Pre-hospital trauma training in rural Indiana: A needs assessment

Background The Indiana State Department of Health (ISDH) is developing a statewide trauma system dedicated to providing injured persons the full range of medical care. A needs assessment was conducted in counties 60 or more miles from a trauma center to identify what pre-hospital trauma training was required in these areas. The programs surveyed were Pre-hospital Trauma Life Support (PHTLS) and International Trauma Life Support (ITLS). Methods Agencies were contacted via telephone and given a brief survey regarding agency ownership, personnel numbers and status, and whether PHTLS or ITLS was required. Agencies not requiring PHTLS or ITLS were then asked three additional questions: willingness of personnel to train, ability to pay for training, and whether personnel would leave over additional training requirements. Results A total of 115 agencies were contacted. More than 50% of contacted agencies were volunteer fire departments. Twenty-one agencies required PHTLS and ITLS. Most agencies were willing to require training but expressed financial difficulties. Volunteer fire departments were the most likely to be both unwilling and unable to afford training. Conclusions The most accurate predictor of whether an agency was willing to require PHTLS or ITLS was whether personnel were paid. All paid departments were willing to require training. It may be possible to offer financial incentives or initiate a media campaign calling for volunteers trained in PHTLS or ITLS to volunteer, rather than conduct a statewide training initiative.