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Advanced trauma life support training for ambulance crews
1Health Policy Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK, WC1E 7HT. Dinesh.Sethi@lshtm.ac.uk
The Cochrane Database of Systematic Reviews
|June 19, 2001
Summary
Evidence is lacking on the effectiveness of advanced life support (ALS) ambulance crews for trauma patients. Rigorous trials are needed before widespread promotion in low and middle-income countries.
Area of Science:
- Emergency medicine
- Trauma care systems
- Public health interventions
Background:
- Global injury burden necessitates effective trauma care strategies.
- Advanced Life Support (ALS) ambulance services are being adopted in low and middle-income countries (LMIC).
- The effectiveness of ALS interventions in trauma care remains controversial and requires rigorous appraisal.
Purpose of the Study:
- To evaluate the impact of ALS-trained ambulance crews on trauma patient mortality and morbidity.
- Comparison against ambulance crews with alternative training levels.
Main Methods:
- Comprehensive literature search across multiple databases (Cochrane, MEDLINE, EMBASE, CINAHL, PubMed).
- Inclusion of randomized controlled trials, quasi-randomized controlled trials, and controlled before-and-after studies.
- Exclusion of studies comparing physician-staffed versus non-physician-staffed crews.
Main Results:
- One randomized controlled trial involving 16 trauma cases was identified.
- Outcome data from this trial were integrated into a non-randomized cohort analysis.
- Specific outcome data for the 16 cases in the RCT are not yet available.
Conclusions:
- Current evidence is insufficient to support the promotion of ALS ambulance services.
- Further rigorously conducted randomized controlled trials are essential.
- Promotion of ALS should be contingent on robust evidence from well-designed trials.