Saudi Cultural Missions Theses & Dissertations
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Item Restricted Towards Enhanced Prehospital Triage for Patients with Traumatic Brain Injury(The University of Manchester, 2025) Alqurashi ,Naif; Body, Richard; Lecky, Fiona; Wibberley, ChristopherBackground: Traumatic brain injury (TBI) is a serious condition that requires rapid and accurate prehospital triage to ensure patients receive timely and appropriate care. Prehospital triage for TBI is an essential process that can significantly impact patient outcomes. This PhD research aimed to enhance prehospital triage for patients with suspected TBI by identifying gaps in current practices and exploring future opportunities to enhance its accuracy and effectiveness. Methods: A multi-phase approach was adopted, consisting of a systematic review, a mixed- methods study, a feasibility study, and an additional qualitative study. The systematic review evaluated the accuracy of existing prehospital triage tools in identifying TBI. The mixed- methods study was conducted using a convergent design that integrated data from a survey of UK ambulance services with qualitative data from semi-structured interviews. The survey mapped current practices, while the interviews explored the challenges of triaging, future opportunities, and the barriers and facilitators to implementing new diagnostic tools. The feasibility of a large-scale study to assess the implementation of the Canadian CT Head Rule (CCHR) in the prehospital field was also examined. After pre-defined feasibility criteria were not met, an additional qualitative study was conducted to identify the barriers and facilitators to paramedic research participation. Results: The systematic review revealed that existing prehospital triage tools for TBI have variable and generally suboptimal diagnostic accuracy, with sensitivity ranging from 19.8% to 87.9% and specificity from 41.4% to 94.4%. Concerns were particularly identified regarding the under-triaging of older patients. The mixed-methods study highlighted significant challenges faced by paramedics in triaging TBI, especially in non-obvious cases and among older populations. It also identified considerable variation in the use of triage criteria and indicated that existing major trauma triage tools do not adequately address the specific needs of TBI. Key areas for improvement included enhanced education, specific triage criteria for TBI, and the use of new diagnostic tools. The feasibility study faced significant challenges, particularly with regard to recruitment rate. As a result, the study concluded that a large-scale study is not feasible in its current form. These challenges highlight the need to explore factors influencing paramedic engagement with research. Additional qualitative interviews identified several barriers to paramedic research engagement, including time constraints due to demanding work schedules, burnout from high-intensity work, and mixed attitudes toward clinical studies. The interviews also suggested strategies to enhance engagement, such as offering incentives, improving communication, and providing organisational support. Conclusion: This PhD research mapped national care pathways for prehospital TBI triage, identifying key gaps and challenges in current practices. It highlighted the suboptimal diagnostic accuracy of existing triage tools and identified important areas for improvement, such as the need for TBI-specific triage criteria and improved paramedic training. Additionally, the feasibility study revealed significant challenges in paramedic research engagement, emphasising the need for innovative recruitment strategies to support definitive future studies. These findings lay a foundation for advancing prehospital TBI care and guiding future research to optimise patient outcomes.13 0Item Restricted Clinical Feedback in Emergency Medical Service (EMS) Education: Identifying and resolving the training needs of clinical supervisors in Saudi Arabia(Cardiff Univeristy, 2024-03) Algabgab, Mohammed Fahad; Tombs, Michal; Riley, StephenClinical supervision and feedback are crucial in Emergency Medical Services (EMS) education, as they play a significant role in enhancing the competence and professional growth of EMS students . Supporting and addressing the training needs of supervisors is essential to ensuring they can provide effective feedback and guidance. However, there is no existing literature on the specific training needs of EMS supervisors in the unique cultural context of Saudi Arabia, highlighting the need for focused research in this area. Grounded in the Clinical Performance Feedback Intervention Theory (CP-FIT), the research navigated through a comprehensive examination of clinical feedback’s perceptions, challenges, and training needs from the perspectives of both EMS students and clinical supervisors. The thesis begins with a scoping review, finding that only twelve studies specifically targeted clinical feedback in EMS education over the past two decades, highlighting its importance but also underscoring gaps in the literature. Notably, existing studies fail to explore the perceptions of clinical feedback between students and supervisors and largely focus on the general context of clinical placements, thus diluting the potential insights into feedback’s effectiveness, challenges, and impact on learning and performance. Furthermore, it notes a lack of research in EMS education, especially within Saudi Arabia. To address these gaps, the thesis delves into the perceptions of EMS students and clinical supervisors in Saudi Arabia, thereby filling a regional research void. It investigates the specific challenges in feedback provision and receipt, emphasising the training needs of supervisors, including effective communication, personalised feedback, constructive methods, emotional intelligence, feedback follow-up, technology use, understanding feedback differences, and promoting a positive feedback environment. Furthermore, the thesis employs a Delphi study to consolidate expert consensus on the best approaches to address identified challenges and needs in clinical feedback, including the particular training needs of clinical supervisors. The findings highlight the need for a structured feedback approach that considers the diverse needs and perceptions of both students and supervisors. The thesis proposes a comprehensive strategy, including tailored training programmes and quality assurance and ongoing support, to improve clinical feedback standards. This strategy aims to bridge perceptual gaps, and to foster the students’ learning and professional growth.20 0Item Restricted Assessing Disaster Preparedness Among SRCA Emergency Medical Services Personnel in Saudi Arabia(University