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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

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Page 1: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Association between stop bleeding and adverse outcome of patients from road

traffic accident by first response unit and basic life support unit

Prat Intarasaksit

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Page 2: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Background

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Page 3: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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Page 4: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

background

• Emergency Medical Service (EMS)

DispatchCenter

Advance Life support

Basic Life support

First response

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Intermediate Life support

Page 5: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Objective

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

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Basic Life support First response

Page 6: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Variables

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

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Dependent VariablesStop bleeding outcome

Page 7: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Methods

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Page 8: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Baseline characteristics of road traffic accident

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Gender Region

FRBLS

male male

Page 9: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Baseline characteristics of road traffic accident

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Wound(Abrasion )

Stop bleeding inappropriate

Page 10: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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Multivariable analysis

Page 11: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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.

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Page 12: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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

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Page 13: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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

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Page 14: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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.

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Page 15: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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.

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Page 16: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Recommendations

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

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Page 17: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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

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Page 18: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Acknowledgment

• Thank you Assoc. Dr. Bandit Thinkhamrop

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

KKU-Facebook group

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Page 19: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Thank you for your attention

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Page 20: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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Page 21: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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Page 22: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

Bivariate analysis

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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

Page 23: Association between stop bleeding and adverse outcome of patients from road traffic accident by first response unit and basic life support unit Prat Intarasaksit

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