Transformation: Primary Trauma Care

19 March 2015

This week I have the privilege of hosting the Primary Trauma Care team!

Primary Trauma Care is a system for training the front-line staff in hospital trauma management; aimed at preventing death and disability in seriously injured patients.  It is based on straightforward clinical practice and does not require the physician or practitioner to have access to high-tech equipment or facilities.  This type of training is critically needed here in Madagascar as well as the entire Mercy Ships target region of sub-Saharan Africa, where motor vehicle accidents and other trauma cases are one of the largest causes of death.  Many of these deaths can be prevented with a good working knowledge of the ABC's of trauma response.

A = Airway.  It's necessary to make sure the airway is clear and air is able to pass through into the lungs. We can only last a few minutes without oxygen!

B = Breathing. If the airway is clear then we need to make sure the patient is actually breathing. If they can't breathe on their own, that's when we need to use a bag mask or even mouth-to-mouth.

C = Circulation.  Assessing whether there is adequate blood flow, diagnosis of shock, and stopping major hemorrhage is the next critical step.

D = Disability.  If the patient is breathing and has adequate blood flow, we can move to the secondary neurological assessment (disability)

E = Exposure.  This is where we take a look at the rest of the body and evaluate major injury such as a broken leg.

The course is two full day sessions.  The third day, select participants are invited to return to participate in a train-the-trainer day session, where they learn the basics of running their own course; how to set it up, equipment that is needed, and how to teach the different skills stations and lectures. Then the last two days of the week, today and Friday, are a second course, with our new trainers teaching with assistance from our team as needed.

The participants learn how to insert a chest drain using a goat thorax. 

The participants are eager to learn and the new trainers are great!  It's been such a pleasure working with all of them and our hope is that this type of trauma response training will continue on here in Madagascar long after our departure.


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