Guillaume Alinier

Hamad Medical Corporation Ambulance Service

Disaster management, mainly related to chemical, biological, radiological and nuclear (CBRN) incidents, is a critical field that requires constant evaluation to improve preparedness and response strategies. This review synthesises evidence on global health sector strategies for CBRN preparedness, gathering lessons to enhance policymaking for future...

Background Objective structured clinical examination (OSCE) is well‐established and designed to evaluate students' clinical competence and practical skills in a standardized and objective manner. While OSCEs are widespread in higher‐income countries, their implementation in low‐resource settings presents unique challenges that warrant further inves...

Background The global evolution of pre-hospital care systems faces dynamic challenges, particularly in multinational settings. Machine learning (ML) techniques enable the exploration of deeply embedded data patterns for improved patient care and resource optimisation. This study’s objective was to accurately predict cases that necessitated transpor...

Background Efficient resource distribution is important. Despite extensive research on response timings within ambulance services, nuances of time from unit dispatch to becoming available still need to be explored. This study aimed to identify the determinants of the duration between ambulance dispatch and readiness to respond to the next case acco...

Background and Aim Though emergency medical services (EMS) respond to all types of emergency calls, they do not always result in the patient being transported to the hospital. This study aimed to explore the determinants influencing emergency call‐response‐based conveyance decisions in a Middle Eastern ambulance service. Methods This retrospective...

Objective This research explored the experiences and perspectives of patients declining hospital transportation after receiving prehospital emergency care using advanced computational techniques. Method Between 15th June and 1st August 2023, 210 patients in Qatar, treated by Hamad Medical Corporation Ambulance Service (HMCAS) but refusing transp...

Introduction: The values and attitudes of healthcare professionals influence their handling of "do-not-attempt-resuscitation" (DNAR) orders, as does that of the families they interact with. The aim of this study was to describe attitudes, perceptions, and practices among community-based medical practitioners towards discussing cardiopulmonary resus...

Over the past 3 decades, the diversity of ethnic, religious, and political backgrounds worldwide, particularly in countries of the Middle East and North Africa (MENA), has led to an increase in the number of intercountry conflicts and terrorist attacks, sometimes involving chemical and biological agents. This warrants moving toward a collaborative...

Introduction The values and attitudes of healthcare professionals influence their handling of “do-not-attempt-resuscitation” (DNAR) orders, as does that of the families they interact with. The aim of this study was to describe attitudes, perceptions, and practices among community-based medical practitioners towards discussing cardiopulmonary resusc...

Background Health practitioners must be equipped with effective clinical reasoning skills to make appropriate, safe clinical decisions and avoid practice errors. Under-developed clinical reasoning skills have the potential to threaten patient safety and delay care or treatment, particularly in critical and acute care settings. Simulation-based educ...

Introduction: Research on gender differences in OHCA incidence, characteristics, and outcomes is lacking in the Middle East. We evaluated gender differences in adult non-traumatic OHCA by incidence, characteristics, and achieving prehospital ROSC in Qatar. Methods: We analyzed data obtained from Hamad Medical Corporation on adult, non-traumatic, EM...

Simulation can immerse learners in scenarios that mimic clinical situations, simultaneously mitigating safety risks and increasing standardization in healthcare education [1]. Through simulation, learners can get the chance to develop clinical reasoning with focused learning opportunities [2]. Clinical reasoning is multidimensional in nature, and u...

In the past 2 years, ASPiH (Association for Simulated Practice in Healthcare) annual conferences offered a space for reflection on crucial topics central to simulation-based activities [1,2], and this year is no exception. The ASPiH 2023 theme is Sustainable Simulation. The term sustainable derives from the Latin word ‘ The simulation community has...

Introduction: Pets and exotic animals are increasingly popular all over the world. Some of these animals may cause injuries to their owners or other people during interactions. Both injuries and systemic infections always present diagnosis and treatment challenges. Emergency physicians´ clinical experience in managing patients with injuries caused...

