association between stop bleeding and adverse outcome of patients from road traffic accident by...

Association between stop bleeding and adverse outcome of patients from road

traffic accident by first response unit and basic life support unit

Prat Intarasaksit

1

Background

2

3

background

• Emergency Medical Service (EMS)

DispatchCenter

Advance Life support

Basic Life support

First response

4

Intermediate Life support

Objective

• To determine whether type of emergency medical units and other factor are association with of stop bleeding outcome of road traffic accident patients

5

Basic Life support First response

Variables

• Independent variables• EMS units (FR, BLS)• Type of wound

6

Dependent VariablesStop bleeding outcome

Methods

7

Baseline characteristics of road traffic accident

8

Gender Region

FRBLS

male male

Baseline characteristics of road traffic accident

9

Wound(Abrasion )

Stop bleeding inappropriate

10

Multivariable analysis

DISCUSSIONS

• Another finding in this study was that the number of male injury victims is significantly higher than their female. Because man has aggressive driving in men.

11

DISCUSSIONS

• Southern region had ratio of stop bleeding inappropriate higher than other region in both EMS units because

• first trauma case for BLS treatment has severer than FR units therefore it had mistake occur in BLS units than FR unit

12

DISCUSSIONS

• Second, stop bleeding inappropriate caused from lack of EMS team, result from NIEMS shown that southern region had slightest EMS team in Thailand, 55.2% EMS team coverage in southern region, but more than 60% of EMS team in each region for help patients, it’s caused to inefficient for stop bleeding or other trauma management

13

Strength of the study• This study is the first to our knowledge to

analyze data that is a nationally representative sample from the real practice.

Limitation of the study• Case record form in EMS doesn’t generate for

research thereby that might missing some data or value and has duplicate in each variables.

14

Conclusion

• According to results both EMS units (First response unit and Basic life support unit) has each stop bleeding inappropriate, higher in FR unit

• Because staff in BLS units has more training hours than FR units. Therefore, should be increased another program and hours of training for improve both team for trauma management skill.

15

Recommendations

• Should determine the outcome on other trauma management in patients from other case and compare with other EMS units.

•

16

Recommendations

• Should assess accuracy in EMS documentary. Because EMS documentation is often performed in chaotic and complex settings: in the dark, rain, and cold, under time pressure, and sometimes under threat to personal safety that maybe error in data record

17

Acknowledgment

• Thank you Assoc. Dr. Bandit Thinkhamrop

• Dr. Camerons Hurst • Thank you for all my classmate and EMS -

KKU-Facebook group

18

Thank you for your attention

19

20

21

Bivariate analysis

22

48-99

2.20

1.17 0.72 – 1.921.05 0.78 – 1.4126 – 3536 - 48

Male1.69

Male

South South1.55 1.73

Haematoma 2.30

AbrasionContusion

1.28 0.86 – 1.28

0.73 -2.27

23