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Journal Article

Citation

Tatebe L, Speedy S, Kang D, Barnum T, Cosey-Gay F, Regan S, Stone L, Swaroop M. J. Surg. Res. 2019; 238: 255-264.

Affiliation

Department of Surgery, Northwestern University, Chicago, Illinois. Electronic address: mswaroop@nm.org.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.jss.2019.02.029

PMID

30954087

Abstract

BACKGROUND: Timely and effective bystander first aid can improve outcomes for trauma victims. Bystanders are present at most traumas and are more likely to assist with prior training.

MATERIALS AND METHODS: An evidence-based course was created for the general public in high-risk Chicago neighborhoods focused on basic traumatic first aid, including scene management, hemorrhage control, and mitigating the psychological impact of trauma to overcome the bystander effect. Prospectively, participants completed knowledge-based and self-efficacy assessments precourse, postcourse, and 6 mo follow-up. The change in self-efficacy and knowledge scores was analyzed.

RESULTS: Over 32 courses, 503 participants were taught; 474 and 460 participants completed precourse and postcourse surveys, respectively, whereas 60 of 327 who consented for follow-up completed the 6-mo survey. Postcourse, participants were more likely to assist trauma victims and felt more confident in the quality of care they could provide; the effect remained significant at 6 mo (all P < 0.001). All seven self-efficacy empowerment-based questions individually demonstrated improvement from precourse to postcourse (P < 0.001), with an overall mean (SD) increase of 2.8 (2.1, P < 0.001); six maintained significance at follow-up with an overall mean increase of 2.8 (1.9, P < 0.001). Knowledge scores improved from 6.2 of 10 to 7.2 postcourse and 7.7 at follow-up (P < 0.001). Most improved were the ability to render first aid and apply tourniquets.

CONCLUSIONS: The TFRC increased self-efficacy, successfully teaching initial trauma care, particularly hemorrhage control and scene safety, suggesting that a grassroots approach to trauma care may improve outcomes in communities that experience high violence rates.

Published by Elsevier Inc.


Language: en

Keywords

Bystander effect; Immediate responders; Self-efficacy; Tourniquets; Trauma care

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