Emergency Medicine in Jordan Rashed Hijazi MD, FRCSEd (A&E) Consultant EM.
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Emergency Medicine in JordanEmergency Medicine in Jordan
Rashed Hijazi MD, FRCSEd (A&E)Rashed Hijazi MD, FRCSEd (A&E)Consultant EMConsultant EM
Pre-hospital care ( Public )Pre-hospital care ( Public )
Covered by the civil defense directorate
Multiple locations with 2 ambulances for each
2 crew members in each ambulance
Supplied with basic equipment
Dispatch by central communication center
Transportation time: average 10 minutes
Level of training: 6 months, started in 1988, 3 months theoretical, 3m. practical
BLS and first aid , no invasive procedures
New regulations in progress for advanced New regulations in progress for advanced medical protocols for IV access, drugs, medical protocols for IV access, drugs, defibrillators, etc.defibrillators, etc.
Dispatch to the nearest public hospital, Dispatch to the nearest public hospital, unless life threatening situation, then unless life threatening situation, then nearest private or publicnearest private or public
Communication with hospitals
Funded by ministry of healthFunded by ministry of health
Free for the publicFree for the public
The Royal medical services (Military Sect.)
Air medical evacuation by the Jordanian air force for eligible patients
Civil DefenseCivil Defense(public)(public)
2001
2002
940950960970980990
1000101010201030
Death Rate
2001
2002
52000
52500
53000
53500
54000
54500
55000
55500
56000
56500
Ambulance Calls
Type of CallType of Call
38769
54542960 2562 2450
0
5000
10000
15000
20000
25000
30000
35000
40000
Medical Fallingdown
Delivery MVA Trauma
Pre hospital Care ( Private )Pre hospital Care ( Private )Each private hospital runs its own ambulancesEach private hospital runs its own ambulances
Medical services on special request only Medical services on special request only
High standard , well equippedHigh standard , well equipped
Recently started mobile intensive care unitsRecently started mobile intensive care units
Ambulance crew including a physicianAmbulance crew including a physician
Dispatch by the private hospital if called upon Dispatch by the private hospital if called upon
Retrieval to the same hospital onlyRetrieval to the same hospital only
No communication with other private hospitalsNo communication with other private hospitals
Funded privately or by private health insurance Funded privately or by private health insurance
The Jordanian Board In The Jordanian Board In Emergency MedicineEmergency Medicine
Independent specialty since July 99Independent specialty since July 99Five approved training centersFive approved training centersRegistration in the medical associationRegistration in the medical association Four year programFour year program Part I during the 2Part I during the 2ndnd year year Only successful candidates are Only successful candidates are promoted to the 3promoted to the 3rdrd year year Board exam after 4Board exam after 4thth year year
Training ProgramTraining Program
- Established after reviewing Established after reviewing Australian, American, Canadian and Australian, American, Canadian and European programsEuropean programs
- Independent specialty Independent specialty - Started 1Started 1stst at Jordan University 1998 at Jordan University 1998- 7 candidates at start of program7 candidates at start of program- 5 candidates obtained Jord. board5 candidates obtained Jord. board
11stst Year Year
General MedicineGeneral Medicine3m3m
ERER3m3m
General PediatricsGeneral Pediatrics2m2m
General SurgeryGeneral Surgery2m2m
OrthopedicOrthopedic2m2m
22ndnd Year Year
OB & Gyn.OB & Gyn.1m1m
ERER3m3m
ER PedER Ped..2m2m
CCUCCU2m2m
ICUICU2m2m
PsychPsych..2m2m
33rdrd Year Year
ERERER ped.ER ped.ER Adm.ER Adm.Anesth.Anesth.Plast.SurgPlast.Surg
2m2m1m1m1m1m1m1m1m1m
Neur.SurgNeur.SurgPed.SurgPed.SurgForensicForensicResearchResearchElective Elective
1m1m1m1m1m1m1m1m2m2m
44thth Year Year
ER 12 monthsER 12 months
Senior : Clinical & administrativeSenior : Clinical & administrative
Medical, Surgical, Pediatric and Medical, Surgical, Pediatric and OB/Gyne.OB/Gyne.
Program ActivitiesProgram Activities
Emergency medicine topicsEmergency medicine topics
Emergency Surgery topicsEmergency Surgery topics
Pediatric Emergency topicsPediatric Emergency topics
Obstetrics & Gynecology topicsObstetrics & Gynecology topics
Mortality & MorbidityMortality & Morbidity
Journal ClubJournal Club
RadiologyRadiology
Case presentationCase presentation
Principles and basic science Principles and basic science
Program ProgressProgram Progress
Periodical evaluationEnd of year examination Written, Oral and Clinical Pass mark 60% Publication Program director Committee ( From other specialties ) Successful : Jordanian Board Certificate
Exemption of part1 Arab Board Unsuccessful : 3 trials with conditions
EM Training CentersEM Training Centers
Jordan University Hospital ( 1Jordan University Hospital ( 1stst center ) center )
- Started in July 1998 - Started in July 1998
- Jordan University has 550 beds with - Jordan University has 550 beds with 60,000 visits to the ER per year60,000 visits to the ER per year
- Requirement, selection criteria- Requirement, selection criteria
EM Training CentersEM Training Centers KA University hospital KA University hospital
11stst Yr #3 candidates Yr #3 candidates22ndnd Yr #4 candidates Yr #4 candidates Commenced June 02Commenced June 02
Ministry of Health hospital Ministry of Health hospital 11stst Yr #5 candidates Yr #5 candidatesCommenced June 03Commenced June 03
Military hospital Military hospital 11stst Yr Yr
Private hospitalPrivate hospital11stst Yr #1 candidate Yr #1 candidate22ndnd Yr #1 candidate Yr #1 candidate
ChallengesChallengesNew specialty New specialty
Shortage of ER physiciansShortage of ER physicians
Limited understandingLimited understanding
Under-estimationUnder-estimation
Lack of supportLack of support
Financial Financial
StaffStaff
FacilitiesFacilities
Regulations and guidelinesRegulations and guidelines
Future and securityFuture and security
Optimistic outlookOptimistic outlook Population and need Population and need High incidence of trauma High incidence of trauma Increasing No. of Private hospitalsIncreasing No. of Private hospitalsCompetitive other specialtyCompetitive other specialtyEstablishment of the Arab Board in Establishment of the Arab Board in EMEMInternational applicantsInternational applicantsOther specialties applicantsOther specialties applicantsStrong link with Family medicineStrong link with Family medicine
ImprovementImprovement
More ER physiciansMore ER physicians
Supervisors and trainersSupervisors and trainers
Introduction of academic courses, eg: Introduction of academic courses, eg: ACLS, ATLS, U/S etc.ACLS, ATLS, U/S etc.
Advertising Advertising
Legal and ethical issuesLegal and ethical issues
ConferencesConferences
Establishment of an EM association and Establishment of an EM association and Collaboration with othersCollaboration with others
Communication and reciprocal recognitionCommunication and reciprocal recognition
SummarySummary
New developing specialty among New developing specialty among well developed and high standard well developed and high standard medical servicesmedical services
The future is brightThe future is bright
High spirit presentHigh spirit present
International support neededInternational support needed
Thank youThank you
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