functions to assure quality trauma care, including trauma registries, trauma-related quality improvement programs, and uniform in-service training.

Conclusions: This study identified several low-cost ways to strengthen trauma care in Mexico. The study also highlighted the usefulness of the recommended norms in the Guidelines for Essential Trauma Care publication in providing a standardized template by which to assess trauma care capabilities in nations worldwide.
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February 2006

Emergency medical systems in low- and middle-income countries: recommendations for action.

Bull World Health Organ 2005 Aug 22;83(8):626-31. Epub 2005 Sep 22.

Disability, Injury Prevention and Rehabilitation, WHO Regional Office for Africa, Republic of the Congo.

Emergency medical care is not a luxury for rich countries or rich individuals in poor countries. This paper makes the point that emergency care can make an important contribution to reducing avoidable death and disability in low- and middle-income countries. But emergency care needs to be planned well and supported at all levels--at the national, provincial and community levels--and take into account the entire spectrum of care, from the occurrence of an acute medical event in the community to the provision of appropriate care at the hospital. The mix of personnel, materials, and health-system infrastructure can be tailored to optimize the provision of emergency care in settings with different levels of resource availability. The misconception that emergency care cannot be cost effective in low-income settings is demonstrably inaccurate. Emergencies occur everywhere, and each day they consume resources regardless of whether there are systems capable of achieving good outcomes. With better planning, the ongoing costs of emergency care can result in better outcomes and better cost-effectiveness. Every country and community can and should provide emergency care regardless of their place in the ratings of developmental indices. We make the case for universal access to emergency care and lay out a research agenda to fill the gaps in knowledge in emergency care.
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August 2005