Background In pre-hospital emergency care, decisions regarding patient non-conveyance emerged as significant determinants of healthcare outcomes and resource utilization. These complex decisions became integral to the progress of emergency medical services, thus warranting an evolving exploration within the medical discourse. Objectives and method...

Since 1970, Middle East and North African (MENA) countries have witnessed evolutionary industrial development and long‐running terrorist and inter‐country conflicts. Additionally, the risk of accidental, deliberate or natural chemical, biological, radiological, and nuclear (CBRN) threats has also increased, requiring a collaborative review of the h...

Background: Previous studies conducted in North America, Europe, and East Asia (Liu et al., EClinicalMedicine 44:101293, 2022; Matsui et al., JAMA Netw Open 2:e195111, 2019; Awad et al., J Am Coll Emerg Physicians Open 4:e12957, 2023; Yoon et al., Prehosp Emerg Care :1-7, 2022) reported gender disparities in the provision of bystander CPR for pati...

Background Data on stability and suitability to use normal saline stored under stress conditions in ambulances is lacking. Objective We aimed to study the impact of exposure to extreme temperature variations on normal saline stability and compatibility with its packaging. Methods Normal saline in 96 polyolefin bags were exposed to continuous temp...

Background: The increasing prevalence of comorbidities worldwide has spurred the need for time-effective pre-hospital emergency medical services (EMS). Some pre-hospital emergency calls requesting EMS result in patient non-conveyance. Decisions for non-conveyance are sometimes driven by the patient or the clinician, which may jeopardize the patien...

This article is an illustration of ‘Lessons from the Field’. The Journal of Contingencies and Crisis Management has begun to present lessons coming from professionals engaged in crisis management. ‘Lessons for the Field’ provides insights that can be useful to other professionals. Moreover, ‘Lessons from the Field’ can stimulate ideas for researche...

This simulation toolkit for pre-registration physiotherapy education evolved from a project funded by the Chartered Society of Physiotherapy (CSP) in the United Kingdom (UK), KNOWBEST: The KNOWledge, BEhaviours and Skills required of the modern physioTherapy graduate including the future role of practice- based learning. The mixed methods project,...

Aim: This scoping review aims to explore the effect of FSS and mental simulation on the decision-making skills of nursing students. Background: Full-scale simulation (FSS) has been the most used simulation modality in nursing education due to its applicability to enhance both technical and non-technical skills. However, FSS can be excessively co...

Background: Pre-hospital emergency calls do not always result in the patient being transported to the hospital. Such decisions can jeopardize healthcare outcomes and lead to wasting resources. Objectives and Methods: The purpose of this review was to summarize the various theories reported in the literature regarding patient non-conveyance to healt...

Background Previous studies conducted in North America, Europe, and East Asia (10, 16, 20, 21) reported gender disparities in the provision of bystander CPR for patients with out of hospital cardiac arrest (OHCA). However, it remains unknown whether similar disparities exist in the Middle Eastern and Gulf regions. The primary objective of this stud...

Simulation in healthcare education enables learners to practice in a realistic and controlled environment without putting real patients at risk. Deception can be incorporated to generate a realistic learning experience. We aim to perform a systematic review of the literature to study the effect of deception in SBE in healthcare. Online database sea...

Background: The critical care environment is characterized with a high level of workload, complexity, and risk of committing practice mistakes. To avoid clinical errors, health care professionals should be competent with effective clinical reasoning skills. To develop effective clinical reasoning skills, health care professionals should get the ch...

Background: Paramedics who perform patient triaging in case of a mass casualty incident generally receive triage training during their undergraduate educational program. Triage training can be facilitated using various simulation modalities together with theoretical training. Objectives: The aim of this study is to determine the effectiveness of...

