Trauma Mortality Patterns in Three Nations at Different Economic Levels

Mock, Charles; Jurkovich, Gregory; nii-Amon-Kotei, D.; Arreola-Risa, Carlos; Maier, Ronald V.

doi:10.1097/00005373-199707000-00061

Cited by 88 publications

(127 citation statements)

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“…As an example, a primary hospital might be located 300 km away from the district hospital, which is also only occasionally staffed with a surgeon, and 700 km from a tertiary level hospital, which always has surgical capabilities. In countries without a formal EMS-system, it is known that the majority of trauma deaths occur prehospital, for example in Ghana more than 80 % -17 - [7], partly due to the fact that transport from accident scene to hospital may take several hours. This is also the case from many locations in Botswana.…”

Section: Staffing and Trainingmentioning

confidence: 99%

“…Mock et al found increased mortality with decreasing economic level in a study comparing outcomes for seriously injured patients in Kumasi, Ghana, Monterey, Mexico, and Seattle, US, and that the majority of deaths occured before arrival at a hospital, concluding that improvement efforts in LMIC countries should focus on injury prevention, prehospital treatment, and emergency room care [7].…”

Section: Introductionmentioning

confidence: 99%

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Trauma Care in Africa: A Status Report From Botswana, Guided by the World Health Organization’s “Guidelines for Essential Trauma Care”

et al. 2012

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Section: Staffing and Trainingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trauma Care in Africa: A Status Report From Botswana, Guided by the World Health Organization’s “Guidelines for Essential Trauma Care”

et al. 2012

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“…By 2030, road traffic crashes are predicted to be the eighth-leading cause of death and fourth-leading cause of disability-adjusted life years worldwide [2,3]. Currently, more than 90% of road traffic injury deaths occur in developing countries [4][5][6] where approximately 80% of injury deaths occur in the prehospital setting [7]. This disproportionate burden is projected to increase as developing countries rapidly urbanize and motorize without associated improvements in injury prevention and control [8,9].…”

mentioning

confidence: 99%

Current Patterns of Prehospital Trauma Care in Kampala, Uganda and the Feasibility of a Lay‐First‐Responder Training Program

et al. 2009

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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.

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“…5 Trauma mortality in LMICs can be as high as 40%-50%, with the majority of deaths occurring in the prehospital setting. 6 With road traffic accidents on the rise, improving prehospital trauma care is an important public health priority, with evidence illustrating that improvements in prehospital trauma care are a cost-effective method of reducing trauma mortality in diverse LMICs. 7 Prior research and interventions in LMICs have found that attempting to imitate highincome country (HIC) prehospital trauma care systems in LMICs often results in high expense and minimally improved outcomes.…”

Section: Introductionmentioning

confidence: 99%

Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority

Debenham

Fuller

Stewart

et al. 2017

Prehosp. Disaster med.

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By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low-and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of traumarelated deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks.Debenham S, Fuller M, Stewart M, Price RR. Where there is no EMS: lay providers in Emergency Medical Services care -EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):593-595.

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Trauma Mortality Patterns in Three Nations at Different Economic Levels

Cited by 88 publications

References 0 publications

Trauma Care in Africa: A Status Report From Botswana, Guided by the World Health Organization’s “Guidelines for Essential Trauma Care”

Trauma Care in Africa: A Status Report From Botswana, Guided by the World Health Organization’s “Guidelines for Essential Trauma Care”

Current Patterns of Prehospital Trauma Care in Kampala, Uganda and the Feasibility of a Lay‐First‐Responder Training Program

Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority

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