Effects of preparation and telemedicine support for laypersons as first responders for building-site severe injury events: a randomized simulation study

Abstract

Abstract Background: The risk of high-energy trauma injuries on construction sites is relatively high. A delayed response time could affect outcomes after severe injury. This study assessed if preparation for first aid response for laypersons (employees or apprentices) in the construction industry, a first aid training course or atelemedicine supporting system, would lead to better immediate vital responses. Method: This was a randomized, controlled simulation study. Employees or apprentices at a construction site were recruited and randomly allocated into a group where groups had telemedicine support or not, and preparatory course training or not. One group had both, and one group had neither. The primary outcomes were correct behavior to recognize a blocked breathing passage and restore adequate breathing and correct behavior to stop life-threatening bleeding from a lower extremity injury. Results: A total of 90 participants were included and were assessed as 10 groups of 3 for each of 4 exposures (one group was tested first as a baseline group, and then later after having done the training course). For bleeding, and airway management within 90 seconds, telemedicine support by itself, with no course preparation, gave benefit to trauma response. The preparatory course by itself showed improved immediate responses, at least for airway management. The pre-treatment course and telemedicine support together were shown to be not clearly superior to the course by itself or telemedicine by itself. Conclusion: These findings show that laypersons, here construction industry employees, can be supported to achieve good performance as first responders in a major injury scenario either by a 6 hour practical training course or with distance video support from ambulance personnel by itself, or with both. Since effects of training course/education is expected to decay over time without recurrent training or repetition, telemedicine support for local laypersons in response to a serious injury event could be a practical way to improve vital immediate response effectiveness, even for those who have not had recent first aid courses.