Does community emergency care initiative improve the knowledge and skill of healthcare workers and laypersons in basic emergency care in India?

Abstract

Background:Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC) to address the issue.Aim:To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course.Materials and Methods:Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated.Results:A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates) and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12th standard) and were nonmedicos.Conclusion:BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care.

Surgical and Trauma Capacity Assessment in Rural Haryana, India

“…A trauma-specific intervention could engage local physicians to teach an existing first responder training course to ASHAs in order to safely stabilize patients at the scene of injury and transport them safely to more definitive care. A formalized training program would leverage ASHAs in stabilizing patients and guiding them to the appropriate level of care [ 7 35 ].…”

SOSAS Study in Rural India: Using Accredited Social Health Activists as Enumerators

“…The implementation of first responder courses in Nanakpur could address this issue by training laypeople to perform initial stabilization and transportation of the injured to a higher level of care [36]. These courses cover topics including cardiopulmonary resuscitation, fracture management, and triage [3738]. Such programs have been shown to decrease mortality and physiological severity scores in trauma patients, and can improve prehospital infrastructure by empowering community members with basic emergency and trauma care skills [36].…”

“…The ASHAs are a well-known and accepted presence within rural Indian communities, familiar with village families, and able to speak the local language and dialect. Given their proximity to the local population and demonstrated investment in villagers’ health, the ASHAs would likely be adept first responders [363738]. The ASHAs could also be trained to elicit symptoms, perform physical examinations, and assist in the detection of early surgical site infections, as they are accustomed to making daily trips to villagers’ homes for maternal and child health assessments [40].…”

Attending Training Workshop of BLS/ACLS

“…1 Thirty percent of acutely ill patients die before reaching the hospital in India and more than 80% of injured patients do not reach the hospital within the golden hour. 2 Fear of injuring the victim, fear of poor performance and liability, reluctance to perform mouth-to-mouth cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest, early evacuation of a trauma victim, and stoppage of bleeding are the keys to this outcome. 2 The average health personnel in our centre lack adequate knowledge in CPR/Basic life support (BLS) which should be addressed promptly.…”