role of performing life support courses in rural areas in improving pre-hospital physiologic conditions of patients with penetrating injuries

To evaluate the impact of animal model based medical training courses for village healthcare workers on prehospital physiologic condition and prognosis of patients with penetrating injuries. Experimental study. This study was carried out in Mehran city and its neighbouring rural districts in western part of Iran from 2002 to 2004. Seventy-six village healthcare workers were trained and equipped to deliver in-field medical first cares. First group [226 patients] consisted of those who received this cares by the trained group and second group [245 patients] were those who received no in-field cares and were transported directly to the trauma center in provincial capital, Ilam. Physiologic Severity Score [PSS] was calculated to determine the physiologic condition of patients in both groups. The most prevalent cause of trauma in both groups was car accidents [61.6%]. Controlling of hemorrhage was the most frequent provided initial medical care [40.6%]. A significant improvement regarding the PSS score was observed in the first group of patients compared to the second group [7.505 vs. 6.799, 95% CI for difference: 0.3 to 0.9]. The mortality rates of the first and second group of patients were 3% and 7.3%, respectively [p=0.051]. Performing life support courses in rural areas of low-income countries where there is no pre-hospital triage and emergency medical system and provision of classic resuscitative measures are limited, has a significant impact on improvement of pre-hospital physiologic condition and prognosis of patients with penetrating injuries

Triage of war-injured troops in the Iran-Iraq War

This study compared the triage of Iran-Iraq war-injured troops within the first two years of the war with that after the first two years. This was a retrospective study, which compared the triage of the admissions for abdominal injuries during the first two years of the Iran-Iraq War with that in the next 6 years. Out of nearly 50, 000 cases, 1, 176 ones were randomly selected and their triage information was recorded and analyzed. About 12.5% of patients were operated on within less than 8 hours during the first two years. From 1982 towards the end of the conflict [1988], the patients were treated within progressively shorter periods of sustaining injury; 68.8% were operated on within less than 4 hours of injury. The mean delay between injury and treatment in the first two years of war was 12 hours while it was 5 hours between 1982 and 1988. The difference was significant [P<0.05] but the mortality rate was not significantly different. Patient triage was conducted differently at various stages of conflict. Better patient triage after 1982, may have been due to improved care and more specialized triage of injured troops