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Prehosp Disaster Med. 2010 Nov-Dec;25(6):533-9.

Trained lay first responders reduce trauma mortality: a controlled study of rural trauma in Iraq.

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Trauma Care Foundation Iraq, Suleimaniah.



Recent studies demonstrate that early, in-field, basic life support by paramedics improves trauma survival where prehospital transport times are long. So far, no case-control studies of the effect of layperson trauma first responders have been reported. It was hypothesized that trained layperson first responders improve trauma outcomes where prehospital transit times are long.


A rural prehospital trauma system was established in the mine and war zones in Iraq, consisting of 135 paramedics and 7,000 layperson trauma first responders in the villages. In a non-randomized clinical study, the outcomes of patients initially managed in-field by first-responders were compared to patients not receiving first-responder support.


The mortality rate was significantly lower among patients initially managed in-field by first responders (n=325) compared to patients without first-responder support (n=1,016), 9.8%; versus 15.6%;, 95%; CI=1.3-10.0%;.


Trained layperson first responders improve trauma outcomes where prehospital evacuation times are long. This finding demonstrates that simple interventions done early-by any type of trained care provider-are crucial for trauma survival. Where the prevalence of severe trauma is high, trauma first-responders should be an integral element of the trauma system.

[Indexed for MEDLINE]

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