title: Bystander trauma care--effect of the level of training.
abstract: BACKGROUND
  The bystander is often the first person present at the scene of an accident. Our aim was to determine how often and how well bystanders perform trauma care and whether trauma care is affected by the bystander's level of training, relationship to the patient and numbers of bystanders present.
  
  
  METHODS
  In a prospective 1-year study, the emergency medical service in two European cities collected data on trauma calls. Questionnaires were used to document the bystanders' level of training (none, basic, advanced, professional), the bystander's relationship to the patient, and the number of bystanders present, and to assess whether five separate measures of trauma care (ensuring scene safety, extrication of the patient, positioning, control of haemorrhage, prevention of hypothermia) were performed correctly, incorrectly, or not at all.
  
  
  RESULTS
  Two thousand nine hundred and thirty-two trauma calls were documented and bystanders were present in 1720 (58.7%). All measures except ensuring scene safety and prevention of hypothermia were affected by the bystander's level of training. Correct extrication, positioning, and control of haemorrhage increased with the level of bystander training while the number of patients who were not attended decreased (P < 0.05, P < 0.005, P < 0.005), respectively. The relationship to the patient did not affect whether, or how well, any measure was performed. The number of bystanders present only affected prevention of hypothermia, which was performed most often when only one bystander was present.
  
  
  CONCLUSIONS
  Improved, more widespread training could increase the frequency and quality of bystander trauma care further.
authors.affiliation: Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria. lindapel@via.at
authors.forename: Linda E
authors.initials: LE
authors.lastname: Pelinka
authors.forename: Andreas R
authors.initials: AR
authors.lastname: Thierbach
authors.forename: Silja
authors.initials: S
authors.lastname: Reuter
authors.forename: Walter
authors.initials: W
authors.lastname: Mauritz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004522:Educational Status; D004632:Emergency Medical Services; D005260:Female; D005392:First Aid; D006282:Health Personnel; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D014947:Wounds and Injuries / Q000628:therapy*