An Applicable Model for Trauma First Aid and Transport : A Mini Review

Introduction Worldwide, trauma constitutes a massive public health problem. Approximately 5.8 million people die annually as a result of injury, representing 10% of the world’s deaths [1]. Those who die as a result of trauma represent only a fraction of those injured. Every year, approximately 50 million people suffer moderate or severe disability, resulting in the loss of 180 million disability–adjusted life years [2]. These economic and treatment costs in the U.S (2009) have been estimated 693.5 billion dollars [3]. A short review of the history of transportation methods of trauma casualties shows that there has been a remarkable decrease in the death rate by considering progressed methods of transportation, so that during world war II, transportation time was four hours and the death rate was 4.5% and in Vietnam war, transportation time was reached to 27 minutes and the death rate was reached to 1.9% [4]. Although some factors such as frontlines hospitals and blood bank availability were effective in this regard, development and progress of trauma care organization and rapid evacuation of casualties are among the main causes of death decrease [5]. In the study about trauma care model in pre-hospital environment, it is shown that trauma pre-hospital care system has developed and progressed in many countries during the last decade and this progress was due to military medicine experiences modeling [6]. Among the studies in this regard, it can be pointed out to military medicine experiences modeling in Korea war. In this war, using modern methods such as helicopter, field hospital, blood bank and bulletproof vest caused saving lives of thousand soldiers and it has been suggested to use medical experiences as a model [7]. Studies show that trauma transport and first aid with appropriate quality is encountered with many challenges; to overcome these challenges, thoughtful design of the system and care processes models are required [8]. Currently, this issue is in discussion in trauma transport and first aid model that whether the presence of a physician is necessary in the team or not? [9]. In some European countries, trauma transport and first aid model is in this way that pre-hospital care is started from the scene of the event and in crisis moments by the presence of a physician [10]. First aid interventions for saving casualties’ lives are started from the event scene and after stabilizing the clinical situation, the casualties are transported to the trauma centers rapidly. Interventions are based on necessary transport and triage protocols [11]. In the stated models, considering injuries etiology particularly in thoracic injuries is very important. The study about thoracic injuries shows that in penetrating injuries of the chest, rapid transportation is more important than measurements for stabilizing casualty’s conditions in the event scene [12]. According to the above studies, it is necessary to have a model for transport and first aid with the aim of overcoming transport and first aid challenges and The nature of trauma triage and transportation services is along with limited opportunities, chaos and irregularities. In such conditions, a model is required to prevent a problem through anticipating the future and appropriate decision making. This study tried to suggest an applicable model through surveying weak and strong points of the available models in trauma triage and transportation. In this study by using a mini review method in purposive form and by focusing on the research question that is; “what are the available models for transport and first aid? ”, necessary information was searched, retrieved, evaluated and integrated in the related information databases based on the key words and inclusion criteria. Five articles had the inclusion criteria. These articles were narrative ordered, summarized and categorized according to the research question and finally findings were reported based on the achieved themes. The theme of “responsible model in trauma transport and first aid” was achieved through data analysis and integration; this theme includes: three main categories; “recognition and decision making in trauma transport and first aid”, “trauma transport and first aid in remote areas” and “crisis management of trauma transport and first aid”. We propose that trauma transport and triage models are actual images of first aid measures which lead to performance increase and successful results in first aid system in different conditions. Responsive model in trauma first aid and triage is an applicable model that improves first aid speed, transportation and prehospital care in terms of motivation, skill and promotion of management ability through human sources empowerment.