As almost 1.5 million additional people from around the globe poured into Qatar—a small country of 2.8 million inhabitants—immense planning went into being prepared for the significant influx of people and the increased pressure on prehospital healthcare services

Prehospital emergency health services play an important role in reducing mortality and morbidity by providing the necessary medical interventions at the scene and during patient transportation to hospital. The effectiveness of prehospital health services depends greatly on having a sufficient number of an appropriately trained professional workforc...

Diabetes is rising at an alarming rate, as 1 in 10 adults worldwide now lives with the disease. In Qatar, a middle eastern Arab country, diabetes prevalence is equally concerning and is predicted to increase from 17% to 24% among individuals aged 45 and 54 years by 2050. While most healthcare strategies focus on preventative and improvement of in-h...

Background: As the State of Qatar is soon to host the Federation International of Football Associations (FIFA) 2022 World Cup tournament, the health sector has also been preparing for the event to increase its capacity to meet the expected additional health demand. The readiness of the health sector is being tested and improved through a number of...

This study aimed to determine whether the Hamad Medical Corporation Ambulance Service (HMCAS) personnel fulfil the pre-hospital readiness requirements for hazardous material and chemical, biological, radiological, and nuclear (HazMat-CBRN) incidents. This cross-sectional study performed an online assessment of non-specialist paramedics’ behaviour a...

Background and Aim The transport of coronavirus‐2019 (COVID‐19) patients on extracorporeal membrane oxygenation (ECMO) is a challenging situation, especially for healthcare workers (HCWs), due to the risk of cross‐infection. Hence, certain precautions are needed for their safety. The study aims to evaluate the risk of COVID‐19 transmission to HCWs...

Background: In the past 20 years, humanity, particularly in the Middle East, has experienced three outbreaks of coronavirus disease, restricting our ordinary activities. In addition to the growing risk of chemical, biological, radiological, nuclear, and explosive incidents, discussing an alternative to the usual refresher or first-time face-to-face...

Background: Research strengthening and capacity development in academic health systems are important for advancing medicine, delivering best practices, improving patient outcomes, and reducing healthcare costs. The Research Forum is a biomedicine and health research strengthening program facilitated by the lead organization of the Academic Health S...

Background: Qatar has a unique demographic composition, involving hundreds of thousands of male blue-collar workers living in places where physical distancing measures are difficult to implement. This study aimed to describe the rapid development and operations of a temporary isolation facility, which was composed of tents, for asymptomatic COVID-...

Building upon the use of simulation to improve systems, as considered during last year’s conference The simulation community has been attentive to the issues raised and must not shy away from exploring deeper these underlying issues that may impair adequate care. Sensitive to this need, diversity and inclusion are the themes of this year’s Associat...

The critical care environment is stressful with complex clinical cases and high levels of workload [1]. Adequate exposure to various clinical experiences is essential to develop effective clinical reasoning skills [2]. Taking into consideration the risk of clinical practice mistakes and the importance of patient safety, simulation is an effective m...

The risk of novel coronavirus disease (COVID-19) transmission in the confined mobile ambulance compartment is increased during aerosol-generating procedures and close proximity. Paramedics are encouraged to increase body-surface-isolation by donning additional personal protective equipment (PPE) during patient encounters. This study aimed to better...

The provision of prehospital emergency healthcare around the world varies greatly. Each country implements a delivery model according to its own economy, population, culture, policy and geography, including Qatar. In the past decade, in preparation to host the FIFA 2022 World Cup, significant technological investments have been made to improve and...

Smart health presents an ever-expanding attack surface due to the continuous adoption of a broad variety of Internet of Medical Things (IoMT) devices and applications. IoMT is a common approach to smart city solutions that deliver long-term benefits to critical infrastructures, such as smart healthcare. Many of the IoMT devices in smart cities use...

Effective clinical reasoning depends upon the nurse's ability to collect the right cues and to take the right action for the right patient at the right time and for the right reason. Effective clinical reasoning is essential to ensure patient safety and to enhance patient outcomes, therefore having structured clinical reasoning models for clinical...

