Editor’s Note: This is part four of a four-part series.
Explore This IssueACEP Now: Vol 36 – No 04 – April 2017
The International Liaison Committee on Resuscitation (ILCOR) appointed a task force in 2013 to prepare recommendations regarding first-aid care by trained or untrained rescuers. The recommendations were released with the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The goal was to provide an evidence base for the initial care provided by laypersons, EMS, and physicians outside of the office or hospital setting.
ACEP Now has partnered with three emergency medicine residency training programs (Wake Forest School of Medicine, Winston-Salem, North Carolina; Mayo School of Graduate Medical Education/Mayo Clinic, Rochester, Minnesota; and Warren Alpert Medical School of Brown University, Providence, Rhode Island) to review 15 of these recommendations following the PICO (Population, Intervention, Comparator, and Outcomes) analytic format utilized by the recommendation authors.
- Howard Mell, MD, MPH, CPE, FACEP, emergency physician and member of ACEP Now’s editorial advisory board
- Jessica L. Smith, MD, FACEP, associate professor (clinical), Warren Alpert Medical School of Brown University, and program director, Emergency Medicine Residency
- Jason Stopyra, MD, FACEP, assistant professor, Wake Forest Baptist Medical Center, Department of Emergency Medicine
- Matthew Sztajnkrycer, MD, PHD, FACEP, associate professor, Mayo Clinic, Department of Emergency Medicine
Reference: Singletary EM, Charlton NP, Epstein JL, et al. Part 15: first aid: 2015 American Heart Association and American Red Cross guidelines update for first aid. Circulation. 2015;132(suppl 2):S574–S589.
First-Aid Education (FA 773)
Recommendation Author: Jennifer Beatty, MD
Dr. Beatty is a member of the residency training class of 2018 at the Wake Forest University School of Medicine.
Question: Among patients receiving first aid (P), does care from trained first-aid providers (I) compared with care from untrained persons (C) change survival rates, recognition of acute injury/illness, prevention of further illness/injury, time to resolution of injury, likelihood of harm, or time to symptom resolution (O)?
Results: Results: Low- or very-low-quality observational studies were identified to address some PICO outcomes.
Outcomes: One low-quality observational study showed reduced mortality among 1,341 patients initially managed by first-aid providers (9.8 percent versus 15.6 percent). One very-low-quality observational study of 125 subjects with burns showed 88.5 percent of patients treated by first-aid providers required hospitalization fewer than 10 days versus only 67.2 percent of subjects without intervention. One low-quality observational study of 244 burn patients showed benefit from care after a burn treatment campaign, with reduction in requiring inpatient wound care/surgery (35.6 percent versus 64.2 percent). Additionally, a review was found that showed training of laypersons with a stroke assessment system led to improved recognition of stroke after training (94.4 percent versus 76.4 percent).