Table 1

Components of prehospital trauma course

Area of emphasisMajor componentsModification from standard developed world EMS protocols
Scene managementLeadership and delegation to insure management of traffic, fuel leaks, fires, crowdsNo Hazmat equipment
Universal precautionsProtection from blood and other bodily fluids practised during all skill stationsTraining in use of improvised barriers such as plastic bags
ExtricationEvaluate and safely disentangle casualties entrapped in vehicle wreckageWithout hydraulic spreaders and “jaws of life”, improvised tools such as car jacks and pry bars encouraged
Moving casualtiesMaintaining stability of cervical spine while carrying and moving unconscious or non-ambulatory casualties by using many persons working together under direction of a trained rescuerWithout 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 surveyUse of “ABCs” method for rapid evaluation for life threatening injuries. Recovery position (lateral decubitus) emphasised for airway protectionCardiopulmonary resuscitation CPR excluded secondary to negligible value in trauma resuscitation
SplintingStudents practised the application of soft and rigid splints on upper and lower extremities to immobilise fracturesUse of improvised splinting materials such as branches, towels, blankets practised and emphasised
TriagePrioritise casualty care by designating casualties as immediate, urgent, walking wounded or non-salvageableInformal nature of prehospital care made stringent mass casualty protocols impractical
TransportDrivers were warned against driving casualties to the hospital at excessive speeds and practised placing casualties in the recovery position in their vehiclesDeceased ability to monitor casualties during transport made use of recovery position in unconscious casualties imperative
First aid kitDrivers 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 vehiclesItems such as cervical collars, airway adjuncts, and commercial splints excluded due to cost and unavailability