Special Manifestations / International EM Flashcards
1
Q
impact on health funding
A
- 2.45 billion dollar reduction in Global health funding for state and USAID from FY 2017 to FY 2019 (30.8% decrease in funding)
- funds used for HIV/AIDS, child and maternal deaths, infectious disease
- 360 million dollar reduction in contributions to international organizations
- US funding to WHO -> planned for 48% decrease
- US funding to Pan American Health Organization ->planned for 49% decrease
- international coffee organization -> 100% decrease*** -> important bc some people made all their money off this
2
Q
bureau of medical services (MED)
A
- mission statement- our mission is to safeguard and promote the health and well being of Americas diplomatic community
- branch of the department of state
- reports to the under secretary for management (vacant since Jan 2017)
- has over 200 clinicians working in over 170 countries, supported by medical and administrative personnel in washington DC and abroad
- provides healthcare to US government employees and their families who are assigned to our embassies and consulate’s worldwide -> not for everyone
- we also advice our embassy and state department management about health issues throughout the world
- although we cannot provide medical services to US citizens abroad who are not affiliated with the US government, we do collaborate with the state departments bureau of consular affairs to ensure the assistance they render is medically appropriate for the situation and available resources
3
Q
post medical providers
A
- most family practice medicine
- countries have assigned posts
- some countries have one post signed with one provider!
- these people are well versed in specialties
- US healthcare presence in other countries
- Doctors, NPs, PAs
- local hires (LES- locally employed staff)
- EFM (eligible family members)
- but also shares responsibility for emergency preparedness -> location may have limited resources
- mass casualty preparations
- size of health unit depends on post and country
4
Q
department of state
A
- connection to the rest of the world when it comes to government entities
- the American way/culture
5
Q
unique challenges
A
- wide variety of medical infrastructure, skills, equipment, medicine
- foreign hospitals need to staff foreign providers bc there is not enough people there
6
Q
non governmental organizations
A
- usually nonprofit and humanity driven
- direct health care
- public health programs- portable water, disease prevention, etc. -> necessary for healthcare
- disaster assistance- not always cutting edge and chaos -> usually treating chronic disease that are disrupted by disaster
- infectious disease research and mitigation efforts
- healthcare training
- funding from mix of government and private donations -> what do you think happens with the government funding gets cut?
- ex. doctors without borders
7
Q
Emergency medicine maturation
A
- EM recognized in the US in 1973
- national organization is recognized in 1968
- academic society recognized in 1970
- national certification in 1979
- the rest of the world it happened a little later (1980s)
8
Q
medical care considerations “over there”
A
- “their’ medicine vs “our” medicine
- language
- what kind of medical care is available
- how do you get to it
- who is providing it
- what medications are available
- how safe are the medicines
- medical insurance- medical evacuation costs
- planning considerations for medical care abroad -> logistics, communications (wifi), details matter
9
Q
COVID-19 (and other infectious diseases)
A
- country might not let you leave or come in
- what do you do with someone whos sick
- some governments have funding for high tech quarantine some not so much
10
Q
travel insurance vs medical evacuation costs
A
- travel insurance- transport to and treatment in nearest, and best medical facility -> don’t cover medical transport home
- health insurance will cover some of your medical bills overseas, but wont transport you home
- credit card medical insurance usually limited
- medical evacuation costs start at $25K, go up very fast
- medical evacuation- pay for membership service
- membership from a week to a year. from $99
- global rescue, medjet assist
11
Q
England (london)- HEMS
A
- socialized medicine
- national health service
- staffing is physician and paramedic
- flight services do not collect money -> just contributions (charity!)
- medical providers work for socialized system and all expenses are covered by charities
- charity*
- quick response
- at night they switch to car
- HEMS
12
Q
Haiti
A
- staffed helicopters to provider higher level of out of hospital care
- initially was staffed by americans but they trained citiziens
- now the americans pulled out but still funds
13
Q
Saudi arabia
A
- part of saudi arabia is extremely wealthy while most isnt and receives socialized medicine
- has wealth -> not distributed
- saudi red crescent authority
- national network
- found foreign programs that they could fund and then eventually take over bc they didnt have anyone to staff the programs
- flight system
14
Q
Australia
A
- vast majority is rural
- royal flyng doctor service (RFDS) - emergency and family medicine
- some places has no access to healthcare at all
- someone is going into labor -> someone would fly in
- all levels of care
- in the cities -> ground ambulance and flight that is funded by the government * (socialized)
15
Q
canada
A
- population centers
- vast majority is not populated (similar to australia)
- separated by temperatures
- so cold IV bags and ventilator moisture freezes
- once they fly out they may be stuck there if the weather is too bad to fly back
- wilderness
- socialized medicine paid by the government (taxes)
- early adopters of community paramedicine
