Thesis--Columbia University. / Includes bibliographical references (leaves 157-165).

Thesis (M. Med. Sc.)--University of Hong Kong, 2005.

Thesis (M.Nurs.)--Washington State University, May 2006. / Includes bibliographical references (p. 39-46).

A dissertation submitted in fulfilment of the requirements for the degree of Master in Technology: Emergency Medical Care in the Department of Emergency Medical Care and Rescue, Durban University of Technology / Strong earthquakes are frequent catastrophic disasters occurring worldwide and often lead to structural collapse of buildings. Urban Search and Rescue (USAR) is the specialised process of locating, extricating and providing immediate medical treatment to victims trapped in collapsed structures. This research project aimed to identify the key preparedness efforts necessary by an earthquake affected country to ensure best coordinated use of international USAR assistance. / M

No description available.

Dissertation submitted in fulfilment of the requirements for the Degree of Master in Technology: Emergency Medical Care, Durban University of Technology, 2010. / South Africa currently has 1631 registered Advanced Life Support (ALS) paramedics to tend to the pre-hospital advanced life support needs of just under 50 million people. Compared to the globally accepted ratio of 1:10 000, the number of ALS paramedics in South Africa is grossly inadequate. The current shortage of South African ALS paramedics may be ascribed to migration. However, although literature on health worker migration in general abounds, there is a marked lack of national or international statistics and information on migration of ALS paramedics and their migration. Current measures to manage migration appear to be ineffective. The success of future strategies is dependent on an understanding of the migration of South African ALS paramedics - an understanding that presently does not exist. Purpose The purpose of this study was to describe the migration of South African undergraduate Advanced Life Support paramedics who qualified between 2001 and 2006, and to then develop a framework of retention strategies. In particular, it determined the extent and nature of their migration, identified the factors that have contributed to their decision to work outside South Africa and identified strategies to retain or encourage the return of ALS paramedics to practice exclusively in South Africa. Methods The study consisted of a two-phase mixed method descriptive survey. Paramedics with ALS undergraduate diplomas who qualified in South Africa between 2001 and 2006 made up the study population. Quantitative data (Phase One) was obtained from a web-based survey distributed to the accessible population (N=97). Thereafter, qualitative data (Phase Two) was gathered through in-depth interviews with selected information rich participants (n=10) also from within the accessible population. Through methodological triangulation, data from Phase One and Phase Two were Page vi integrated to obtain an in-depth understanding of South African ALS paramedic migration. Results Significant differences existed in the distribution of age (p=0.035), and years of experience post-graduation (p=0.007) and the ALS paramedic deemed most likely to migrate were individuals between the ages of 21 – 30. 15 (55%) of the participants working outside the country were engaged in short term contracts while all 24 (100%) of participants working inside South Africa were permanently employed. 18 (75%) of respondents working inside South Africa intended migrating, 12 (67%) of which intended to do so within 0 to 2 years. Nine major factors or reasons for migration were identified by participants. Working conditions, physical security and economic considerations were ranked as the top three major factors most likely to contribute to the decision or intended decision to migrate. This study also found five primary decisions that likely emerge during the life of a South African ALS Paramedic. The outcome of each decision is a result of facilitators weighted against barriers. Facilitators are factors that supported each of the primary decisions while barriers weakened or rejected them. Findings indicated that many barriers existed which rejected or weakened the decision of ALS paramedics to work inside South Africa, return to South Africa or remain in South Africa. On the converse, a vast number of facilitators existed which spurred continued migration. Conclusions As the decision to migrate may be conceptualised as early on as when individuals decide to become ALS paramedics, the constructs of return and retention strategies have to extend as far as revising recruitment policies. Preference or places into training programmes should be given to individuals who are less inclined to migrate, these include: military personnel; those already employed in the EMS, older mature candidates; candidates with families that have already settled in SA; and recognition of prior learning (RPL) candidates who are predominately obligated by contract to remain in South African EMSs.

Strong earthquakes are frequent catastrophic disasters occurring worldwide and often lead to structural collapse of buildings. Urban Search and Rescue (USAR) is the specialised process of locating, extricating and providing immediate medical treatment to victims trapped in collapsed structures. This research project aimed to identify the key preparedness efforts necessary by an earthquake affected country to ensure best coordinated use of international USAR assistance.

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

No description available.

Emergency medical services (EMS) personnel experience direct traumatic exposure that can leave a lasting negative impact. However, little is known about the vicarious exposure that EMS personnel experience at challenging calls when family and loved ones are present at the scene. Additionally, there is minimal research that has looked at the experiences among paramedics and EMTs who arrive to mental disturbance calls or completed suicides. In order to add to the substantial body of literature on EMS personnel and traumatic exposure, this study explored their experiences of multifaceted traumatization; the lived experiences of paramedics and EMTs who have responded to completed suicides where loved ones of the deceased were present, and as a result, experienced both a negative psychological impact and posttraumatic growth. The study explored the risk factors and protective factors that paramedics and EMTs experience in their work. Additionally, this inquiry sought to explore the ways in which participants find meaning in providing emergency medical services and how they sustain their work. <br>This qualitative, phenomenological study was conducted through semi-structured individual interviews with 12 paramedics or EMTs who have been employed or volunteered for at least one year. Explication of data was completed using van Manen's (1990) four existential themes: spatiality, corporeality, temporality, and relationality. The results of this study identified themes that address van Manen's (1990) lived existentials, protective factors against posttraumatic symptoms through direct and vicarious traumatization, risk factors that contribute to these symptoms, and meaning making in their work. The implications of the study for the field of emergency medical services and suggestions for future research are provided. / School of Education; / Counselor Education and Supervision (ExCES) / PhD; / Dissertation;