of Portsmouth, 2024-11-14) Aldhilan, Ahmed; Solana, CarmenPrehospital Emergency Medical Services (EMS) play a critical role in disaster response, particularly in regions prone to various hazards, such as Saudi Arabia. This study evaluates the readiness and effectiveness of the Saudi Red Crescent Authority (SRCA) workforce in disaster response, focusing on regional variations, skill competencies response strategies, and identifying potential areas for improvement. The research utilised a mixed-methods approach, including a quantitative questionnaire completed by 259 SRCA personnel and qualitative interviews with key management figures. The findings reveal significant strengths in basic emergency response skills such as First Aid and CPR, especially among more experienced personnel. However, notable gaps were identified in inter-agency coordination and awareness of certain disaster risks, such as earthquakes and terror attacks. Additionally, regional disparities in disaster preparedness were observed, with some areas, like Jazan and Asir, demonstrating higher confidence levels, while others, such as Tabuk and Makkah, indicated lower preparedness. These findings underscore the need for targeted training, enhanced inter-agency collaboration, and region-specific disaster management strategies. The study concludes that while experience significantly enhances individual preparedness, comprehensive disaster management requires a broader focus on collaborative efforts and tailored interventions across all regions. Further research is recommended to expand these findings and support the ongoing improvement of disaster preparedness within the SRCA and similar organizations.24 0Item Restricted Facilitators and barriers to the effective management of major trauma by pre-hospital medical services following road traffic accidents in Saudi Arabia(Saudi Digital Library, 2023-02-28) Althagafi, Zayed Masad; Wark, Stuart; Ranmuthugala, Geetha; Leek, MalcolmEmergency medical services (EMS) provide assistance to patients through pre-hospital management and support, including on-site treatment of traumatic injuries arising from road traffic accidents. Saudi Arabia currently has one of the highest road traffic accident-related mortality rates in the world; however, there is a dearth of published research in the Saudi Arabian context that examines pre-hospital emergency management practices in the context of blunt trauma patients' outcomes arising from road traffic accidents. The Saudi Red Crescent Authority, the main provider of community emergency medical services in Saudi Arabia, is the primary service that delivers pre-hospital trauma assistance to patients injured in a road traffic accident. The goal of this thesis is to establish information can be used to develop and recommend specialised and specific solutions for adoption by the Saudi Red Crescent Authority to reduce the currently high rate of mortality and morbidity following road traffic accidents.27 0Item Restricted Disaster Preparedness Among Emergency Medical Services Worker in Saudi Arabia(Saudi Digital Library, 2023-05-03) Almukhlifi, Yasir Matar D; Hutton, Alison; Crowfoot, GaryDisasters are unexpected events that impose destructive consequences which can adversely overwhelm countries' healthcare response systems. Countries are required to prepare their healthcare workers for disaster response effectively. A greater level of preparedness is associated with a more effective response to disasters. Emergency Medical Services (EMS) workers are vital and essential to effective disaster response in Saudi Arabia. This research aims to examine the perception of knowledge, skills, and preparation for disaster preparedness among EMS workers in Saudi Arabia. It further seeks to explore the needs of EMS workers and perceived barriers and facilitators of disaster preparedness within this context. This study used an explanatory sequential mixed method design to examine disaster preparedness among EMS workers in Saudi Arabia. A descriptive cross-sectional survey using the Disaster Preparedness Evaluation Tool (DPET) was distributed to EMS workers in military and government hospitals across three Saudi Arabian cities (Riyadh, Jeddah, and Dammam) in phase one of the study. This phase aimed to explore the perceived disaster knowledge, skills, and preparedness levels of EMS workers in Saudi Arabia. The findings from Phase One were used to inform phase two by providing direction for interview questions. Participants who expressed their interest in phase one were interviewed in phase two. This phase aimed to explore the facilitators, barriers, and cultural factors that affect disaster preparedness among EMS workers in Saudi Arabia. Two-hundred-and-eighty-seven EMS workers participated in this study. In phase one, participants reported moderate knowledge, skills, and preparedness levels for disasters. However, EMS workers were underprepared in certain areas of disaster preparedness, specifically a lack of isolation and decontamination skills during bioterrorist or biological attacks (CBRNE). Interview findings showed that three factors influenced their preparedness levels: personal preparedness, workplace preparedness, and socio-cultural influences. Participants reported difficulties in accessing workplace policies and procedures, a lack of standardisation in managing and implementing EMS regulations, and irregularity in providing drills and exercise regimes in Saudi Arabia. Results also highlighted the socio-cultural impact on disaster knowledge, skills, and preparedness of EMS workers. Prevailing social-cultural expectations in Saudi Arabia are biased against women. This results in a predominantly male and patriarchal structure within the EMS profession. Consequently, women in this study had fewer opportunities to enhance their knowledge, skills, and preparedness than their male EMS peers. This research was able to explore the perception of EMS workers’ disaster knowledge, skills and preparedness from a geographically and demographic representative sample of the Saudi Arabia EMS workforce. Important insights from the study could advance the EMS workforce and increase disaster preparedness. These include providing equitable, standardised, and inclusive education and training opportunities for all EMS workers in Saudi Arabia. In addition, local, postgraduate programs would further support Saudi Arabia’s disaster preparedness. Saudi Arabian workplaces will benefit from recruiting more female EMS workers and standardising staff rotation. This will empower EMS workers within all healthcare systems in Saudi Arabia. The Saudi Association of Emergency Medical Services (SAEMS) should implement these changes and be provided with appropriate governance powers to regulate the profession.50 0