Developing and integrating a destination decision support algorithm into an innovative electronic communication platform to improve injury care service coordination in Rwanda: The Rwanda912 study protocol.

Introduction: Delays in getting injured patients to hospital in a timely manner can increase avoidable death and disability. Like many low- or middle-income countries (LMICs), Rwanda experiences delays related to lack of efficient prehospital communication and formal guidelines to triage patients for hospital care. This paper describes the protocol to develop, roll out, and evaluate the effectiveness of a Destination Decision Support Algorithm (DDSA) integrated in an electronic communication platform, '912Rwanda'.

Challenges and opportunities to improve efficiency and quality of prehospital emergency care using an mHealth platform: Qualitative study in Rwanda.

Introduction: Prompt, high-quality pre-hospital emergency medical services (EMS) can significantly reduce morbidity and mortality. The goal of this study was to identify factors that compromise efficiency and quality of pre-hospital emergency care in Rwanda, and explore the opportunities for a mobile health (mHealth) tool to address these challenges.

Methods: In-depth interviews were conducted with 21 individuals representing four stakeholder groups: EMS dispatch staff, ambulance staff, hospital staff, and policymakers.

Challenges Locating the Scene of Emergency: A Qualitative Study of the EMS System in Rwanda.

Background: Timely prehospital emergency care significantly improves health outcomes. One substantial challenge delaying prehospital emergency care is in locating the patient requiring emergency services. The goal of this study was to describe challenges emergency medical services (EMS) teams in Rwanda face locating emergencies, and explore potential opportunities for improvement.

Developing Sustainable Prehospital Pediatric Care in Rwanda.

Objective: Unintentional injury is the leading cause of death in children older than 1 year and disproportionately affects pediatric patients in low- and middle-income countries.Improved prehospital care capacity has demonstrated the ability to improve care and save lives. Our collaboration developed and implemented a sustainable prehospital emergency pediatrics care course (EPCC) for Service d'Aide Medicale Urgente, the public emergency medical service in Rwanda.

Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations.

Background: Surgical capacity building has gained substantial momentum. However, care at the hospital level depends on improved access to emergency services. There is no established model for facilitating trauma and EMS system capacity in LMIC settings.

The impact of data feedback on continuous quality improvement projects in Rwanda: A mixed methods analysis.

Background: Injuries are a leading cause of death and disability globally. Over 90% of injury-related mortality happens in low- and middle- income countries (LMICs). Rwanda's pre-hospital emergency system - Service d'Aide Medicale Urgente (SAMU) - and their partners created an electronic pre-hospital registry and Continuous Quality Improvement (CQI) project in 2014.

Developing sustainable prehospital trauma education in Rwanda.

Introduction: Every year, >5 million people worldwide die from trauma. In Kigali, Rwanda, 50% of prehospital care provided by SAMU, the public prehospital system, is for trauma. Our collaboration developed and implemented a context-specific, prehospital Emergency Trauma Care Course (ETCC) and train-the-trainers program for SAMU, based on established international best practices.

Prehospital emergency obstetric and neonatal care train-the-trainers program in Rwanda.

Objective: To improve maternal mortality rates, our collaboration developed and implemented a context-specific, prehospital Emergency Obstetrics and Neonatal Course (EONC) and train-the-trainers program in Rwanda.

Methods: Two cohorts of staff participated in the program-the SAMU emergency medical service and staff from district hospitals. A 2-day course was developed, consisting of skills stations, simulations, and didactics.

The Initial Prehospital Management of Traumatic Brain Injuries in Kigali, Rwanda.

Introduction: Traumatic brain injuries (TBIs) are an important cause of mortality and disability around the world. Early intervention and stabilization are necessary to obtain optimal outcomes, yet little is written on the topic in low- and middle-income countries (LMICs). The aim is to provide a descriptive analysis of patients with TBI treated by Service d'Aide Medicale Urgente (SAMU), the prehospital ambulance service in Kigali, Rwanda.

Prehospital epidemiology and management of injured children in Kigali, Rwanda.

Introduction: Paediatric injuries are a major cause of mortality and disability worldwide, yet little information exists regarding its epidemiology or prehospital management in low-income and middle-income countries. We aimed to describe the paediatric injuries seen and managed by the prehospital ambulance service, Service d'Aide Medicale d'Urgence (SAMU), in Kigali, Rwanda over more than 3 years.

Methods: A retrospective, descriptive analysis was conducted of all injured children managed by SAMU in the prehospital setting between December 2012 and April 2016.