Pre-hospital trauma care

Fact sheet

Key facts

• Fewer than 10% of road traffic victims receive first aid on site (1).
• Fewer than 10 provinces/cities have a dedicated emergency medical services (EMS) system with the remainder dependent upon hospital based resources
• The quality of first aid is poor, with 50% of cases treated incorrectly (1).
• Fewer than 10% of victims are referred to hospital by the formal emergency medical services system with the majority of patients arriving at hospital by taxi or motorcycle.

The situation

• According to a National Injury Survey in 2010, road traffic mortality was 15 people per 100,000, or more than 13,000 deaths every year on the roads.
• The number of people injured is estimated in the hundreds of thousands each year.
• Viet Nam has one of the highest road traffic mortality and morbidity rates in the region.
• The number of victims who receive first aid on the scene is very limited, around 6% to 10%.
• In addition, according to a survey of trauma patient’s referred to Hanoi's Viet Duc hospital during 2002-2004, 50% received inappropriate treatment in the field.
• The victim referral service is also quite limited, with fewer than 10 provinces/cities having a formal EMS system (total: 115).
• The response ability of the 115 systems is limited because of a shortage of qualified staff and resources.
• In big cities such as Hanoi and Ho Chi Minh, traffic congestion is another major hindrance to a swift response to incidents.

WHO's response

• Project Improving Prehospital Trauma Care Services in Viet Nam, supported by the Atlantic Philanthropies,
• The overall aim of the project is to help the Government identify the most appropriate pre-hospital care system.
• The project is to be implemented between 2009 and 2011. It is anticipated that this model will then be widely disseminated throughout Viet Nam.
• Objectives:
• To strengthen capacity for providing first- and second-tier care by developing a standard first-aid training programme and equipping trained volunteers with essential equipment.
• To reinforce the operation of the pre-hospital trauma care system through an appropriate national operating protocol/guideline.
• To continuously monitor the quality of pre-hospital services in order to identify gaps for improvement.
• Activities implemented:
• Developing a nationally standardized curriculum for training first- and second-tier responders;
• Establishing a group of 10 central-level trainers; plus a further 50 for first aid in five provinces/cities;
• Establishing a network of 3,000 trained responders, including commune and village health workers and volunteers to provide care to victims of road traffic accidents;
• Equip all trained responders with nationally standardized first-aid kits;
• Develop a pre-hospital trauma care surveillance and information system;
• Develop an operational and administrative protocol for pre-hospital trauma care (including communication and transportation) to be used at central, provincial and district levels;
• Outcomes to date (2008-2011)
• 3000 volunteers from selected districts in 5 provinces have been trained in pre-hospital trauma care utilizing a specifically developed and nationally standardized training curriculum
• A national standard operational protocol was developed and is currently informing efforts on a wider national push by MOH on expanding PHTC for victims of road trauma
• In the 2-4 months since training was completed, first aid was provided to 1363 patients in the 5 provinces.
• Implementation of the model will continue in 2012-2013 in preparation for an outcome evaluation at the end of 2013

(1) Report on admissions to Viet Duc Hospital from 2002-2004