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World trauma education: hemorrhage control training for healthcare providers in India

BACKGROUND: Hemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these poor outcomes is multifactorial. We describe findings from the first Stop the Bleed (StB) course recently offere...

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Autores principales: Smith, Lindsay Andrea, Caughey, Sarah, Liu, Susan, Villegas, Cassandra, Kilaru, Mohan, Gupta, Aakanksha, Winchell, Robert J, Narayan, Mayur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407539/
https://www.ncbi.nlm.nih.gov/pubmed/30899794
http://dx.doi.org/10.1136/tsaco-2018-000263
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author Smith, Lindsay Andrea
Caughey, Sarah
Liu, Susan
Villegas, Cassandra
Kilaru, Mohan
Gupta, Aakanksha
Winchell, Robert J
Narayan, Mayur
author_facet Smith, Lindsay Andrea
Caughey, Sarah
Liu, Susan
Villegas, Cassandra
Kilaru, Mohan
Gupta, Aakanksha
Winchell, Robert J
Narayan, Mayur
author_sort Smith, Lindsay Andrea
collection PubMed
description BACKGROUND: Hemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these poor outcomes is multifactorial. We describe findings from the first Stop the Bleed (StB) course recently offered to a group of medical providers in southern India. METHODS: A cross-sectional survey of 101 participants who attended StB trainings in India was performed. Pre-training and post-training questionnaires were collected from each participant. In total, 88 healthcare providers’ responses were analyzed. Three bleeding control skills were presented: wound compression, wound packing, and tourniquet application. RESULTS: Among participants, only 23.9% had received prior bleeding control training. Participants who reported feeling ‘extremely confident’ responding to an emergency medical situation rose from 68.2% prior to StB training to 94.3% post-training. Regarding hemorrhage control abilities, 37.5% felt extremely confident before the training, compared with 95.5% after the training. For wound packing and tourniquet application, 44.3% and 53.4%, respectively, felt extremely confident pre-training, followed by 97.7% for both skills post-training. Importantly, 90.9% of StB trainees felt comfortable teaching newly acquired hemorrhage control skills. A significant majority of participants said that confidence in their wound packing and tourniquet skills would improve with more realistic mannequins. CONCLUSION: To our knowledge, this is the first StB training in India. Disparities in access to care, long transport times, and insufficient numbers of prehospital personnel contribute to its significant trauma burden. Dissemination of these critical life-saving skills into this region and the resulting civilian interventions will increase the number of trauma patients who survive long enough to reach a trauma center. Additionally, considerations should be given to translating the course into local languages to increase program reach. LEVEL OF EVIDENCE: Level IV.
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spelling pubmed-64075392019-03-21 World trauma education: hemorrhage control training for healthcare providers in India Smith, Lindsay Andrea Caughey, Sarah Liu, Susan Villegas, Cassandra Kilaru, Mohan Gupta, Aakanksha Winchell, Robert J Narayan, Mayur Trauma Surg Acute Care Open 4th World Trauma Congress Article BACKGROUND: Hemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these poor outcomes is multifactorial. We describe findings from the first Stop the Bleed (StB) course recently offered to a group of medical providers in southern India. METHODS: A cross-sectional survey of 101 participants who attended StB trainings in India was performed. Pre-training and post-training questionnaires were collected from each participant. In total, 88 healthcare providers’ responses were analyzed. Three bleeding control skills were presented: wound compression, wound packing, and tourniquet application. RESULTS: Among participants, only 23.9% had received prior bleeding control training. Participants who reported feeling ‘extremely confident’ responding to an emergency medical situation rose from 68.2% prior to StB training to 94.3% post-training. Regarding hemorrhage control abilities, 37.5% felt extremely confident before the training, compared with 95.5% after the training. For wound packing and tourniquet application, 44.3% and 53.4%, respectively, felt extremely confident pre-training, followed by 97.7% for both skills post-training. Importantly, 90.9% of StB trainees felt comfortable teaching newly acquired hemorrhage control skills. A significant majority of participants said that confidence in their wound packing and tourniquet skills would improve with more realistic mannequins. CONCLUSION: To our knowledge, this is the first StB training in India. Disparities in access to care, long transport times, and insufficient numbers of prehospital personnel contribute to its significant trauma burden. Dissemination of these critical life-saving skills into this region and the resulting civilian interventions will increase the number of trauma patients who survive long enough to reach a trauma center. Additionally, considerations should be given to translating the course into local languages to increase program reach. LEVEL OF EVIDENCE: Level IV. BMJ Publishing Group 2019-02-18 /pmc/articles/PMC6407539/ /pubmed/30899794 http://dx.doi.org/10.1136/tsaco-2018-000263 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle 4th World Trauma Congress Article
Smith, Lindsay Andrea
Caughey, Sarah
Liu, Susan
Villegas, Cassandra
Kilaru, Mohan
Gupta, Aakanksha
Winchell, Robert J
Narayan, Mayur
World trauma education: hemorrhage control training for healthcare providers in India
title World trauma education: hemorrhage control training for healthcare providers in India
title_full World trauma education: hemorrhage control training for healthcare providers in India
title_fullStr World trauma education: hemorrhage control training for healthcare providers in India
title_full_unstemmed World trauma education: hemorrhage control training for healthcare providers in India
title_short World trauma education: hemorrhage control training for healthcare providers in India
title_sort world trauma education: hemorrhage control training for healthcare providers in india
topic 4th World Trauma Congress Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407539/
https://www.ncbi.nlm.nih.gov/pubmed/30899794
http://dx.doi.org/10.1136/tsaco-2018-000263
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