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Effect of the Rural Rescue System on Reducing the Mortality Rate of Landmine Victims: A Prospective Study in Ilam Province, Iran

  • Masoud Saghafinia (a1), Nahid Nafissi (a2) and Reza Asadollahi (a2)
Abstract
Abstract<span class='bold'>Background:</span>

In several Iranian provinces, there are large numbers of landmines that threaten the lives of many civilians. Ilam is one of the most polluted areas with 1,086 injuries from landmines between 1989 to 1999, with an overall mortality rate of 36.4%. A remarkable number of deaths occurred before the injured were conveyed to the hospital. In this survey, the effects of on trauma outcome of the use of prehospital trauma life support provided by t rained paramedics and ru ral health workers as first responders were examined.

<span class='bold'>Methods:</span>

In an interventional, prospective study, 4,834 persons (general physicians, nurses, rural health workers, and emergency technicians, high- and low-educated people, layperson villagers, and nomads) were trained in one level of advanced (for general physicians and nurses) and four levels of basic life support courses during two years (2000–2001). Following the training, the data from 288 landmine victims who were referred to the main hospital in Ilam (trauma center) were registered prospectively (2001–2005). The effects of prehospital trauma life support training were assessed by using the Injury Severity Scale (ISS) score and prehospital physiologic severity (PSS) score.

<span class='bold'>Results:</span>

There were 288 injuries from landmines in the Mehran region between 2002 and 2005. The mean ISS score was 20.3 with a median of 13. Forty percent were severely injured with an ISS score >15. Of the injured who received prehospital care at the Mehran Emergency Center, the mean value of the PSS scores was 6.40, which improved to 7.43 in the hospital (p = 0.01; 95% CI for difference -0.72 to -0.45), in comparison with 5.97 in the injured who were conveyed to Ilam Hospital directly (mean of ISS was approximately equal in both groups).The total mort ality rate was 27% between 2001 and 2005.

<span class='bold'>Conclusions:</span>

Prehospital educations and training help improve PSS scores and reduce the death toll of landmine accidents in the remote areas.

Copyright
Corresponding author
PO Box 14665-199Tehran, Iran E-mail: drezaa@gmail.com
References
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6. CN Mock , GJ Jurkovich , D nii-Am on-Kotei , C Arreola-Riisa , RV Maier : Trauma mort alitypatterns in three nations at different econ omic levels: implications for global trauma system development. J Trauma 1998;44:804812.

7. C Arreola-Riisa , CN Mock , L Lojero-Wheatly , O de la Cruz , C Garcia , F Canavati-Ayub , GJ Jurkovich : Low cost improvements in prehospital trauma care in a Latin American city. J Trauma 2000;48:119124.

8. J Ali , RU Adam , TJ Gana , H Bedaysie , JI Williams : Effect of the Prehospital Trauma Life Support Program (PHTLS) on prehospital trauma care. J Trauma 1997;42:786790.

9. A Ascherio , R Biellik , A Epstein : Deaths and injuries caused by land mines in Mozambique. Lancet 1995;346:721–274.

10. H Husum : Effects of prehospital life support to war injureds: The battle of Jalalabad, Afghanistan. Prehospital Disast Med 1999;14:7580.

11. H Husum , M Gilbert , T Wisborg , YV Heng , M Murad : Rural prehospital trauma systems improve trauma outcome in low-incomecountries:A prospective study from North Iraq and Cambodia. J Trauma 2003;54:11881196.

14. HR Champion , WS Copes , WJ Sacco , : The Major Trauma Outcome Study: Establishing national norms for trauma care. J Trauma 1990;30:13561365.

16. H Husum , M Gilbert , T Wisborg , : Respiratory rate as a prehospital triage tool in rural trauma. J Trauma 2003;55:466470.

19. EL Jones , AF Peters , RM Gasior : Early management of battle casualties in Vietnam. Arch Surg 1968;97:116.

20. FM Burkle , C Newland , SJ Meiser : Emergency medics in the Persian Gulf war—Part 3: Battlefield casualties. Ann Emeg Med 1994;23:755760.

22. MJ VanRooyen , EP Sloan , AE Radvany , : The incidence and outcome of penetrating and blunt trauma in central Bosnia: The Nova Bila hospital for war wounded. J Trauma 1995;38:863866.

23. H Husum , M Gilbert , T Wisborg :Training prehospital trauma ca re in low-income countries:The “Village University”experience. Med Teach 2003;25:142148.

24. T Karstread , CL Larsen PD Farmer : Analysis of a rural trauma program using the TRISS methodology—A 3-year prospective study. J Trauma 1994;36:395400.

25. GJ Jurkovich , C Mock : Systematic review of the trauma system effectiveness based on registry comparison. J Trauma 1999;47:346355.

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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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