PT - JOURNAL ARTICLE AU - Jon Moussally AU - Arup Chandra Saha AU - Susan Madden TI - TraumaLink: A Community-Based First-Responder System for Traffic Injury Victims in Bangladesh AID - 10.9745/GHSP-D-21-00537 DP - 2022 Aug 30 TA - Global Health: Science and Practice PG - e2100537 VI - 10 IP - 4 4099 - http://www.ghspjournal.org/content/10/4/e2100537.short 4100 - http://www.ghspjournal.org/content/10/4/e2100537.full SO - GLOB HEALTH SCI PRACT2022 Aug 30; 10 AB - Key FindingsTraumaLink established a community-based emergency response model to address barriers in rapidly responding to road traffic accidents, accurately triaging patients, providing first aid, and transporting victims to hospitals in a timely manner to reduce crash-related deaths and disability.Communities showed a high level of acceptance and dedication to the program, evidenced by high volunteer recruitment and retention rates, and a 100% incident response rate.The program has expanded from a 14-km section of 1 highway to 135 km on 3 national highways.Key ImplicationsPolicy makers and stakeholders in Bangladesh may consider expanding a volunteer-based, emergency response system on a larger scale and broadly integrating it with police and fire services to help manage traffic accidents.Other low- and middle-income countries could adapt this service model to help manage similar challenges with traffic injury victims.Introduction:Road traffic injuries are a rapidly growing epidemic in low- and middle-income countries (LMICs). However, many countries lack formal prehospital emergency medical services, often leaving victims without access to first aid when it can be most effective in preventing death or disability.Methods:To address the lack of a dedicated prehospital emergency medical system in Bangladesh, we developed TraumaLink, a community-based network of volunteer first responders for traffic injury victims. The service uses an emergency hotline number and 24-hour call center with local first responders who are trained in basic trauma first aid, given essential medical supplies, and dispatched to crash scenes through mobile phone text message notifications. We designed the training curriculum to teach simple lifesaving skills that people with any level of education and no prior medical background could learn and perform. We retrospectively analyzed data originally collected for quality monitoring and evaluation to provide a descriptive analysis of the program’s impact.Results:During the first 6 years, operations were expanded from a 14-km section of 1 highway to 135 km on 3 national highways, and free care was provided to 3,119 patients involved in 1,544 crashes. All calls to the service received a response, and in 88% of cases, first responders were at the scene in 5 minutes or less. Most patients were young adult men, and 76% of victims transported to the hospital arrived there within 30 minutes of the crash. Assessments of injury severity at the accident scene aligned closely with patient dispositions, reflecting the accuracy of these triage decisions.Conclusion:The strong community support and rapid, reliable volunteer responses suggest that this flexible and scalable model could be expanded throughout Bangladesh and adapted for other LMICs that face similar challenges with traffic injury victims.