A. Aekka2, M. V. Hollis2, E. M. Boudiab2, G. P. Laput2, H. Purohit3, A. K. Vyas2,4, D. Vyas1,2 1Michigan State University,Department Of Surgery,Lansing, MI, USA 2Michigan State University,College Of Human Medicine,Lansing, MI, USA 3Arogyaa.com,Meerut, UP, India 4Michigan State University,Department Of Pediatrics,Lansing, MI, USA
Introduction:
The burden of trauma and injury is particularly devastating for developing nations such as India. The crux of the problem lies in the astonishing lack of prehospital trauma services: 80% of trauma victims in India cannot access medical care within the first hour. Existing health education initiatives fail to engage first responders and neglect the local context.
Methods:
A 2-day hands-on prehospital trauma management training program with video lectures was developed for first responders in the local language. The course consists of 10 interactive sessions dealing with essential prehospital trauma care concepts, such as airway establishment, hemorrhage control, CPR, fracture stabilization, triage, and communication. Extensive self-learning videos, which help to overcome the language barrier, and high-fidelity simulation, which presents the most realistic training experience, provide a level of engagement that traditional didactic methods cannot offer. Video-debriefing serves as a valuable evaluation method. First responders are further introduced to advanced tools, such as the King LT airway and pulse oximeter, but are instructed in improvised management as resources are limited on the field. A comprehensive, but concise manual and specialized tool kit were also developed for trainees.
48 participants from Jodhpur, Rajasthan, including police officers, firemen, ambulance and taxi drivers, EMTs, hospital staff, and nursing staff and students, attended the pilot course. 18 instructors were recruited from Jodhpur and included medical students/residents and faculty, private practice physicians, and police officials. These individuals were trained in a 4-hour session prior to the program regarding the course content, materials, expectations, methods of engagement, and principles, such as collaborative learning, positive reinforcement, and the use of native, lay-person language.
Results:
Pre- and post-training surveys were used to evaluate participants' competence in managing 10 prehospital trauma matters. Statistically significant increases in competence were demonstrated for all topics: Airway (35.0%), Hemorrhage (36.1%), Fractures (32.0%), Cervical Spine Injury (45.4%), Chest Injury (41.3%), IV Line Placement (29.9%), Extrication (18.6%), Scene Assessment (35.1%), Triage (26.5%), and Communication (25.4%). The greatest increases were observed in cervical spine and chest injury management. The lowest, but still significant, increases were observed in extrication and communication. A six-month post-training survey will be conducted.
Conclusion:
First responder training in the native language with simulation and video-debriefing improves understanding and skills in all essential aspects of prehospital care, however, results suggest that discussion of extrication and communication should be strengthened. The goal is to develop a program that engages and prepares first responders in the procedural, cognitive, and affective aspects of prehospital trauma management.