title: Prehospital Emergency Care Education for the Nepal Mountaineering Association.
abstract: BACKGROUND
  Prehospital emergency care training programs are effective in reducing mortality and disability in low-income countries. Implementation of a specifically designed program in the mountainous regions of Nepal has the potential to benefit local populations, trekking and mountaineering guides, and adventure tourists.
  
  
  OBJECTIVE
  Our aims were to survey Nepal Mountaineering Association (NMA) members' past experiences with emergencies and medical training, characterize a geographic-specific prehospital emergency care training program, and evaluate the effectiveness and outcome of the program.
  
  
  METHODS
  Sixty-two trekking guides, police officers, and students attended the 2-day training program in Pokhara, Nepal in May 2014. Training curriculum was determined in coordination with the NMA. Instructors included Tulane University faculty, surgical residents, and graduate students. Surveys identified participants' experience with emergencies, confidence in providing emergency care, and interest in future trainings. Multiple modalities were utilized to assess trainees' comprehension.
  
  
  RESULTS
  Participants rated the program as valuable and expressed desire for additional trainings. Survey results indicated that participants had prior experience with a myriad of emergencies, were more confident in managing traumatic emergencies than medical or environmental, and showed that few had previously received training in cardiopulmonary resuscitation. Areas of instruction included general first responder and geographic-specific content. Participants achieved the course objectives and documented their abilities to successfully manage simulated clinical problems.
  
  
  CONCLUSIONS
  The training program, an international collaboration, was documented to be successful by instructors, NMA leadership, and participants. The training program's content matched the participants' specific needs and abilities. Areas for improvement include providing content related to burns, motorcycle injuries, cold-exposure injuries, fever management, and toxicology emergencies.
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Jeremiah M
authors.initials: JM
authors.lastname: Kinsman
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Bernard M
authors.initials: BM
authors.lastname: Jaffe
mesh_terms: D000293:Adolescent; D000328:Adult; D003479:Curriculum; D004632:Emergency Medical Services; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D009051:Mountaineering; D009390:Nepal; D015397:Program Evaluation; D011795:Surveys and Questionnaires
keywords: Nepal; emergency; low-income; prehospital; training