How pre-clinical medical care following road accidents is experienced. First-aiders have hitherto had to rely solely on their intuitive psychological competence when dealing with accident victims. No well-founded, empirical findings were available on how pre-clinical psychological care was experienced. There were only a few indications for how to deal with accident victims at the scene of the accident; these had been compiled by a task force at the University of Dortmund. This work was based on information provided by professional helpers and retrospective data from accident victims. There was however no comprehensive survey in days immediately following the road accident. The aim of the present study was to analyse, using interviews with road accident victims, how both the accident and the subsequent rescue chain were experienced by the victims. Between February 1997 and July 1998, 91 adult road accident victims were questioned in the days immediately following the accident on how they experienced the medical care provided by the first-aiders and by the professional emergency medical service. Overall the patients stated that the pre-clinical medical care was of a very high standard. However, the psychological abilities of the helpers were rated significantly lower than their medical abilities. This implies that psychological topics should be more heavily emphasised in the professional and further training of the personnel in the emergency medical service. The evaluation of the comprehensive, structured interviews showed that the expectations which the patients had of a helpers varied according to whether it was a lay helper or a member of the emergency medical service. The patients expected to receive concrete offers of assistance from lay helpers (e.g. notification of the emergency medical service, the meeting of physical needs, notification of relatives and employer) and did not so much expect medical care. Conversation and physical contact were experienced as being very beneficial; the patients felt calmer and not left alone. Expectations of the staff in the emergency medical service were orientated more towards competent medical care. The decisive aspect for the psychological well-being of the patient was seen to be the fact that a helper was constantly nearby. Hectic behaviour and agitation at the scene of the accident were experienced as being very unpleasant. There were isolated cases of deficits in psychological care, mainly when several injured persons had to be cared for at the scene of an accident and where patients were then left alone after initial medical assistance. The patients were also questioned as to their first reactions while waiting for assistance. The main factor mentioned by the patients was fear, mainly of being seriously injured. Using the findings, indications for how first-aiders and the emergency medical service personnel should deal with adult road traffic victims were drawn up and suggestions given for improving helpers' professional and further training. (Author/publisher)
Samenvatting