Impact of the Prehospital Trauma Life Support programme in Trinidad and Tobago

The impact of the Prehospital Trauma Life Support (PHTLS) programme, introd uced in Trinidad and Tobago in 1992, was assessed by questionnaires complet ed by 26 medical personnel (MP); 71 ambulance personnel (AP); and 50 non am bulance paramedical personnel (NAP). Of the 23 MP, 45 AP and 38 NAP who wer e aware of the programme, 19 (82.6%) MP, 40 (88.9%) AP and 25 (65.8%) NAP w ere able to differentiate personnel that had taken the PHTLS programme base d on their performance. 32 (71.1%) of the AP were PHTLS trained 24 (53.3%) and 4 (9%) of the AP identified poor equipment and poor supervision, respec tively, as reasons for difficulty in applying PHTLS principles. Improvement s observed among those completing the PHTLS programme were: improved resusc itation techniques by 20 (86.9%) MP, 38 (84.4%) AP and 27 (71.1%) NAP; bett er vital signs recording by 8 (34.8%) MP, 27 (60%) AP and 8 (21.1%) NAP; im proved immobilization by 23 (100%) MP, 40 (88.9%) AP and 33 (86.8%) NAP; be tter haemorrhage control by 22 (95.6%) MP, 40 (88.9%) AP and 24 (63.2%) NAP ; appropriate splinting of fractures by 23 (100%) MP, 40 (88.9%) AP and 32 (84.2%) NAP; and increased utilization of oxygen by IS (65.2%) MP, 31 (68.9 %) AP and 21 (55.3%) NAP. 32 (71.1%) AP with PHTLS training indicated impro vement in their ability to resuscitate and transport trauma victims, with 4 2 (93.3%) reporting improvement in overall prehospital care. Medical, param edical and ambulance personnel all perceive a significant positive impact o f PHTLS training on prehospital trauma care. Although improvements in super vision, documentation and equipment are still required, improved trauma res uscitative techniques after PHTLS training should improve trauma patient ou tcome in Trinidad and Tobago.