Mr Jamie Ranse

Ms Courtney Aitken

Casualties referred to hospital by first aiders:

A RETROSPECTIVE ANALYSIS OF CASUALTY PRESENTATIONS

Overview

• What we already know• Problem and Aim• Method• Results• Discussion• Questions

What we already know

• Many event organisers use St John• St John members make referral decisions

• A number of factors influence casualty presentation The weather (temperature and humidity); Duration of the event; Indoors or outdoor event; Seated

or mobile crowd; Bounded (fenced or contained) or unbounded; Type of event; Mood of the crowd; Availability of alcohol and drugs; Crowd density; Geography of the venue (or terrain/locale); and Average age of the crowd.

• Laypersons consult family and friends prior to calling an ambulance

• Casualties transported to the ED are more acutely unwell then those who self present

What we already know

• Ambulance personnel make complex decisions regarding transportation of casualties

• A number of in-hospital tools exist to assist in decision-making for assistance

What we already know

• Ambulance personnel make complex decisions regarding transportation of casualties

• A number of in-hospital tools exist to assist in decision-making for assistance

Problem and Aim

Problem• Are there patterns and/or characteristics of casualties who are

referred to hospital by first aiders?

Aims• Identify patterns and/or characteristics of casualties who are

referred to hospital by first aiders;• Make recommendations for future guidelines for casualty

referral by first aiders;• Make recommendations for training and education of first

aiders regarding casualty referral.

Method

• Retrospective audit of casualty report forms,

Inclusion criteria:1) The casualty was from within the studied population, and2) Were referred by St John Ambulance Australia first aiders to:

– hospital via the local government ambulance service;– hospital via their own private means; or to – personnel of an onsite government ambulance service.

Results

During 2006 487 events7462 hours1120 casualties100 referrals

Results

R e f e r r e d t oh o s p i t a l b y a m b u l a n c e

4 % ( n = 4 5 )

R e f e r r e d t oh o s p i t a l b y o w n m e a n s

3 . 7 5 % ( n = 4 2 )

T r a n s p o r t e d t o h o s p i t a lb y a m b u l a n c e

( n = 1 )

R e f e r r e d t o h o s p i t a lb y o w n m e a n s

( n = 1 )

R e r r e r e d t og e n e r a l p r a c t i t i o n e r

( n = 6 )

N o t r e f e r r e d( n = 5 )

R e f e r r e d t oo n s i t e a m b u l a n c e

1 . 1 5 % ( n = 1 3 )

N o t r e f e r r e d O Rr e f e r r e d t o g e n e r a l p r a c t i t i o n e r

9 1 . 1 % ( n = 1 0 2 0 )

T o t a l n u m b e r o f p r e s e n t a t i o n s i n 2 0 0 6( n = 1 1 2 0 )

Results

Results

Discussion

• Presentation and referral rates assist planning• Illness• Vital signs• Further research• Clinical Governance

Questions

Acknowledgement: Thankyou to St John Ambulance Australia for providing a grant to

conduct this research.

Mr Jamie Ranse

Ms Courtney Aitken

Casualties referred to hospital by first aiders:

A RETROSPECTIVE ANALYSIS OF CASUALTY PRESENTATIONS