title: The role of performing life support courses in rural areas in improving pre-hospital physiologic conditions of patients with penetrating injuries.
abstract: OBJECTIVE
  To evaluate the impact of animal model based medical training courses for village healthcare workers on prehospital physiologic condition and prognosis of patients with penetrating injuries.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  This study was carried out in Mehran city and its neighbouring rural districts in western part of Iran from 2002 to 2004.
  
  
  METHODS
  Seventy-six village healthcare workers were trained and equipped to deliver in-field medical first cares. First group (226 patients) consisted of those who received this cares by the trained group and second group (245 patients) were those who received no in-field cares and were transported directly to the trauma center in provincial capital, Ilam. Physiologic Severity Score (PSS) was calculated to determine the physiologic condition of patients in both groups.
  
  
  RESULTS
  The most prevalent cause of trauma in both groups was car accidents (61.6%). Controlling of hemorrhage was the most frequent provided initial medical care (40.6%). A significant improvement regarding the PSS score was observed in the first group of patients compared to the second group (7.505 vs. 6.799, 95% CI for difference: 0.3 to 0.9). The mortality rates of the first and second group of patients were 3% and 7.3%, respectively (p=0.051).
  
  
  CONCLUSIONS
  Performing life support courses in rural areas of low-income countries where there is no pre-hospital triage and emergency medical system and provision of classic resuscitative measures are limited, has a significant impact on improvement of pre-hospital physiologic condition and prognosis of patients with penetrating injuries.
authors.affiliation: Trauma Research Center, Baqiyatallah Medical Sciences University, Molla-Sadra Avenue, Vanak Square, Tehran, Iran. dr_sagafi@yahoo.com
authors.forename: Masoud Saghafi
authors.initials: MS
authors.lastname: Nia
authors.forename: Nahid
authors.initials: N
authors.lastname: Naffisi
authors.forename: Hassan Ali
authors.initials: HA
authors.lastname: Mohebbi
authors.forename: Yashar
authors.initials: Y
authors.lastname: Moharamzadeh
mesh_terms: D015998:Abbreviated Injury Scale; D003479:Curriculum; D004632:Emergency Medical Services; D006297:Health Services Accessibility; D006801:Humans; D008020:Life Support Care; D011203:Poverty; D011379:Prognosis; D012424:Rural Population; D012959:Socioeconomic Factors; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014950:Wounds, Penetrating / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*