With SDC support, the pediatric emergency and intensive care services were regionalized in Moldova. Three regional paediatric emergency centers, endowed with modern medical equipment, were created in the municialities of Balti (North), Chisinau (Center) and Cahul (South). These regional centers cover the entire country providing better chances of survival to children, especially to those living in remote localities. As importantly, medical personnel from hospitals and ambulace services benefited from many trainings and exchanges. New training methodologies introduced are being currently used in training medical professionals at training centers created across the country.
Patients’ lives often depend on the quality of care received prior to arriving to the hospital. Therefore, SDC helped improving the dispatch and ambulance services. Now the regionalized system allows sending the closest available and most appropriate ambulance to an emergency, regardless of which region this ambulance belongs to. In addition, the new dispatch system reduces the response time and makes more efficient use of resources. A greater number of life-threatening emergency calls are responded within less than 90 seconds (the time in which the emergency team is briefed and the ambulance is sent on site).
Veaceslav Plamadeala, the head of the Dispatch Department of the National Center for Pre-Hospital Emergency Assistance, and one of the pioneers of the reform said: “I start my every work day by listening to a few records from the previous tour to identify issues related to the interaction with people calling for help. In the past, from the moment of the emergency call to the departure of ambulance, ten minutes would pass. Now the team is mobilized in a minute due to clear operating algorithms and constant monitoring".
Aurelia Muntean, medical dispatcher, noted: "Stress is indispensable to our work. There are times when we have particularly demanding and complicated callers, and our task is to deal with them professionally in order to ensure help reaches the patient. Thanks to SDC support, we are better equipped to manage extremely difficult cases. And we have learnt that teamwork is very important for our efficiency. Now the dispatch and ambulance personnel work as a team and support each other."
With SDC support, five regional emergency training centers have been created and fully-equipped. Here, emergency care providers, including ambulance drivers, are trained in Pediatric Basic and Advanced Life Support. Training results have not been long awaited; ambulance teams applied the acquired skills right away. Ala Rabovila, assistant professor at the State Medical University, said: "Thanks to SDC, we are equipped with low and high fidelity simulation mannequins. We can simulate real emergency cases. It is very important that both medical professionals and students have access to these practical courses.”
Every day emergency doctors, medical assistants and ambulance drivers take decisions that make a difference between life and death. Ambulance teams experience strong emotions side by side with patients’ families.
Natalia Catanoi, assistant university professor and medical doctor in a resuscitation team, shared one of her experiences: “One evening, the dispatcher received a call for a one-month-old child choking on vomit. The resuscitation team was mobilized immediately. At the same time, the dispatcher continued talking to the child's father, guiding him in delivering the first aid, which is extremely important in child emergency. When we arrived, parents were carrying out maneuvers to discharge the child's airways. Yet he did not breathe. We intervened with resuscitation maneuvers and after four minutes the baby began to breathe independently. We stabilized his condition and transported him to the hospital for further medical care. The baby's mother knelt in the ambulance thanking us for saving her baby's life."
A national innovation, supported by SDC, was the introduction, by the National Center for Pre-Hospital Emergency Assistance (NCPHEA), of pediatric first aid courses for community members, particularly for parents, preschool and school teachers, and other adults supervising children. When community members know the danger signs, call instantly emergency service and are able to give first aid, the persons in life-threatening conditions have increased chances to survive, as demonstrated by a recent case in Chisinau.
In the summer of 2017, an accident occurred in a shopping center -- a four-year-old boy fell into the void from a two-meter height. The panicking parents and witnesses of the accident jumped to pick him up, but a woman in the crowd stopped them. She insisted that the boy should not be moved, as this might cause more serious injuries. She added that trauma victims could be moved only by professionals after being properly immobilized. She defended her position by telling that she learned it at a first aid training provided by NCPHEA. The following hospital investigations showed that the boy had a dangerous cervical spine trauma. The woman, who stopped the crowd, saved the child’s life.
