Bystander first aid in trauma - prevalence and quality: a prospective observational study (original) (raw)
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Bystander trauma care—effect of the level of training
Resuscitation, 2004
The bystander is often the first person present at the scene of an accident. Our aim was to determine how often and how well bystanders perform trauma care and whether trauma care is affected by the bystander's level of training, relationship to the patient and numbers of bystanders present. Patients and methods: In a prospective 1-year study, the emergency medical service in two European cities collected data on trauma calls. Questionnaires were used to document the bystanders' level of training (none, basic, advanced, professional), the bystander's relationship to the patient, and the number of bystanders present, and to assess whether five separate measures of trauma care (ensuring scene safety, extrication of the patient, positioning, control of haemorrhage, prevention of hypothermia) were performed correctly, incorrectly, or not at all. Results: Two thousand nine hundred and thirty-two trauma calls were documented and bystanders were present in 1720 (58.7%). All measures except ensuring scene safety and prevention of hypothermia were affected by the bystander's level of training. Correct extrication, positioning, and control of haemorrhage increased with the level of bystander training while the number of patients who were not attended decreased (P < 0.05, P < 0.005, P < 0.005), respectively. The relationship to the patient did not affect whether, or how well, any measure was performed. The number of bystanders present only affected prevention of hypothermia, which was performed most often when only one bystander was present. Conclusion: Improved, more widespread training could increase the frequency and quality of bystander trauma care further.
ternational Journal of Public Health Science (IJPHS), 2021
Traffic incidents become typical cases of trauma outside of hospitals. The integrated-emergency nursing system outside of hospitals becomes an important component to minimize any worsening condition of the traumatic victims. However, this pre-hospitalized service system has not been formally established in several cities or municipalities. This research aims to explore various hopes of the trauma-victim aid process in a region that has not applied pre-hospitalized emergency service formally. This research was carried out by implementing a qualitative research method and a case study approach to identify the themes. The research was conducted in Konawe municipality, from February until March 2020. It was done by interviewing eight participants consisting of the citizens, traffic police officers, hospital party, and health agency. Four themes result from this research. Establishing the pre-hospitalized emergency service, socializing the first aid for the incident victims, training dealing with the first aid of taking care of trauma victims, and promoting socialization for all citizens about the emergency numbers of health service institutions which could be immediately contacted when an accident occurs. There is a need for an emergency service system establishment and development.
Resuscitation, 2012
BACKGROUND: The Prehospital Trauma Life Support (PHTLS) course has been widely implemented and approximately half a million prehospital caregivers in over 50 countries have taken this course. Still, the effect on injury outcome remains to be established. The objective of this study was to investigate the association between PHTLS training of ambulance crew members and the mortality in trauma patients. METHODS: A population-based observational study of 2830 injured patients, who either died or were hospitalized for more than 24h, was performed during gradual implementation of PHTLS in Uppsala County in Sweden between 1998 and 2004. Prehospital patient records were linked to hospital-discharge records, cause-of-death records, and information on PHTLS training and the educational level of ambulance crews. The main outcome measure was death, on scene or in hospital. RESULTS: Adjusting for multiple potential confounders, PHTLS training appeared to be associated with a reduction in mortal...
First aid: Level of knowledge of relatives and bystanders in emergency situations
Advances in Therapy, 2007
Bystanders who are able to provide immediate first aid to patients who require emergency care can make a big difference in the outcome. Thus, first-aid training should be made available to as many people as possible. The aims of this study were to assess the level of first-aid knowledge among bystanders in emergency situations and to identify factors that affected this level of knowledge. At Dokuz Eylul University Emergency Service between February 1 and February 15, 2002, 318 bystanders were given a questionnaire. The first part of the questionnaire was concerned with demographic characteristics and factors that would affect first-aid knowledge level. The second part consisted of 16 multiple choice questions about first aid. Bystanders answered an average of 7.16±3.14 questions correctly. Bystanders who had graduated from a university, were health care personnel, had taken a first-aid course, had a first-aid certificate, or had a driver's license were considered to be more successful.
