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Effect of the Rural Rescue System on Reducing the Mortality Rate of Landmine Victims: A Prospective Study in Ilam Province, Iran

Published online by Cambridge University Press:  28 June 2012

Masoud Saghafinia ,
Nahid Nafissi  and
Reza Asadollahi
Masoud Saghafinia*
Affiliation:
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Nahid Nafissi
Affiliation:
Iranian Mine Victim Rescue Center (IMC), Tehran, Iran
Reza Asadollahi
Affiliation:
Iranian Mine Victim Rescue Center (IMC), Tehran, Iran
*
PO Box 14665-199Tehran, Iran E-mail: [email protected]
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Abstract

Background:

In several Iranian provinces, there are large numbers of landmines that threaten the lives of many civilians. Ilam is one of the most polluted areas with 1,086 injuries from landmines between 1989 to 1999, with an overall mortality rate of 36.4%. A remarkable number of deaths occurred before the injured were conveyed to the hospital. In this survey, the effects of on trauma outcome of the use of prehospital trauma life support provided by t rained paramedics and ru ral health workers as first responders were examined.

Methods:

In an interventional, prospective study, 4,834 persons (general physicians, nurses, rural health workers, and emergency technicians, high- and low-educated people, layperson villagers, and nomads) were trained in one level of advanced (for general physicians and nurses) and four levels of basic life support courses during two years (2000–2001). Following the training, the data from 288 landmine victims who were referred to the main hospital in Ilam (trauma center) were registered prospectively (2001–2005). The effects of prehospital trauma life support training were assessed by using the Injury Severity Scale (ISS) score and prehospital physiologic severity (PSS) score.

Results:

There were 288 injuries from landmines in the Mehran region between 2002 and 2005. The mean ISS score was 20.3 with a median of 13. Forty percent were severely injured with an ISS score >15. Of the injured who received prehospital care at the Mehran Emergency Center, the mean value of the PSS scores was 6.40, which improved to 7.43 in the hospital (p = 0.01; 95% CI for difference -0.72 to -0.45), in comparison with 5.97 in the injured who were conveyed to Ilam Hospital directly (mean of ISS was approximately equal in both groups).The total mort ality rate was 27% between 2001 and 2005.

Conclusions:

