Trauma Responders Unify to Empower Communities in Santa Cruz, Bolivia: Course Participants and their Feedback

Abstract

Introduction: More than half of all trauma deaths occur in the prehospital setting with lowand middle-income countries assuming the greatest burden. Coordinated prehospital responses to trauma, including layperson first responders, can reduce the mortality. Trauma first responder courses (TFRCs) in Bolivia have improved participant knowledge and confidence levels. This study aims to analyze participant baseline characteristics and postworkshop evaluations to inform future course promotion and development. Materials and methods: Trauma responders unify to empower (TRUE)-Bolivia is a 4-hour didactic and practical TFRC covering scene safety, basic airway management, bleeding control, and pelvic binding. Participants, recruited from Santa Cruz, Bolivia, completing all preand post-course assessments were included. Quantitative data were aggregated and analyzed in SAS v9.4 with Chi-square analyses, and qualitative data were analyzed for thematic content in Microsoft Excel. Results: A total of 269 people, with an average age of 35.4 years, participated in 18 courses. Most participants were male (n = 211/269, 78.4%) with n = 149/253 (58.9%) working in public transportation, n = 64/253 (25.3%) in medical training, and n = 40/253 (15.8%) working in other fields. Of the 246 and 205 participants who responded to the safety behavior questions, respectively, 55.7% (n = 137/246) of participants wore seat belts less than 50% of the time and 60.5% (n = 124/205) wore helmets less than half the time while on a motorcycle. On post-course evaluation, n = 118/250 (47.2%) quoted skill acquisition to be the greatest benefit of the course, n = 37/250 (14.8%) quoted helping others, and n = 64/250 (25.6%) stated a combination of the two. Suggestions for improvement included adding content on burns, head injuries, and cardiopulmonary resuscitation. Conclusion: Understanding participants’ background and incorporating feedback allowed us to tailor the course to participants’ interests while maintaining the focus on trauma prevention and initial management. To maximize course impact, a local partnership has been formed with the municipal government to provide the courses to public transportation drivers who are likely to arrive first at a scene of trauma. Clinical significance: The didactic and practical content of TRUE-Bolivia empowers participants to save lives in the prehospital setting where ambulances can take over an hour to arrive.