Are prehospital deaths from trauma and accidental injury preventable? A summary report 31 a range of reasons for action or inaction. Early be nearby immediately, so while it is still vitally research into this social phenomenon proposed important to ensure that the 25 per cent of people that a diffusion of responsibility was the key reason found injured and possibly alive are found by a why people do not act (Latane and Darley 1968a). person trained in first aid, a different additional However, our understanding has grown, and we strategy is also required to aid the remaining now understand action to be also affected by 75 per cent. There may well be opportunities the context in which the emergency takes place, to prevent falls or, when falls happen, a swifter including how our perception of how much alike way to raise the alarm to bring about a first aid we are to those injured (referred to as belonging to intervention at the earliest opportunity. the/our ‘in-group’) influences our decision to act (Levine et al. 2002 and 2005; Levine and Crowther Previous Red Cross research (White and 2008). While we cannot deduce the nature of McNulty 2011) has shown that first aid can make the relationship between bystanders and the communities more resilient; therefore, there may deceased in the studies reported herein, the fact well be value in exploring how best community that the bystander was on the scene immediately members can support each other – especially or within minutes suggests that there is a likelihood those who are living alone. that they may well have known the deceased. And yet these people still did not always provide basic Assistive technology has become increasingly first aid. popular to support people with health and care needs – including frailty – who live alone Looking specifically at the two main causes of (Department of Health 2013). A popular form is death – road deaths and falls – there are clearly ‘push button care’, where help can be called for missed opportunities to provide first aid. In their by pressing a button on a pendant or wrist strap. review of the available literature, Hall et al. (2013) The device is connected to a telephone landline found evidence to suggest that drivers are more and a power supply via a simple unit installed willing to stop at the scene of an accident if they in the home. Once activated, the unit dials an are trained in first aid. Furthermore, Arbon et operator who instantly responds and contacts a al. (2011) found that among 773 respondents, friend, family member or neighbour who holds a 11 per cent had provided first aid in a RTC and, key. If none of the named responders are available, of those, 75 per cent were travelling in the vehicle then the operator will dispatch a member of their involved. They also found that first aid training team. Immediate emergency assistance can also increased the likelihood of them owning a first aid be requested. kit or pocket mask. And while our own Everyday First Aid training methodology encourages learners Though this research has shown that the to make use of everyday items and, therefore, proportions of deaths from injury which might does not rely on ownership of a first aid kit, have been survivable have remained unchanged Arbon et al.’s findings point to a readiness and in the past 20 years or more, it is important to a motivation to act. This suggests that drivers, note that the studies do not report on the levels when trained, are well placed to respond to injuries of first aid training received by the bystander or which occur on the road. passer-by and their reasons for intervening or not. Furthermore, the studies do not examine The circumstances surrounding deaths from whether intervention would have been affected falls are different from those for road deaths. The by the mechanism of injury and the level of deceased were older, and nearly three-quarters the emergency – would instances of first aid were found dead. The findings fit with data intervention have been higher in those with which suggest a growth in the size of the elderly injuries that were not as traumatic? Despite these population and the number of people living alone limitations, however, it is important to address the (The King’s Fund 2012). Unlike road deaths, findings raised in these studies in future research a passer-by or bystander seems less likely to and make recommendations for the future.