oa One year exploring Qatar's ambulance service: Views from an Emergency Medicine Fellow

Introduction: Pre-hospital care professionals work outside or in confined spaces. Issues like population demography, cultural diversity, geography, roads, and climate regularly challenge them. Some of these factors might be overlooked by the hospital-based mentality of other clinicians. Providing them an opportunity to accompany paramedics in their own environment may help them better understand the paramedics' role and scope of practice, and improve the patient handover process between these two “alienated worlds” of medical professionals.

Methods: An Emergency Medicine Specialist spent 12 months within Qatar's national Ambulance Service. Regular rotations through its various departments were facilitated, including an 8-week ride along with a Rapid Response Vehicle (Delta unit) dealing with emergency calls. A daily journal was written to record the experiences and audit data was accessed to gain a deeper understanding of the Service.

Results: This experience was an eye opener. Delta officers are very experienced and can provide a global perspective of the operations. Their main focus is safety from a 360-degree scene perspective, team leadership, and communication. The type of calls and circumstances provided a unique view of the scene realities. Ambulance crews were observed dealing with difficult situations, assessing patients, and initiating treatment in challenging environments. Depending on the type of emergency, Ambulance Paramedics were joined by a Critical Care Paramedic who has more advanced skills and the ability to administer a broader range of medications.

Conclusion: This program has been effective at introducing a hospital-based clinician to the pre-hospital world and should be Considered to all Emergency Fellows. It highlighted the complexities of working in the community with limited resources and the importance of communication to ensure the provision of safe and effective care. Understanding the Ambulance Service staff's level of competency will also enhance the handover process and help build trust in the Paramedics.