Prehospital educations and training help improve PSS scores and reduce the death toll of landmine accidents in the remote areas.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 2 , April 2009 , pp. 126 - 129
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1. Orifice, D: A History of Mine Action. In: A Guide to Mine Action 2nd ed. Geneva: GICHD, 2004, pp 19–21.Google Scholar
2. Centers for Disease Control and Prevention. Injuries associated with landmines and unexploded ordnance–Afghanistan, 1997–2002. MMWR 2003;52(36):859–862.Google Scholar
3. ICRC: Anti-personnel landmines and explosive remnants of war: Available at http://www.icrc.org/eng/mines. Accessed 13 April 2008.Google Scholar
4. Winslow, PC: The case against landmines: Available at http://www.redcross.int/EN/mag/magazine1997_2/10-11.html. Accessed 13 April 2008.Google Scholar
5. Landmine Monitor report 2007 on Iran. Available at http://www.icbl.org/lm/2007.iran.html. Accessed 13 April 2008.Google Scholar
6. Mock, CN, Jurkovich, GJ, nii-Am on-Kotei, D, Arreola-Riisa, C, Maier, RV: Trauma mort alitypatterns in three nations at different econ omic levels: implications for global trauma system development. J Trauma 1998;44:804–812.CrossRefGoogle Scholar
7. Arreola-Riisa, C, Mock, CN, Lojero-Wheatly, L, de la Cruz, O, Garcia, C, Canavati-Ayub, F, Jurkovich, GJ: Low cost improvements in prehospital trauma care in a Latin American city. J Trauma 2000;48:119–124.CrossRefGoogle Scholar
8. Ali, J, Adam, RU, Gana, TJ, Bedaysie, H, Williams, JI: Effect of the Prehospital Trauma Life Support Program (PHTLS) on prehospital trauma care. J Trauma 1997;42:786–790.CrossRefGoogle ScholarPubMed
9. Ascherio, A, Biellik, R, Epstein, A: Deaths and injuries caused by land mines in Mozambique. Lancet 1995;346:721–274.CrossRefGoogle ScholarPubMed
10. Husum, H: Effects of prehospital life support to war injureds: The battle of Jalalabad, Afghanistan. Prehospital Disast Med 1999;14:75–80.CrossRefGoogle Scholar
11. Husum, H, Gilbert, M, Wisborg, T, Heng, YV, Murad, M: Rural prehospital trauma systems improve trauma outcome in low-incomecountries:A prospective study from North Iraq and Cambodia. J Trauma 2003;54:1188–1196.CrossRefGoogle ScholarPubMed
12. Jahunlu, HR, Husum, H, Wisborg, T: Mortality in land mine accidents in Iran. Prehospital Disast Med 2002;17:107–109.CrossRefGoogle ScholarPubMed
13. Husum, H, Gilbert, M, Wisborg, T: Life Support to Victims of Mines, Wars, and Accidents. In: Save Lives, Save Limbs. Penang: TWN, 1999.Google Scholar
14. Champion, HR, Copes, WS, Sacco, WJ, et al. : The Major Trauma Outcome Study: Establishing national norms for trauma care. J Trauma 1990;30:1356–1365.CrossRefGoogle ScholarPubMed
15. Husum, H, Gilbert, M, Wisborg, T, et al. : Rural prehospital trauma systems improve trauma outcome in low-income countries: A prospective study from North Iraq and and Cambodia. J Trauma 2003;54:1188–1196.CrossRefGoogle ScholarPubMed
16. Husum, H, Gilbert, M, Wisborg, T, et al. : Respiratory rate as a prehospital triage tool in rural trauma. J Trauma 2003;55:466–470.CrossRefGoogle ScholarPubMed
17. Association for the Advancement of Automotive Medicine. The Abbreviated Injury Scale, 1990 Revision, Update 98. Des Plaines, IL; 1998:Google Scholar
18. Newcombe, RG, Altman, DG: Proportions and their Differences. In: Altman, DG, Machin, D, Bryant, TN, Gardner, MJ, eds: Statistics with Confidence. Landon: British Medical Journal 2000, pp 46–48.Google ScholarPubMed
19. Jones, EL, Peters, AF, Gasior, RM: Early management of battle casualties in Vietnam. Arch Surg 1968;97:1–16.CrossRefGoogle ScholarPubMed
20. Burkle, FM, Newland, C, Meiser, SJ: Emergency medics in the Persian Gulf war—Part 3: Battlefield casualties. Ann Emeg Med 1994;23:755–760.CrossRefGoogle ScholarPubMed
21. Arreola-Risa, C, Mock, CN, Padilla, D, et al. : Trauma care systems in urban Latin America: The priorities should be prehospital and emergency room management. J Trauma 1995;39:457–462CrossRefGoogle ScholarPubMed
22. VanRooyen, MJ, Sloan, EP, Radvany, AE, et al. : The incidence and outcome of penetrating and blunt trauma in central Bosnia: The Nova Bila hospital for war wounded. J Trauma 1995;38:863–866.CrossRefGoogle ScholarPubMed
23. Husum, H, Gilbert, M, Wisborg, T:Training prehospital trauma ca re in low-income countries:The “Village University”experience. Med Teach 2003;25:142–148.CrossRefGoogle Scholar
24. Karstread, T, Larsen, CL Farmer, PD: Analysis of a rural trauma program using the TRISS methodology—A 3-year prospective study. J Trauma 1994;36:395–400.CrossRefGoogle Scholar
25. Jurkovich, GJ, Mock, C: Systematic review of the trauma system effectiveness based on registry comparison. J Trauma 1999;47:346–355.CrossRefGoogle Scholar