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Developing sustainable prehospital trauma education in Rwanda

INTRODUCTION: Every year, >5 million people worldwide die from trauma. In Kigali, Rwanda, 50% of prehospital care provided by SAMU, the public prehospital system, is for trauma. Our collaboration developed and implemented a context-specific, prehospital Emergency Trauma Care Course (ETCC) and tra...

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Autores principales: Rosenberg, Ashley, Kabagema, Ignace, Asay, Basil, Uwitonze, Jean Marie, Louka, Stephanie, Nkeshimana, Menelas, Mbanjumucyo, Gabin, Wolfe, Luke, Valukas, Catherine, Dushime, Theophile, Jayaraman, Sudha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: African Federation for Emergency Medicine 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700902/
https://www.ncbi.nlm.nih.gov/pubmed/33299755
http://dx.doi.org/10.1016/j.afjem.2020.07.015
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author Rosenberg, Ashley
Kabagema, Ignace
Asay, Basil
Uwitonze, Jean Marie
Louka, Stephanie
Nkeshimana, Menelas
Mbanjumucyo, Gabin
Wolfe, Luke
Valukas, Catherine
Dushime, Theophile
Jayaraman, Sudha
author_facet Rosenberg, Ashley
Kabagema, Ignace
Asay, Basil
Uwitonze, Jean Marie
Louka, Stephanie
Nkeshimana, Menelas
Mbanjumucyo, Gabin
Wolfe, Luke
Valukas, Catherine
Dushime, Theophile
Jayaraman, Sudha
author_sort Rosenberg, Ashley
collection PubMed
description INTRODUCTION: Every year, >5 million people worldwide die from trauma. In Kigali, Rwanda, 50% of prehospital care provided by SAMU, the public prehospital system, is for trauma. Our collaboration developed and implemented a context-specific, prehospital Emergency Trauma Care Course (ETCC) and train-the-trainers program for SAMU, based on established international best practices. METHODS: A context-appropriate two-day ETCC was developed using established best practices consisting of traditional 30-minute lectures followed by 20-minute practical scenario-based team-driven simulation sessions. Also, hands-on skill sessions covered intravenous access, needle thoracostomy and endotracheal intubation among others. Two cohorts participated — SAMU staff who would form an instructor core and emergency staff from ten district, provincial and referral hospitals who are likely to respond to local emergencies in the community. The instructor core completed ETCC 1 and a one-day educator course and then taught the second cohort (ETCC2). Pre and post course assessments were conducted and analyzed using Student's t-test and matched paired t-tests. RESULTS: ETCC 1 had 17 SAMU staff and ETCC 2 had 19 hospital staff. ETCC 1 mean scores increased from 40% to 63% and ETCC 2 increased from 41% to 78% after the course (p < 0.001 using matched pair analysis). A one-way ANOVA mean square analysis showed that regardless of the baseline level of training for each participant, all trainees reached similar post-course assessment scores, F (1) = 15.18, p = 0.0004. DISCUSSION: This study demonstrates effective implementation of a context-appropriate prehospital trauma training program for prehospital staff in Kigali, Rwanda. The course resulted in improved knowledge for an instructor core and for staff from district and provincial hospitals confirming the effectiveness of a train-the-trainers model. This program may be effective to support capacity development for prehospital trauma care in the country using a qualified local source of instructors.
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spelling pubmed-77009022020-12-08 Developing sustainable prehospital trauma education in Rwanda Rosenberg, Ashley Kabagema, Ignace Asay, Basil Uwitonze, Jean Marie Louka, Stephanie Nkeshimana, Menelas Mbanjumucyo, Gabin Wolfe, Luke Valukas, Catherine Dushime, Theophile Jayaraman, Sudha Afr J Emerg Med Original Article INTRODUCTION: Every year, >5 million people worldwide die from trauma. In Kigali, Rwanda, 50% of prehospital care provided by SAMU, the public prehospital system, is for trauma. Our collaboration developed and implemented a context-specific, prehospital Emergency Trauma Care Course (ETCC) and train-the-trainers program for SAMU, based on established international best practices. METHODS: A context-appropriate two-day ETCC was developed using established best practices consisting of traditional 30-minute lectures followed by 20-minute practical scenario-based team-driven simulation sessions. Also, hands-on skill sessions covered intravenous access, needle thoracostomy and endotracheal intubation among others. Two cohorts participated — SAMU staff who would form an instructor core and emergency staff from ten district, provincial and referral hospitals who are likely to respond to local emergencies in the community. The instructor core completed ETCC 1 and a one-day educator course and then taught the second cohort (ETCC2). Pre and post course assessments were conducted and analyzed using Student's t-test and matched paired t-tests. RESULTS: ETCC 1 had 17 SAMU staff and ETCC 2 had 19 hospital staff. ETCC 1 mean scores increased from 40% to 63% and ETCC 2 increased from 41% to 78% after the course (p < 0.001 using matched pair analysis). A one-way ANOVA mean square analysis showed that regardless of the baseline level of training for each participant, all trainees reached similar post-course assessment scores, F (1) = 15.18, p = 0.0004. DISCUSSION: This study demonstrates effective implementation of a context-appropriate prehospital trauma training program for prehospital staff in Kigali, Rwanda. The course resulted in improved knowledge for an instructor core and for staff from district and provincial hospitals confirming the effectiveness of a train-the-trainers model. This program may be effective to support capacity development for prehospital trauma care in the country using a qualified local source of instructors. African Federation for Emergency Medicine 2020-12 2020-11-02 /pmc/articles/PMC7700902/ /pubmed/33299755 http://dx.doi.org/10.1016/j.afjem.2020.07.015 Text en © 2020 African Federation for Emergency Medicine. Publishing services provided by Elsevier. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Rosenberg, Ashley
Kabagema, Ignace
Asay, Basil
Uwitonze, Jean Marie
Louka, Stephanie
Nkeshimana, Menelas
Mbanjumucyo, Gabin
Wolfe, Luke
Valukas, Catherine
Dushime, Theophile
Jayaraman, Sudha
Developing sustainable prehospital trauma education in Rwanda
title Developing sustainable prehospital trauma education in Rwanda
title_full Developing sustainable prehospital trauma education in Rwanda
title_fullStr Developing sustainable prehospital trauma education in Rwanda
title_full_unstemmed Developing sustainable prehospital trauma education in Rwanda
title_short Developing sustainable prehospital trauma education in Rwanda
title_sort developing sustainable prehospital trauma education in rwanda
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700902/
https://www.ncbi.nlm.nih.gov/pubmed/33299755
http://dx.doi.org/10.1016/j.afjem.2020.07.015
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