The development and implementation of a layperson trauma first responder course in La Paz, Bolivia: A pilot study

Boeck, Marissa A.; Callese, Tyler E.; Nelson, Sarah K.; Schuetz, Steven J.; Bazan, Christian Fuentes; Laguna, Juan Mauricio P. Saavedra; Shapiro, Michael B.; Issa, Nabil; Swaroop, Mamta

doi:10.1016/j.injury.2017.11.022

Cited by 29 publications

(19 citation statements)

References 20 publications

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“…In this study, law enforcement personnel and firefighters were prioritized for inclusion as they are the first responders to emergency scenes in Guatemala, similar to Boeck et al's study in Bolivia that had prioritized healthcare professionals and first responders. 19 Similar to the results of the study from Bolivia that the criterionreferenced test was implemented during, the study instrument demonstrated reliability through appropriate item difficulty indices, item discrimination indices, and internal consistency. Knowledge improved significantly during the course, with an interquartile mean difference between pretest/post-test of 29.2%.…”

Section: Discussionsupporting

confidence: 56%

“…The secondary outcome of interest included an analysis of participant knowledge acquisition with respect to occupational demographics, and psychometric analyses replicating those employed by Boeck et al were used to evaluate and validate the assessment questions. 19 To assess participant knowledge acquisition, the interquartile mean score and SD were determined for both the pretest and post-test. Distributions of total scores for the pretest and posttest were compiled and compared using a Wilcoxon signed-rank test for nonparametric analysis.…”

Section: Discussionmentioning

confidence: 99%

“…On signing in, participants were asked to complete a criterion-referenced test that had been based on one previously validated by Boeck et al to assess the knowledge of participants in a layperson trauma first responder pilot course in La Paz, Bolivia. 19 The test was administered before and after the course by investigators to measure baseline knowledge and subsequent improvement. Some pre-existing questions were lightly edited, whereas various new questions were created by PGD, JF, and ZJE to accurately reflect course content not included in the previous test.…”

Section: Methodsmentioning

confidence: 99%

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Designing and implementing a practical prehospital emergency trauma care curriculum for lay first responders in Guatemala

Delaney

Figueroa

Eisner

et al. 2020

Trauma Surg Acute Care Open

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BackgroundInjury disproportionately affects low-income and middle-income countries, yet robust emergency medical services are often lacking to effectively address the prehospital injury burden. A half-day prehospital emergency trauma care curriculum was designed for first responders and piloted in the Sacatepéquez, Chimaltenango, and Escuintla departments in Guatemala.MethodsThree hundred and fifty-four law enforcement personnel, firefighters, and civilians volunteered to participate in a 5-hour emergency care course teaching scene safety, triage, airway management, cardiopulmonary resuscitation, fracture management, and victim transport. A validated 26-question pretest/post-test study instrument was contextually adapted and used to measure overall test performance, the primary study outcome, as well as test performance stratified by occupation, the secondary study outcome. Pretest/post-test score distributions were compared using a Wilcoxon signed-rank test. For test evaluation, knowledge acquisition on a by-question and by-category basis was examined using McNemar’s χ² test, whereas item difficulty indices used frequency-of-distribution tests and item discrimination indices used point biserial correlation.ResultsTwo hundred and eighty-seven participants qualified for inclusion. Participant mean pretest versus post-test scores improved 24 percentage points after course completion (43% vs 68%, p<0.001). Cronbach’s alpha yielded values of 0.86 (pretest) and 0.94 (post-test), suggesting testing instrument reliability. Between-group analyses demonstrated law enforcement and civilian participants improved more than firefighters (p<0.001). Performance on 23 of 26 questions improved significantly. All test questions except one showed an increase in their PPDI.DiscussionA 1-day, contextually adapted, 5-hour course targeting laypeople demonstrates significant improvements in emergency care knowledge. Future investigations of similar curricula should be trialed in alternate low-resource settings with increased civilian participation to evaluate efficacy and replicability as adequate substitutes for longer courses. This study suggests future courses teaching emergency care for lay first responders may be reduced to 5 hours duration.Level of evidenceLevel II.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Designing and implementing a practical prehospital emergency trauma care curriculum for lay first responders in Guatemala

Delaney

Figueroa

Eisner

et al. 2020

Trauma Surg Acute Care Open

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“…Posttraining surveys immediately after training and after 6 months showed that there was a significant improvement in first aid knowledge and skills confidence among traffic police. Similar studies on lay responder first aid training with participants other than police officers also demonstrated the positive impact of educational training on first aid knowledge and skills [9,10,[21][22][23]. Common to these studies was the use of didactic and handson approaches to training.…”

