The Chain of Survival. Studies of a prehospital trauma system in Iraq

Abstract

Most trauma deaths in war occur outside hospital, in the mine fields and on the way to hospital. To improve survival, a prehospital trauma system was set up in 1997 by the PhD candidate with trauma experts from UNN in the minefields of North Iraq. The model worked well and reduced death rates from 40% to 10%. The model was further refined and adapted to manage highway traffic casualties, and in 2003 also to support the communities caught in the war zones in Central Iraq. A three-tier rescue system of lay first helpers, trained in-field paramedics, and professional Emergency Room care providers had a significant impact on survival, especially in severely injured patients. The studies document for the first time that trained first helpers at grassroots level improves survival where out-of hospital times are long.