Department of Anaesthesiology and Intensive Care, Hammerfest Hospital, Hammerfest, Norway.
Acta Anaesthesiol Scand. 2012 Nov;56(10):1222-7. doi: 10.1111/j.1399-6576.2012.02739.x. Epub 2012 Aug 17.
Death from trauma is a significant and international problem. Outcome for patients suffering out-of-hospital cardiac arrests is significantly improved by early cardiopulmonary resuscitation. The usefulness of first aid given by laypeople in trauma is less well established. The aim of this study was to review the existing literature on first aid provided by laypeople to trauma victims and to establish how often first aid is provided, if it is performed correctly, and its impact on outcome. A systematic review was carried out, according to preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, of all studies involving first aid provided by laypeople to trauma victims. Cochrane, Embase, Medline, Pubmed, and Google Scholar databases were systematically searched. Ten eligible articles were identified involving a total of 5836 victims. Eight studies were related to patient outcome, while two studies were simulation based. The proportion of patients who received first aid ranged from 10.7% to 65%. Incorrect first aid was given in up to 83.7% of cases. Airway handling and haemorrhage control were particular areas of concern. One study from Iraq investigated survival and reported a 5.8% reduction in mortality. Two retrospective autopsy-based studies estimated that correct first aid could have reduced mortality by 1.8-4.5%. There is limited evidence regarding first aid provided by laypeople to trauma victims. Due to great heterogeneity in the studies, firm conclusions can not be drawn. However, the results show a potential mortality reduction if first aid is administered to trauma victims. Further research is necessary to establish this.
创伤导致的死亡是一个重大且具有国际影响的问题。对院外心搏骤停患者进行早期心肺复苏可显著改善其预后。非专业人员实施的急救在创伤中的作用尚未得到充分证实。本研究旨在回顾有关非专业人员对创伤患者实施急救的现有文献，并确定急救的实施频率、实施是否正确以及其对结果的影响。我们按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，对涉及非专业人员对创伤患者实施急救的所有研究进行了系统回顾。我们系统性地检索了 Cochrane、Embase、Medline、Pubmed 和 Google Scholar 数据库。确定了 10 项符合条件的文章，共涉及 5836 名患者。其中 8 项研究与患者结局相关，2 项研究为模拟研究。接受急救的患者比例从 10.7%到 65%不等。多达 83.7%的急救操作不正确。气道处理和出血控制是特别令人关注的领域。来自伊拉克的一项研究调查了生存情况，并报告称死亡率降低了 5.8%。两项基于尸检的回顾性研究估计，正确的急救可能使死亡率降低 1.8-4.5%。关于非专业人员对创伤患者实施急救的证据有限。由于研究之间存在很大的异质性，因此无法得出明确的结论。但是，这些结果表明，如果对创伤患者进行急救，可能会降低死亡率。需要进一步的研究来确定这一点。
