Components of prehospital trauma course
| Area of emphasis | Major components | Modification from standard developed world EMS protocols |
|---|---|---|
| Scene management | Leadership and delegation to insure management of traffic, fuel leaks, fires, crowds | No Hazmat equipment |
| Universal precautions | Protection from blood and other bodily fluids practised during all skill stations | Training in use of improvised barriers such as plastic bags |
| Extrication | Evaluate and safely disentangle casualties entrapped in vehicle wreckage | Without hydraulic spreaders and “jaws of life”, improvised tools such as car jacks and pry bars encouraged |
| Moving casualties | Maintaining stability of cervical spine while carrying and moving unconscious or non-ambulatory casualties by using many persons working together under direction of a trained rescuer | Without backboards or cervical collars, a rolled blanket placed around the neck, crossed at the chest with ends under the axilla was practised and recommended |
| Primary survey | Use of “ABCs” method for rapid evaluation for life threatening injuries. Recovery position (lateral decubitus) emphasised for airway protection | Cardiopulmonary resuscitation CPR excluded secondary to negligible value in trauma resuscitation |
| Splinting | Students practised the application of soft and rigid splints on upper and lower extremities to immobilise fractures | Use of improvised splinting materials such as branches, towels, blankets practised and emphasised |
| Triage | Prioritise casualty care by designating casualties as immediate, urgent, walking wounded or non-salvageable | Informal nature of prehospital care made stringent mass casualty protocols impractical |
| Transport | Drivers were warned against driving casualties to the hospital at excessive speeds and practised placing casualties in the recovery position in their vehicles | Deceased ability to monitor casualties during transport made use of recovery position in unconscious casualties imperative |
| First aid kit | Drivers were encouraged to assemble an inexpensive first aid kit (gloves, bandages, a blanket, splinting materials, extrication equipment) of readily available materials to keep in their vehicles | Items such as cervical collars, airway adjuncts, and commercial splints excluded due to cost and unavailability |