Journal article : Review
Prehospital hemorrhage management in low- and middle-income countries: a scoping review
- Abstract:
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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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- Files:
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(Preview, Version of record, pdf, 2.9MB, Terms of use)
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- Publisher copy:
- 10.1002/wjs.12054
Authors
- 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:
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1432-2323
- ISSN:
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0364-2313
- Pmid:
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38265259
- Language:
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English
- Keywords:
- Subtype:
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Review
- Pubs id:
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1612356
- Local pid:
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pubs:1612356
- Deposit date:
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2024-10-09
Terms of use
- Copyright holder:
- Kulkarni et al.
- Copyright date:
- 2024
- Rights statement:
- © 2024 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of Société Internationale de Chirurgie. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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