Could bystander first-aid prevent trauma deaths at the scene of injury?

Emerg Med Australas. 2007 Apr;19(2):163-8. doi: 10.1111/j.1742-6723.2007.00948.x.

Abstract

Objective: To identify potentially preventable prehospital deaths following traumatic cardiac arrest.

Methods: Deaths following prehospital traumatic cardiac arrest during 2003 were reviewed in the state of Victoria, Australia. Possible survival with optimal bystander first-aid and shorter ambulance response times were identified. Injury Severity Scores (ISS) were calculated. Victims with an ISS <50 and signs of life were reviewed for potentially preventable factors contributing to death including signs of airway obstruction, excessive bleeding and/or delayed ambulance response times.

Results: We reviewed 112 cases that had full ambulance care records, hospital records and autopsy details in Victoria 2003. Most deaths involved road trauma and 55 victims had an ISS <50. Twelve patients received first-aid from bystanders. Ambulance response times >10 min might have contributed to five deaths with an ISS <25.

Conclusion: Five (4.5%) potentially preventable prehospital trauma deaths were identified. Three deaths potentially involved airway obstruction and two involved excessive bleeding. There is a case for increased awareness of the need for bystander first-aid at scene following major trauma.

MeSH terms

  • Adult
  • Ambulances*
  • Electrocardiography
  • First Aid*
  • Heart Arrest / mortality*
  • Heart Arrest / therapy*
  • Humans
  • Injury Severity Score
  • Middle Aged
  • Pulse
  • Retrospective Studies
  • Survival Analysis
  • Victoria / epidemiology
  • Wounds and Injuries / mortality*
  • Wounds and Injuries / therapy*