Peter G Delaney1, Richard Bamuleke2, Yang Jae Lee3. 1. Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA. peter.delaney@wustl.edu. 2. Uganda Red Cross Society, Plot 61/62 Stadium Rd, Bulubandi, Iganga District, Uganda. 3. Washington University School of Medicine in St. Louis, 660 S Euclied Ave, St. Louis, MO, 63110, USA.
Abstract
BACKGROUND: Though road traffic injuries (RTIs) are a major cause of mortality in East Africa, few countries have emergency medical services. The aim was to create a sustainable and efficient prehospital lay first responder program, creating a system with lay first responders spread through the 53 motorcycle taxi stages of Iganga Municipality. METHODS: One hundred and fifty-four motorcycle taxi riders were taught a first aid curriculum in partnership with a local Red Cross first aid trainer and provided with a first aid kit following WHO guidelines for basic first aid. Pre- and post-survey tests measured first aid knowledge improvement over the course. Post-implementation incident report forms were collected from lay first responders after each patient encounter over 6 months. Follow-up interviews were conducted with 110 of 154 trainees, 9 months post-training. RESULTS: Improvement was measured across all five major first aid categories: bleeding control (56.9 vs. 79.7%), scene management (37.6 vs. 59.5%), airway and breathing (43.4 vs. 51.6%), recovery position (13.1 vs. 43.4%), and victim transport (88.2 vs. 94.3%). From the incident report findings, first responders treated 250 victims (82.8% RTI related) and encountered 24 deaths (9.6% of victims). Of the first aid skills, bleeding control and bandaging was used most often (55.2% of encounters). Lay first responders provided transport in 48.3% of encounters. Of 110 lay first responders surveyed, 70 of 76 who had used at least one skill felt "confident" in the care they provided. CONCLUSION: A prehospital care system composed of lay first responders can be developed leveraging existing transport organizations, offering a scalable alternative for LMICs, demonstrating usefulness in practice and measurable educational improvements in trauma skills for non-clinical lay responders.
BACKGROUND: Though road traffic injuries (RTIs) are a major cause of mortality in East Africa, few countries have emergency medical services. The aim was to create a sustainable and efficient prehospital lay first responder program, creating a system with lay first responders spread through the 53 motorcycle taxi stages of Iganga Municipality. METHODS: One hundred and fifty-four motorcycle taxi riders were taught a first aid curriculum in partnership with a local Red Cross first aid trainer and provided with a first aid kit following WHO guidelines for basic first aid. Pre- and post-survey tests measured first aid knowledge improvement over the course. Post-implementation incident report forms were collected from lay first responders after each patient encounter over 6 months. Follow-up interviews were conducted with 110 of 154 trainees, 9 months post-training. RESULTS: Improvement was measured across all five major first aid categories: bleeding control (56.9 vs. 79.7%), scene management (37.6 vs. 59.5%), airway and breathing (43.4 vs. 51.6%), recovery position (13.1 vs. 43.4%), and victim transport (88.2 vs. 94.3%). From the incident report findings, first responders treated 250 victims (82.8% RTI related) and encountered 24 deaths (9.6% of victims). Of the first aid skills, bleeding control and bandaging was used most often (55.2% of encounters). Lay first responders provided transport in 48.3% of encounters. Of 110 lay first responders surveyed, 70 of 76 who had used at least one skill felt "confident" in the care they provided. CONCLUSION: A prehospital care system composed of lay first responders can be developed leveraging existing transport organizations, offering a scalable alternative for LMICs, demonstrating usefulness in practice and measurable educational improvements in trauma skills for non-clinical lay responders.
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