Various simulation modalities are commonly used to enhance learners' technical and non-technical skills in individual and group-based educational activities. After having taken part in such activities, knowledge and skills can then be consolidated by providing feedback to learners or engaging them in a facilitated debriefing process promoting refle...

Background: Mental simulation has been used in many healthcare disciplines to enhance technical skills as well as non-technical skills. However, mental simulation is mostly conducted individually which is not suitable to practise skills requiring teamwork skills. We propose an enhanced mental simulation modality which enables nurses to practise ski...

Introduction: Clinical reasoning is described as a complex cognitive process that uses formal and informal thinking to gather and analyze patient information (1). Effective clinical reasoning depends upon the nurse’s ability to collect the right cues and to take the right action for the right patient at the right time, and for the right reason (2)....

Background: Cardiac arrests in admitted hospital patients with trauma have not been described in the literature. We defined "in-hospital cardiac arrest of a trauma" (IHCAT) patient as "cessation of circulatory activity in a trauma patient confirmed by the absence of signs of circulation or abnormal cardiac arrest rhythm inside a hospital setting,...

Simulations are beneficial in evaluating clinicians’ empirical competencies through practical skills, prioritizing, and decision-making as part of patient care scenarios generally run in a full-scale physical context. However, such simulations require physical space, manufacturing, and replacement of damaged or used equipment. On the other hand, vi...

Background Hazardous Material—Chemical, Biological, Radiological, and Nuclear (HazMat‐CBRN) incidents, though infrequent, are environmentally precarious and perilous to living beings. They can be deliberate or accidental or follow the re‐emergence of highly contagious diseases. Successful management of such incidents in pre‐hospital settings requir...

Introduction: Healthcare research contributes to the well-being of a population; hence, it is important to use the right system to ensure that junior researchers develop the required skills. Current research-strengthening and capacity development programs might lack a research process-based common framework or model leading to variable and subopti...

The blind bougie technique is performed when the epiglottis is visible to the intubator, but the vocal cords cannot be seen (Grade III Cormack-Lehane view). The blind bougie technique for endotracheal intubation is not routinely performed by Critical Care Paramedics for a failed intubation in the prehospital setting. However, at Hamad Medical Corpo...

Background Prehospital administration of tranexamic acid (TXA) to injured patients is increasing worldwide. However, optimal TXA dose and need of a second infusion on hospital arrival remain undetermined. We investigated the efficacy and safety of the second in-hospital dose of TXA in injured patients receiving 1 g of TXA in the prehospital setting...

As the COVID-19 pandemic and associated measures continue to have an impact on global populations, Guillaume Alinier explores the effects on the wellbeing of frontline prehospital care professionals and what can be done to support them to continue providing high-calibre care and growing as a profession

Background: The transport of coronavirus-2019 (COVID-19) patients on extracorporeal membrane oxygenation (ECMO) is a challenging situation, especially for the healthcare workers (HCWs), due to the risk of cross-infection. Hence, certain precautions are needed for their safety. Aim: The study aims to evaluate the risk of COVID-19 transmission to HC...

The level of performance of every clinician and of the overall multiprofessional team relies on the skills and expertise they have individually and collectively acquired through education, training, self-directed learning, and reflection. Simulation-based education (SBE) is playing an increasingly important role in that respect, and it is sometimes...

Introduction: Young driver behavior and safety are key concerns in Qatar, where they are disproportionately represented amongst road victims and fatalities. This paper summarizes the proceedings of a workshop, entitled “Enhancing the Safety of Young and Novice Drivers in Qatar”, held as a pre-conference workshop of the 24th World Congress of the In...

In the above article [1] , the fifth author, Guillaume Alinier, was missing. The author byline should have five authors: Abdullah Alsalemi, Yahya Alhomsi, Fayçal Bensaali, Guillaume Alinier, and Ali Ait Hssain.

