El Médico Familiar Rural en la Sala de Emergencia

Tara Johnson Bruns

Resumen


Este artículo revisa la literatura médica que discute el conocimiento y las habilidades en medicina de emergencia que un médico de familia que practica en áreas rurales debe poseer. Adicionalmente, un médico de emergencias comparte recomendaciones para médicos de familia rurales basándose en un estudio epidemiológico que busca las principales quejas realizadas en un pequeño hospital en el Ecuador rural.

Objetivo: Conocer mediante una investigación bibliográfica, los conocimientos y destrezas que un médico de familia debe poseer en las salas de emergencia en zonas rurales.  .     

Metodología: Se realiza una breve revisión de la literatura médica sobre las recomendaciones para médicos familiares rurales en los EEUU.  Concluyendo con recomendaciones contextualizadas, para la formación de médicos familiares rurales en Ecuador.    

Resultados: La revisión de la literatura indica la escasez de especialistas en emergencias, en áreas rurales en los EEUU, y más aún en países como Ecuador,  y el impacto que puede significar un médico de familia rural con conocimientos y destrezas para  la atención de emergencias.  Algunas de esas destrezas son mencionadas para la formación de médicos familiares rurales en Ecuador incluyen: destrezas en Ecografía, competencia avanzada para liderar el soporte vital avanzado, y un conocimiento profundo del sistema de salud para saber cómo superar las limitaciones que presenta.

Conclusión: La falta de especialistas en emergencia en áreas rurales es una realidad en varios sitios en el mundo.  Una estrategia de corto plazo, es incluir en la formación de los médicos familiares, conocimientos y destrezas en la atención de emergencias.

 

Summary

Thus article reviews medical literature that discusses the knowledge and skills in emergency medicine that a family physician practicing in rural areas should possess. Additionally, an emergency medicine physician shares recommendations for rural family physicians based on an epidemiologic study looking at chief complaints conducted in a small hospital in rural Ecuador.

Methodology: A brief review of the medical literature was conducted regarding recommendations for family physicians working in small emergency departments in rural hospitals in the United States. Subsequently, an experience of working in a rural hospital emergency department is shared. Finally, suggestions are made for the formation of family physicians in rural Ecuador.

Results: A review of the medical literature indicates a a shortage of residency trained emergency medicine physicians in rural United States, and the impact a well-trained rural family physician can have with knowledge and skills in emergency medicine care. Some of these skills are mentioned in the Ecuadorian context through a reflection from a rural hospital in the Northwest Pichincha province. Suggestions for the formation of rural family physicians include: ultrasound skills, advanced life support skills, a strong understanding of the healthcare system to better navigate it.

Conclusion: The shortage of residency trained emergency medicine physicians in rural areas is common worldwide. A strategy to train rural family physicians with knowledge and skills in emergency medicine exists in various countries and should be considered in Ecuador.


Palabras clave


Medicina familiar; medicina rural; emergencia

Texto completo:

VER EN L͍NEA

Referencias


Insitute of Medicine, The Future of Emergency Care in the United States Health System, Hospital Based Emergency Care: At the Breaking Point, “The Emergency Care Workforce” June, 2006, www.iom.edu

Graduate Medical Exam National Advisory Counsel report on the Number of Persons Needed to Support Specific Physician Specialties.

Graham Center One-Pager, Peterson LE et al, Family Physicians Help Meet the Emergency Care Needs of Rural America, AFP April 1, 2006, 73:7

Critical Cghallenges for Family Medicine: Delivering Emergency Medical Care – “Equipping Family Physicians for the 21st Century” (Position Paper) http://www.aafp.org/about/policies/all/critical-challenges.html accedido 10 Mayo 2016

Acreditation Council for Graduate Medical Education. Program Requirements for Graduate Medical Education in Family Medicine. Chicago, Il (2006)

Rodney WM, Martin J, Hahn RG. Enhancing the Family Medicine Curriculum in deliveries (OB) and emergency medicine as a way of developing a world teaching site. Family Medicine, 30, 712-719.

Carter D, Ruiz E, Lappe K. Comprehensive Advanced Life Support: a course for rural emergency care teams. Minnesota Medicine Noviembre 2001. www.mmaonline.net

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Duke, T and Cheema B. “Paediatric emergency and acute care in resource poor settings.” Journal of Paediatrics and Child Health. 52 (2016): 221-226.

Casaletto JJ, Wadman MC, Ankel FK, Bourne CL. “Emergency medicine rural rotations: A program director’s guide.” Annals of Emergency Medicine. 61:5, (2013): 578-584.

Stolz LA, Muruganandan KM, Bisanzo MC, et al. “Point-of-care ultrasound education for non-physician clinicians in a resource-limited emergency department.” Tropical medicine and international health. 10:8, (2015): 1067-1072.

Sippel S, Muruganandan K, Levin A, Shah S. “Review article: Use of ultrasound in the developing world.” International Journal of Emergency Medicine. 4:72, (2011): 1-11.

Menser TL, Radcliff TA, Schuller KA. “Implementing a medical screening and referral program for rural emergency departments.” The Journal of Rural Health. 31 (2015): 126-134.




DOI: http://dx.doi.org/10.23936/pfr.v0i3.162

DOI (VER EN L͍NEA): http://dx.doi.org/10.23936/pfr.v0i3.162.g225

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