Tiska M A, Adu-Ampofo M, Boakye G, Tuuli L, Mock C N
School of Public Health, George Washington University, Washington, USA.
Emerg Med J. 2004 Mar;21(2):237-9. doi: 10.1136/emj.2002.002097.
Few low income countries have emergency medical services to provide prehospital medical care and transport to road traffic crash casualties. In Ghana most roadway casualties receive care and transport to the hospital from taxi, bus, or truck drivers. This study reports the methods used to devise a model for prehospital trauma training for commercial drivers in Ghana.
Over 300 commercial drivers attended a first aid and rescue course designed specifically for roadway trauma and geared to a low education level. The training programme has been evaluated twice at one and two year intervals by interviewing both trained and untrained drivers with regard to their experiences with injured persons. In conjunction with a review of prehospital care literature, lessons learnt from the evaluations were used in the revision of the training model.
Control of external haemorrhage was quickly learnt and used appropriately by the drivers. Areas identified needing emphasis in future trainings included consistent use of universal precautions and protection of airways in unconscious persons using the recovery position.
In low income countries, prehospital trauma care for roadway casualties can be improved by training laypersons already involved in prehospital transport and care. Training should be locally devised, evidence based, educationally appropriate, and focus on practical demonstrations.
很少有低收入国家拥有紧急医疗服务来为道路交通事故伤员提供院前医疗护理和转运。在加纳,大多数道路交通事故伤员由出租车、公交车或卡车司机送往医院并接受治疗。本研究报告了为加纳商业司机设计院前创伤培训模型所采用的方法。
300多名商业司机参加了专门为道路创伤设计的急救与救援课程,该课程针对低教育水平人群。通过对受过培训和未受过培训的司机就其与受伤人员的经历进行访谈,对该培训项目每隔一年进行了两次评估。结合对院前护理文献的回顾,将评估中吸取的经验教训用于培训模型的修订。
司机们很快学会了控制外部出血并能正确运用。确定未来培训中需要重点强调的方面包括持续使用通用防护措施以及对昏迷人员采用恢复体位保护气道。
在低收入国家,通过培训已经参与院前运输和护理的非专业人员,可以改善道路交通事故伤员的院前创伤护理。培训应在当地设计、基于证据、符合教育要求,并注重实际演示。