Clinical reasoning is interconnected with decision-making which is a critical element to ensure patient safety A scoping review was undertaken to answer the questions: What are the best available valid and reliable tools to evaluate clinical reasoning while attending simulation-based activities? Do we have valid and reliable clinical reasoning asse...

Full-scale simulation (FSS) is one of the most effective and commonly used simulation modalities in healthcare education. It enables the rehearsal of skills in a safe and controlled environment without the risk of harming patients, which provides a strong argument for it being a useful educational approach. With technological developments and the w...

Debriefing is a key component of all simulation-based educational (SBE) activities and is an activity for which a multitude of approaches and models have been developed and implemented (Oriot & Alinier, 2016). To improve SBE practice in general, the International Nursing Association for Clinical Simulation and Learning (INACSL) has outlined a set o...

Offering high-quality and purposeful simulation-based educational (SBE) activities to learners requires careful planning The aim of this abstract was to present the changes made to the Simulation Design Standard in comparison to its previously published version From 2019 to 2021, a group of simulation educators and researchers representing multiple...

Background: Failed intubation is the single most important cause of patient morbidity and mortality during anesthesia for surgery. The incidence of difficult intubation could be as high as 12% while failed intubation is around 0.5%. 1 Disaster and mass casualty management may increase this risk multi-fold due to the paucity of airway-trained medica...

Background: Paramedics are subjected to high levels of stress, which increase their risk of depression, burnout, quitting the profession, or even committing suicide. 1 Some recent studies have focused on the coping strategies used by nurses in response to the COVID-19 pandemic 2 , but little is known regarding paramedics. This study explored the po...

Background: The lack of healthcare quality management poses significant legal and financial implications 1,2 . A proactive approach to systems improvement seems warranted and reasonable. It is not clear if current quality control measures are perceived by patients. The study aims to understand if any correlation exists in this respect in the contex...

Welcome to this special issue of JEMTAC dedicated to the selection of 74 abstracts submitted to the Qatar Health 2022 online conference. The years are passing and the COVID-19 pandemic situation has not changed much globally. Although new vaccines have been developed and several restrictive measures have been rolled out in most countries to protect...

Background: Normal saline 0.9 % (NS) is the most widespread crystalloid used as a life-saving intravenous (IV) fluid. 1 NS contains sodium and chloride in equal concentrations and is subject to thermal stress conditions while stored and transported by clinicians in the pre-hospital environment. 2 This study aimed to investigate the effect of high-t...

Background: People respond to stressful situations differently based on their ethnicity. 1 This study explored the impact of ethnicity on coping strategies used to deal with work-related stress among Hamad Medical Corporation Ambulance Service (HMCAS) paramedics in Qatar before and during the COVID-19 pandemic. It is based on the associated work co...

Background: In the pre-hospital context, paramedics carry medications in multi-compartment medication bags. However, these medications are occasionally subjected to temperature and humidity variations as they are being carried around by paramedics during their operational duties. 1,2 To develop a protocol to investigate medications’ stability insid...

Background: Paramedics need a range of medications that are stored in bags for easy transportation to the patient's side and are exposed to temperature variations, especially in a hot country like Qatar 1 . The thermal stability of some medications was examined in previous studies 2,3 . Methods: A safe and practical solution had to be found and sho...

Background: The lack of healthcare quality management poses significant legal and financial implications 1,2 . A proactive approach to systems improvement seems warranted and reasonable. It is not clear if current quality control measures are perceived by patients. The study aims to understand if any correlation exists in this respect in the contex...

Background: 0.9% sodium chloride (NaCl) fluid bags are commonly stored in ambulances. Despite that the ambulances normally use air-conditioning during operational shifts, NaCl bags are exposed to deviations from the controlled environmental conditions that could affect their integrity 1,2 , as all ambulances are not constantly in use. Although stre...

