Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, MA, USA.
TraumaLink, Dhaka, Bangladesh.
Glob Health Sci Pract. 2022 Aug 30;10(4). doi: 10.9745/GHSP-D-21-00537.
Road traffic injuries are a rapidly growing epidemic in low- and middle-income countries (LMICs). However, many countries lack formal prehospital emergency medical services, often leaving victims without access to first aid when it can be most effective in preventing death or disability.
To address the lack of a dedicated prehospital emergency medical system in Bangladesh, we developed TraumaLink, a community-based network of volunteer first responders for traffic injury victims. The service uses an emergency hotline number and 24-hour call center with local first responders who are trained in basic trauma first aid, given essential medical supplies, and dispatched to crash scenes through mobile phone text message notifications. We designed the training curriculum to teach simple lifesaving skills that people with any level of education and no prior medical background could learn and perform. We retrospectively analyzed data originally collected for quality monitoring and evaluation to provide a descriptive analysis of the program's impact.
During the first 6 years, operations were expanded from a 14-km section of 1 highway to 135 km on 3 national highways, and free care was provided to 3,119 patients involved in 1,544 crashes. All calls to the service received a response, and in 88% of cases, first responders were at the scene in 5 minutes or less. Most patients were young adult men, and 76% of victims transported to the hospital arrived there within 30 minutes of the crash. Assessments of injury severity at the accident scene aligned closely with patient dispositions, reflecting the accuracy of these triage decisions.
The strong community support and rapid, reliable volunteer responses suggest that this flexible and scalable model could be expanded throughout Bangladesh and adapted for other LMICs that face similar challenges with traffic injury victims.
道路交通伤害是中低收入国家（LMICs）日益严重的问题。然而，许多国家缺乏正式的院前急救医疗服务，这使得受害者在最需要急救时往往无法获得帮助，从而导致死亡或残疾的风险增加。
为了解决孟加拉国缺乏专门的院前急救医疗系统的问题，我们开发了 TraumaLink，这是一个由志愿者急救员组成的社区网络，专门为交通事故受害者提供服务。该服务使用紧急热线号码和 24 小时呼叫中心，当地的急救员接受过基本创伤急救培训，配备了必要的医疗用品，并通过手机短信通知赶赴事故现场。我们设计了培训课程，教授简单的救生技能，任何教育程度和无医学背景的人都可以学习和实施。我们对最初为质量监测和评估收集的数据进行了回顾性分析，以提供对该项目影响的描述性分析。
在最初的 6 年中，业务从一条 14 公里长的高速公路扩展到了 3 条国家高速公路的 135 公里，为 3119 名涉及 1544 起事故的患者提供了免费治疗。该服务的所有来电都得到了回应，在 88%的情况下，急救员在 5 分钟或更短的时间内到达现场。大多数患者是年轻的成年男性，76%的送往医院的患者在事故发生后 30 分钟内到达。在事故现场对伤势严重程度的评估与患者的处置情况密切相关，反映了这些分诊决策的准确性。
强大的社区支持和快速、可靠的志愿者响应表明，这种灵活和可扩展的模式可以在孟加拉国全境推广，并适用于其他面临类似交通伤害受害者挑战的 LMICs。