Prehospital trauma management: a national study of paramedic activities
Emergency Medicine Journal, 2004
The benefits of prehospital trauma management remain controversial. This study aimed to compare the processes of care and outcomes of trauma patients treated by paramedics, who are trained in advanced prehospital trauma care, with those treated by ambulance technicians. Methods: A six year prospective study was conducted of adult trauma patients attended to by the Scottish Ambulance Service and subsequently admitted to hospital. Prehospital times, interventions, triage, and outcomes were compared between patients treated by paramedics and those treated by technicians. Results: Paramedics attended more severely injured patients (16.5% versus 13.9%, p,0.001); they attended a higher proportion of patients with penetrating trauma (6.6% versus 5.7%, p = 0.014) and had longer prehospital times. Patients managed by paramedics were more likely to be taken to the intensive care unit, operating theatre or mortuary, (11.2% versus 7.8%, p,0.001) and had higher crude mortality rates (5.3% versus 4.5%, p = 0.07). However, no difference in mortality between the two groups was noted when corrected for age, Glasgow coma score and injury severity score. Conclusions: This large scale national study shows that paramedics show good triage skills and clinical judgement when managing trauma patients. However, the value of the individual interventions they perform could not be ascertained. Further controlled trials are necessary to determine the true benefits of advanced prehospital trauma life support.
Lay first aid giving as a specific traumatic experience
PSYCHOLOGIE PRO PRAXI
Despite first aid process has mainly been considered a medical or technical issue; it seems obvious that psychological and social aspects play an important role too. As a pilot study we interviewed ten helping bystanders about their ideas and feelings during and after the first aid. Their reports were analysed, using a qualitative approach. There were various feelings and ideas respondents experienced – temporary blockade, limited ability to recall relevant information, performance decrease, time distortion, selective perception, strong subjective stress. After first aid people experienced doubts about their acts and decisions, quilt and failure feelings, specific relationship between the rescuer and rescued person, feeling of non-terminating, PTSD symptoms, strong need to share the experience. Our respondents reported long lasting discomfort, persisting even years after the experience. Psychological aspects of lay first aid giving are a crucial aspect influencing the efficacy of fi...
World Journal of Surgery, 2009
Background Uganda currently has no organized prehospital emergency system. We sought to measure the current burden of injury seen by lay people in Kampala, Uganda and to determine the feasibility of a lay first-responder training program. Methods We conducted a cross-sectional survey of current prehospital care providers in Kampala: police officers, minibus taxi drivers, and Local Council officials, and collected data on types and frequencies of emergencies witnessed, barriers to aid provision, history of training, and current availability of first-aid supplies. A context-appropriate course on basic first-aid for trauma was designed and implemented. We measured changes in trainees’ fund of knowledge before and after training. Results A total of 309 lay people participated in the study, and during the previous 6 months saw 18 traumatic emergencies each; 39% saw an injury-related death. The most common injury mechanisms were road crashes, assault, and burns. In these cases, 90% of trainees provided some aid, most commonly lifting (82%) or transport (76%). Fifty-two percent of trainees had previous first-aid training, 44% had some access to equipment, and 32% had ever purchased a first-aid kit. Before training, participants answered 45% of test questions correctly (mean %) and this increased to 86% after training (p < 0.0001). Conclusions Lay people witness many emergencies and deaths in Kampala, Uganda and provide much needed care but are ill-prepared to do so. A context-appropriate prehospital trauma care course can be developed and improve lay people’s knowledge of basic trauma care. The effectiveness of such a training program needs to be evaluated prospectively.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Background Selection of incidents and accurate identification of patients that require assistance from physician-staffed emergency medical services (P-EMS) remain essential. We aimed to evaluate P-EMS availability, the underlying criteria for dispatch, and the corresponding dispatch accuracy of trauma care in south-east Norway in 2015, to identify areas for improvement. Methods Pre-hospital data from emergency medical coordination centres and P-EMS medical databases were linked with data from the Norwegian Trauma Registry (NTR). Based on a set of conditions (injury severity, interventions performed, level of consciousness, incident category), trauma incidents were defined as complex, warranting P-EMS assistance, or non-complex. Incident complexity and P-EMS involvement were the main determinants when assessing the triage accuracy. Undertriage was adjusted for P-EMS availability and response and transport times. Results Among 19,028 trauma incidents, P-EMS were involved in 2506 (13.2...