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Journal article : Review

Prehospital hemorrhage management in low- and middle-income countries: a scoping review

Abstract:

Introduction: Low- and middle-income countries (LMICs) account for 90% of deaths due to injury, largely due to hemorrhage. The increased hemorrhage mortality burden in LMICs is exacerbated by absent or ineffective prehospital care. Hemorrhage management (HM) is an essential component of prehospital care in LMICs, yet current practices for prehospital HM and outcomes from first responder HM training have yet to be summarized.

Methods: This review describes the current literature on prehospital HM and the impact of first responder HM training in LMICs. Articles published between January 2000 and January 2023 were identified using PMC, MEDLINE, and Scopus databases following PRISMA-ScR guidelines.

Inclusion criteria spanned first responder training programs delivering prehospital care for HM. Relevant articles were assessed for quality using the Newcastle-Ottawa scale.

Results: Of the initial 994 articles, 20 met inclusion criteria representing 16 countries. Studies included randomized control trials, cohort studies, case control studies, reviews, and epidemiological studies. Basic HM curricula were found in 15 studies and advanced HM curricula were found in six studies. Traumatic hemorrhage was indicated in 17 studies while obstetric hemorrhage was indicated in three studies. First responders indicated HM use in 55%–76% of encounters, the most frequent skill they reported using. Mean improvements in HM knowledge acquisition post-course ranged from 23 to 58 percentage points following training for pressure and elevation, gauze application, and tourniquet application.

Conclusions: Our study summarizes the current literature on prehospital HM in LMICs pertaining to epidemiology, interventions, and outcomes. HM resources should be a priority for further development.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1002/wjs.12054

Authors


More by this author
Role:
Author
ORCID:
0009-0006-5010-9735
More by this author
Role:
Author
ORCID:
0000-0001-6420-481X


Publisher:
Wiley
Journal:
World Journal of Surgery More from this journal
Volume:
48
Issue:
3
Pages:
547-559
Publication date:
2024-01-24
Acceptance date:
2023-11-14
DOI:
EISSN:
1432-2323
ISSN:
0364-2313
Pmid:
38265259


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1612356
Local pid:
pubs:1612356
Deposit date:
2024-10-09

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