A model of prehospital trauma training for lay persons devised in Africa

OBJECTIVES: Few low income countries have emergency medical services to provide prehospital medical care and transport to road traffic crash casualties. In Ghana most roadway casualties receive care and transport to the hospital from taxi, bus, or truck drivers. This study reports the methods used to devise a model for prehospital trauma training for commercial drivers in Ghana. METHODS: Over 300 commercial drivers attended a first aid and rescue course designed specifically for roadway trauma and geared to a low education level. The training programme has been evaluated twice at one and two year intervals by interviewing both trained and untrained drivers with regard to their experiences with injured persons. In conjunction with a review of prehospital care literature, lessons learnt from the evaluations were used in the revision of the training model. RESULTS: Control of external haemorrhage was quickly learnt and used appropriately by the drivers. Areas identified needing emphasis in future trainings included consistent use of universal precautions and protection of airways in unconscious persons using the recovery position. CONCLUSION: In low income countries, prehospital trauma care for roadway casualties can be improved by training laypersons already involved in prehospital transport and care. Training should be locally devised, evidence based, educationally appropriate, and focus on practical demonstrations.