| URN | etd-0721126-131041 | Statistics | This thesis had been viewed 8 times. Download 2 times. |
| Author | Yi-da Cai | ||
| Author's Email Address | No Public. | ||
| Department | Institute of construction technology | ||
| Year | 2025 | Semester | 2 |
| Degree | Master | Type of Document | Master's Thesis |
| Language | zh-TW.Big5 Chinese | Page Count | 116 |
| Title | A Study on the Utilization of Civilian Resources for Emergency Medical Services in Remote Areas | ||
| Keyword | |||
| Abstract | Out-of-hospital cardiac arrest (OHCA) is a highly time-sensitive prehospital emergency, and immediate cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are critical to patient outcomes. In remote Indigenous communities, however, geographical distance, transportation barriers, dispersed settlements, limited medical resources, and prolonged ambulance response times often create a critical gap before emergency medical services (EMS) arrive. How trained local lay responders can help bridge this gap has therefore become an important issue in remote emergency care. This study was conducted in the Indigenous communities of Nanˇ¦ao Township, Yilan County, Taiwan. It examined the feasibility of involving local lay responders in prehospital OHCA care and analyzed how different CPR strategies in confined-space settings affect chest compression quality and the time to first effective chest compression. The study consisted of three components. First, QCPR-based simulations were used to compare chest compression performance across different surface conditions, including the floor, a mattress, and a mattress with a backboard. Second, lay responder drills were conducted to compare chest compression quality before and after training. Third, interviews were used to explore participantsˇ¦ willingness to respond and their perceptions of the first-responder role. The results showed that no single CPR strategy was universally superior in confined-space settings. Instead, chest compression quality and relocation-related delay must be considered together. In the scenario of moving the patient to the floor before starting chest compressions, the first three trials required 68 seconds, 76 seconds, and 60 seconds, respectively, from initial patient contact to the start of compressions, with an average of approximately 68 seconds. This suggests that although the floor and a backboard provide more stable support for CPR, relocation-related delay may postpone the initiation of the first effective chest compression. Compression scores across all support surfaces remained between 99 and 100, indicating similarly high overall compression quality. However, average compression depth differed across settings: 77 mm on the floor, 69 mm on sofa 1, 58 mm on sofa 2, 70 mm on the stretcher bed, and 80 mm on the mattress with a backboard. These findings suggest that a backboard can provide more stable support, whereas softer surfaces may reduce compression depth. The lay responder drills also showed an overall improvement in chest compression quality after training. The most notable change was in adequate recoil, which increased from a pre-training average of 57.1% to a post-training average of 98.1%, an improvement of approximately 41.0 percentage points. Interview findings further indicated that most participants reported greater willingness to provide first aid after training, although their willingness to respond remained conditional. Overall, the findings suggest that trained local lay responders in remote Indigenous communities have the potential to serve as community first responders before EMS arrival. Their role, however, should not be viewed as a substitute for the professional emergency care system, but rather as a complementary resource at the front end of the chain of survival. To strengthen early OHCA response in remote Indigenous communities, future efforts should continue to improve CPR and AED training, establish notification and mobilization mechanisms, enhance access to AEDs and protective equipment, provide education on legal protections, and implement scenario-based drills. These measures may help transform lay responder support from individual goodwill into a more stable and operational community-based emergency response model. |
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| Files | indicate access worldwide | ||
| Date of Defense | 2026-07-08 | Date of Submission | 2026-07-24 |