Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims
Changiz GHOLIPOUR1, Samad SHAMS VAHDATI2, Mehdi NOTASH3, Seyed Hassan MIRI2, Rouzbeh Rajaei GHAFOURI2
1Department of General Surgery, Sina Hospital, Tabriz University of Medical Sciences Tabriz, Iran
2Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Keywords: Pre-hospital emergency medical service; pre hospital trauma life support; trauma
Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a study on the success rate of PHEMS personnel in implementing PHTLS guidelines at the scene of trauma.
Severe trauma patients who had been transferred to the emergency department were included in the study. Evaluations included transfer time, airway management, spinal immobilization, external bleeding management, intravenous (IV) line access, and fluid therapy. All evaluations were performed by an expert emergency physician in the emergency department.
The mean response time was 17.87±9.1 minutes. The PHEMS personnel immobilized cervical spine in 60.4% of patients, out of whom 16.7% were not properly immobilized. Out of 99 (98%) cases of established IV line access by the PHEMS providers, 57% were satisfactory. Fluid therapy, which was carried out in 99 (98%) patients by the PHEMS personnel, was appropriate in 92% of the cases.
PHEMS personnel need more education and supervising to provide services according to PHTLS guidelines.