Browsing by Author "Van Rensburg, Louis"

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    An analysis of the isiXhosa telephonic descriptors of cardiac arrest (ca) in a Western Cape emergency control centre
    (2025) Mgidi, Sinethemba Alphius; Stassen, Willem; Van Rensburg, Louis
    Introduction: Out-of-hospital cardiac Arrest (OHCA) represents a considerable public health challenge, characterised by its critical time sensitivity, high morbidity, and poor survival rates. Despite decades of low survival rates, OHCA survival has been a constant concern for healthcare systems globally. The first stage of managing OHCA is immediate recognition by bystanders and emergency control centre personnel, which rely on the descriptors that callers provide. Varying educational levels and languages make identifying such patients in the Western Cape (WC), South Africa (SA), challenging. This study aims to identify key isiXhosa speaking descriptors used telephonically in the Western Cape Department of Health and Wellness, EMS, when IsiXhosa speaking callers are requesting emergency medical care at the emergency control centre in the event of OHCA. Methodology: Data from the computer-aided dispatch (CAD) programme with a “medical” and "patient unresponsive" incident classification were collected for 12 months (January 2018, to December 2018). A collection of corresponding patient care data were collected to confirm OHCA. The original voice recordings between the caller and the emergency call taker during the emergency were transcribed verbatim. Transcriptions underwent inductive, Hseih and Shannon qualitative content analysis to the manifest level. Descriptors of OHCA in isiXhosa calls were coded, categorised, and quantified. Results: The study identified 729 confirmed OHCA cases, of which 24 (3.3%) were in isiXhosa and were eligible for analysis. Five distinctive categories were identified from the content analysis. Notable descriptors used by callers to describe OHCA were related to respiratory effort (29.4%), cardiac activity (23.5%), level of consciousness (23.5%), clinical features (11.8%) and ill health (11.8%). Conclusion: This study highlighted the descriptors used by isiXhosa-speaking callers when reporting out-of-hospital cardiac arrest telephonically in South Africa's Western Cape province. The findings underscore the importance of providing a list of phrases and words descriptors used in communication between the caller and call takers.
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    Initiating the development of a curriculum for South African adult critical care retrieval
    (2025) Van Rensburg, Louis; Stassen, Willem; Lambert, Craig
    The interfacility transfer of critically ill patients is a crucial component of emergency healthcare in South Africa, necessitated by disparities in healthcare infrastructure, specialist availability, and geographic constraints. Emergency Medical Services (EMS) facilitate these transfers, often requiring specialised Critical Care Retrieval (CCR) teams. Despite its significance, there is no standardised CCR training in South Africa, leading to inconsistencies in provider competence and patient outcomes. Aim of the Study: This research sought to design and validate a contextually relevant and competency-driven curriculum for adult CCR in South Africa. The proposed curriculum aims to enhance the knowledge, clinical proficiency, and decision-making skills of EMS practitioners involved in critical care transport. Methods: A multi-methods approach was used across four phases: 1. Scoping Review: Local and international CCR curricula were analysed to identify best practices and essential competencies. 2. Retrospective Case Review: A three-year analysis of Western Cape EMS patient care records (2018–2020) provided insights into the characteristics and needs of CCR patients. 3. Qualitative Study: Semi-structured interviews with CCR experts and focus groups with EMS learners were conducted to explore training gaps and competency needs. 4. Delphi Study: A panel of 83 experts participated in an iterative consensus-building process to refine and validate curriculum content and learning objectives. Results: Findings revealed systemic deficiencies in EMS training for CCR, including inadequate exposure to critical care principles, ventilation strategies, interfacility transport physiology, and non-technical skills such as leadership and clinical decision-making. The final curriculum framework includes modules on intensive care principles, advanced patient monitoring, procedural interventions, transport logistics, and evidence-based best practices. The curriculum aligns with NQF Level 8 and incorporates blended learning methodologies, including high-fidelity simulations and supervised clinical exposure. Conclusion: This study presents the first structured and standardised CCR curriculum for South African EMS, bridging key knowledge and skill gaps while aligning with international best practices. Its implementation could professionalise CCR, establish it as a recognised EMS specialisation, and improve patient safety and outcomes. Future research should focus on implementation strategies, faculty development, and long-term evaluation of its impact on patient care and system efficiency.