Background: Early assisted patient discharge has been implemented in Qatar since 2014 through the introduction of a Mobile Healthcare Service (MHS) with family physicians, nurses, and paramedics doing home visits 1 . Studies have explored the effect of Ramadan on Muslims, but findings have been variable 2,3 . This research aims to study and quantif...

Background: Acute coronary syndrome (ACS) is one of the most common life-threatening diseases worldwide.1 Early diagnosis, advanced cardiac life support, and rapid transportation to a cardiac center are essential to reduce mortality and morbidity. ST-segment elevation myocardial infarctions (STEMI) are life-threatening and are diagnosed with a 12-l...

Background: Clinical reasoning is described as a reflective process that enables health care practitioners to collect data, solve problems, and make decisions and judgments to enhance patient outcomes and patient safety 1 . To avoid practice mistakes, healthcare professionals should possess or develop effective clinical reasoning skills. To develop...

Background: Internationally, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, causing corona virus disease (COVID-19), has increased the demand on healthcare services and resources 1 . The proper use of personal protective equipment (PPE) by paramedics has recently become apparent 2 . The risk of COVID-19 transmission has...

Background: For some time, paramedics and nurses of the National Ambulance Service in Qatar provided outpatient parenteral antimicrobial therapy (OPAT) to patients with the support of Family Physicians. Like in many other countries of the Middle East, there is a high prevalence of antimicrobial resistance which makes treating infectious conditions...

Background: A high level of emergency medical care is now expected from paramedics dealing with the sick and injured, including pediatric patients. 1,2 Very little is known of the paramedics’ perception of competency and of pediatric prehospital education and training, which is so critical to improve a paramedics’ knowledge and performance of impor...

Background: Paramedics are at risk of burnout which represents a concern for the healthcare system and public health 1 . In Italy, about 20% of health practitioners were infected, and some died during their work fighting against the COVID-19 pandemic 2 , but little is known regarding paramedics. This study assessed the level of stress associated wi...

Background: An inability to assess pain may lead to poor or incorrect treatment. However, pain is often poorly assessed in the prehospital setting. Objective: This study aimed to determine the inter-rater reliability of the Wong-Baker FACES Pain Rating Scale in the prehospital setting in Qatar with five adult standardised patients. Methods: Thi...

Nearly all medical emergency calls are related to someone experiencing some form of discomfort—either due to trauma or pain. Initial pain assessment may be undertaken over the telephone by an emergency medical dispatcher, without seeing the patient; however, the next key moment in pain assessment is completed patient-side by the paramedic. This inq...

Simulation plays an important part in enhancing the outcomes of clinical training worldwide. In particular, extracorporeal membrane oxygenation (ECMO) is a life-saving procedure that utilizes a cardiopulmonary bypass circuit to offer short or mid-term respiratory and circulatory assistance to seriously ill patients. After the current Coronavirus (C...

Background: Transport and retrieval of patients on extracorporeal membrane oxygenation (ECMO) support can be hazardous to patients and healthcare workers (HCWs). COVID-19 is highly contagious and can be transmitted by contact, droplet, or airborne route. Transport of COVID-19 patients exposes HCWs and the public to infection risks, hence strict mea...

Introduction Full-scale simulation (FSS) has been the most commonly used simulation modality in nursing education due to its applicability to enhance both technical and non-technical skills. However, being excessively costly and other factors such as technophobia and lack of trained staff and support make FSS less accessible, especially for nursing...

Background: Hazardous Materials and Chemical/Biological/Radiological/Nuclear (HazMat-CBRN) incidents represent a serious threat to the population and the environment. They require a pre-hospital medical response system well equipped and supported with logistics and clinicians with appropriate knowledge and skills to prevent exposure and mitigate ri...

Background: IoMT (Internet of Medical Things) devices (often referred to IoMT domain) have the potential to quickly diagnose and monitor patients outside the hospital by transmitting information through the cloud domain using wireless communication to remotely located medical professionals (user domain). shows the proposed IoMT framework designed t...