Section: Discussionmentioning

confidence: 79%

Impact of a postcrash first aid educational program on knowledge, perceived skills confidence, and skills utilization among traffic police officers: a single-arm before-after intervention study

et al. 2020

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Background: An overwhelming proportion of road traffic deaths and injuries in low-and middle-income countries (LMICs) occur in prehospital environments. Lay first responders such as police officers play an important role in providing initial assistance to victims of road traffic injuries either alone or in collaboration with others. The present study evaluated a postcrash first aid (PFA) educational program developed for police officers in Tanzania. Method: A 16-h PFA educational program was conducted in Dar es Salaam, Tanzania, for 135 police officers. Participants completed training surveys before, immediately and 6 months after the training (before, N = 135; immediately after, N = 135; after 6 months, N = 102). The primary outcome measures were PFA knowledge, perceived skills confidence, and skills utilization. Parametric and nonparametric tests were used to analyse changes in outcome. Results: The mean PFA knowledge score increased from 44.73% before training (SD = 20.70) to 72.92% 6 months after training (SD = 18.12), p < .001, N = 102. The mean PFA perceived skills confidence score (measured on a 1-5 Likert scale) increased from 1.96 before training (SD = 0.74) to 3.78 6 months after training (SD = 0.70), p < .001, N = 102. Following training, application of the recovery position skill (n = 42, 46%) and application of the bleeding control skill (n = 45, 49%) were reported by nearly half of the responding officers. Less than a quarter of officers reported applying head and neck immobilization skills (n = 20, 22%) following training. Conclusion: A PFA educational program has shown to improve police officers' knowledge and perceived skills confidence on provision of first aid. However qualitative research need to be conducted to shed more light regarding reasons for low utilization of trained first aid skills during follow-up.

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“…Post-training surveys immediately after training and after six months showed that there was a significant improvement in first aid knowledge and skills confidence among traffic police. Similar studies on lay responder first aid training with participants other than police officers also demonstrated the positive impact of educational training on first aid knowledge and skills (9,10,(21)(22)(23). Common to these studies was the use of didactic and hands-on approaches to training.…”

Section: Discussionmentioning

confidence: 79%

Impact of a Postcrash First Aid Educational Program on Knowledge, Perceived Skills Confidence, and Skills Utilization Among Traffic Police Officers: A Single-Arm Before-After Intervention Study

Ndile

Lukumay

Bölenius

et al. 2020

Preprint

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Background An overwhelming proportion of road traffic deaths and injuries in low- and middle-income countries (LMICs) occur in prehospital environments. Lay first responders such as police officers play an important role in providing initial assistance to victims of road traffic injuries either alone or in collaboration with others. The present study evaluated a postcrash first aid (PFA) educational program developed for police officers in Tanzania. Method A 16-hour PFA educational program was conducted in Dar es Salaam, Tanzania, for 135 police officers. Participants completed training surveys before, immediately and six months after the training (before, N = 135; immediately after, N = 135; after six months, N = 102). The primary outcome measures were PFA knowledge, perceived skills confidence, and skills utilization. Parametric and nonparametric tests were used to analyse changes in outcome. Results The mean PFA knowledge score increased from 44.73% before training ( SD = 20.70) to 72.92% six months after training ( SD = 18.12), p ˂ .001, N = 102. The mean PFA perceived skills confidence score (measured on a 1–5 Likert scale) increased from 1.96 before training ( SD = 0.74) to 3.78 six months after training ( SD = 0.70), p ˂ .001, N = 102. Following training, application of the recovery position skill ( n = 42, 46%) and application of the bleeding control skill ( n = 45, 49%) were reported by nearly half of the responding officers. Less than a quarter of officers reported applying head and neck immobilization skills ( n = 20, 22%) following training. Conclusion A PFA educational program has shown to improve police officers’ knowledge and perceived skills confidence on provision of first aid. However qualitative research need to be conducted to shed more light regarding reasons for low utilization of trained first aid skills during follow-up.

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The development and implementation of a layperson trauma first responder course in La Paz, Bolivia: A pilot study

Cited by 29 publications

References 20 publications

Designing and implementing a practical prehospital emergency trauma care curriculum for lay first responders in Guatemala

Designing and implementing a practical prehospital emergency trauma care curriculum for lay first responders in Guatemala

Impact of a postcrash first aid educational program on knowledge, perceived skills confidence, and skills utilization among traffic police officers: a single-arm before-after intervention study

Impact of a Postcrash First Aid Educational Program on Knowledge, Perceived Skills Confidence, and Skills Utilization Among Traffic Police Officers: A Single-Arm Before-After Intervention Study

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