Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims.

Abstract

Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a study on the success rate of PHEMS personnel in implementing PHTLS guidelines at the scene of trauma.Severe trauma patients who had been transferred to the emergency department were included in the study. Evaluations included transfer time, airway management, spinal immobilization, external bleeding management, intravenous (IV) line access, and fluid therapy. All evaluations were performed by an expert emergency physician in the emergency department.The mean response time was 17.87آ±9.1 minutes. The PHEMS personnel immobilized cervical spine in 60.4% of patients, out of whom 16.7% were not properly immobilized. Out of 99 (98%) cases of established IV line access by the PHEMS providers, 57% were satisfactory. Fluid therapy, which was carried out in 99 (98%) patients by the PHEMS personnel, was appropriate in 92% of the cases.PHEMS personnel need more education and supervising to provide services according to PHTLS guidelines.Orta ve dأ¼?أ¼k gelirli أ¼lkelerde travmayla ili?kili ?lأ¼mlerin bأ¼yأ¼k bir b?lأ¼mأ¼nden karayollar?ndaki trafik kazalar?ndaki yaralanmalar sorumludur. Hastane ?ncesi acil t?p ekibi (PHEMS) yaral? ki?ilere kaza yerinden gidilecek hastaneye kadar nakleder ve bu arada onlara t?bbi bak?m sunar. Son zamanlarda geli?mekte olan أ¼lkelerde acil t?bbi bak?m ve tedaviyi أ¼stlenenlerle t?p teknisyenleri travma hastalar?ndan al?nan sonuçlar? iyile?tirme amac?yla Hastane ?ncesi Travma Ya?am Deste?i (PHTLS) k?lavuz ilkeleri konusunda e?itilmektedir. Yaralanma mahallinde bu personele verilen e?itimin ba?ar? oran?na ili?kin bir çal??ma yapmaya karar verdik.?al??maya acil servise aktar?lan a??r travma hastalar? al?nd?. Hasta nakli s?ras?nda geçen sأ¼re, hava yolu aç?lmas?, omurgan?n stabilize edilmesi, d?? kanama tedavisi, intraven?z (IV) giri? yolu aç?lmas? ve s?v? tedavisi de?erlendirildi. De?erlendirmelerin tأ¼mأ¼ acil servisteki acil t?p uzman? taraf?ndan gerçekle?tirildi.Ortalama yan?t verme sأ¼resi 17.87آ±9.1 dakika idi. Acil t?p ekibi, hastalar?n %60.4'أ¼nأ¼n boyun omurlar?n? stabilize etmi? olup bunlar?n %16.7'si usulأ¼ne uygun biçimde gerçekle?tirilmemi?ti. Acil t?p ekibi taraf?ndan %57'si tatminkâr olmak أ¼zere 99 (%98) yaral?ya IV damar yolu aç?lm??t?. Yine 99 (%98) yaral?ya verilen s?v? tedavisinin %92'si usulأ¼ne uygundu.Acil t?p ekibi, hastane ?ncesi acil bak?m ilkelerine uygun hizmet vermesi için daha fazla e?itim ve denetimden geçmelidir.