B. Wondimu1, S. Speedy1, T. Barnum1, F. Cosey-Gay2, S. Regan3, L. Stone3, M. Shapiro1, M. Swaroop1, L. C. Tatebe1 1Northwestern University,Chicago, IL, USA 2University Of Chicago,Chicago, IL, USA 3University Of Illinois At Chicago,Chicago, IL, USA
Introduction:
The city of Chicago has one of the highest rates of violence in the country, and this violence has been shown to disproportionately affect socioeconomically disadvantaged neighborhoods in the south side. The paucity of trauma centers in the south side of Chicago leads to prolonged transport times, increasing morbidity and mortality for those affected by penetrating traumas. A community based Trauma First Responders Course (TFRC) designed for bystanders could potentially mitigate this effect. Bystanders are present at 60-97% of traumas and more likely to assist if given prior training. We seek to design and implement an evidence-based, community driven course designed for the general public to empower bystanders to intervene.
Methods:
A three-hour TFRC was designed using community based focus groups and qualitative analysis of the bystander effect. The course addressed basic first aid, trauma wound care, principles of bystander care, and the psychological impact of trauma. The course was taught in community centers, churches, and schools, to both minor and adult participants. Pre- and post-course questionnaires were offered. Eight evidence-based empowerment questions were assessed on a scale of 1 to 10. Ten knowledge-based questions were presented as single best of four multiple choice answers. The change in empowerment measures and knowledge scores were analyzed using chi-squared methods with p<0.05 considered significant.
Results:
Over the 7 courses offered thus far, 92 participants completed both the pre- and post-course assessments. The mean increase in empowerment was 2.42 out of 10 (0.41-4.66). The area with most improvement was ability to apply a tourniquet, followed by ability to render first aid. Improvement in 5 knowledge-based questions reached significance: tourniquet usage (p<0.01), management of impaled object (p=0.01), exposure to bodily fluids (p<0.01), initial trauma care (p<0.01), and scene safety (p<0.01). Over all 10 questions, participants had a 14% improvement (p=0.02).
Conclusion:
An evidence-based community TFRC is currently being offered throughout Chicago’s south side. The course has been shown to improve both bystander empowerment and knowledge of initial trauma care in the field, particularly trauma wound management and scene safety. Enrollment is ongoing and will improve the power of the study. In addition, 6-month follow-up assessments will be performed to assess knowledge retention and applicability.
