First Responders and Prehospital Care for Road Traffic Injuries in Malawi

Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Maliwichi, Limbika; Jacobsen, Kathryn H.

doi:10.1017/s1049023x16001175

Cited by 49 publications

(41 citation statements)

References 22 publications

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“…Poor knowledge and skills in regard to the provision of care to RTI victims by first responders has been demonstrated in other studies to be the main reason for inappropriate intervention during care provision (22,33). This situation calls for immediate remedies; otherwise, the police officers who are first at the scene will continue to be of no help to victims, except to rush them to the hospital with poor outcomes afterward (34).…”

Section: Discussionmentioning

confidence: 99%

“…The situation of not having ambulances for victim evacuation was also found in many other African countries (27). Those people who are forced to convey victims to the hospital in their private cars do not have knowledge about transporting and caring for injury victims; furthermore, their cars are not designed to carry these victims (17,34). When inappropriate vehicles driven by unauthorized and/or ill-qualified persons are used to transport victims to the hospital, the probability of getting there safely is low (21).…”

Section: Assurance Of Availability Of Resources and Support For Optimmentioning

confidence: 99%

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Traffic Police Officers’ Experience of Post-crash Care to Road Traffic Injury Victims: A Qualitative Study in Dar es Salaam, Tanzania

Gg¹,

Da²,

Ah³

et al. 2019

Preprint

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Background Recently, road traffic injuries (RTIs) have become a major health problem affecting health systems in many low- and middle-income countries. Regardless of whether an ambulance is available for evacuation, police officers have been shown to arrive at the crash scene first, becoming, in effect, the first responders to RTI victims. The experiences of traffic police officers who have provided care to RTI victims in the prehospital environment was therefore the focus of the present study. Method The study used a qualitative approach in which data were obtained from 10 in-depth interviews and three focus group discussions. Data were collected in Dar es Salaam Region, Tanzania, in three phases from December 2017 to June 2018 by means of an interview guide designed by the researchers. Qualitative content analysis was used to analyse all the materials. Results Three themes emerged from the analysis. The theme “Maintain safety while saving injured victims’ lives and facilitating access to a health facility” was comprised of safety, sorting, initial help, and assisting access to hospital care. “Overwhelmed working with limited resources and support” included limited care and transport resources, police fatigue, and little or no support. “Improving supportive system and empowering frontline personnel” included the need for an emergency care system, availability of resources and an emergency medical support system, and training for police and drivers regarding victims’ first-aid care, and road safety. Conclusion The study findings characterize an environment in which the police first responders have no knowledge or skills and no equipment and supplies to provide care to RTI victims at the scene before rushing them to definitive care. The results suggest a favorable climate for training and equipping police officers so that they can deliver competent postcrash care at the scene while emergency medical services are yet to be established. However, more research will be needed to determine the efficacy of such training and its acceptability in the Tanzanian context.

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Section: Discussionmentioning

confidence: 99%

Section: Assurance Of Availability Of Resources and Support For Optimmentioning

confidence: 99%

Traffic Police Officers’ Experience of Post-crash Care to Road Traffic Injury Victims: A Qualitative Study in Dar es Salaam, Tanzania

Gg¹,

Da²,

Ah³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…furthermore, their cars are not designed to carry these victims (17,34). When inappropriate vehicles driven by unauthorized and/or ill-qualified persons are used to transport victims to the hospital, the probability of getting there safely is low (21).…”

Section: Assurance Of Availability Of Resources and Support For Optimmentioning

confidence: 99%

Traffic Police Officers’ Experience of Post-crash Care to Road Traffic Injury Victims: A Qualitative Study in Tanzania

Lukumay

Mkoka

Outwater

et al. 2019

Preprint

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Background Recently, road traffic injuries (RTIs) have become a major health problem affecting health systems in many low- and middle-income countries. Regardless of whether an ambulance is available for evacuation, police officers have been shown to arrive at the crash scene first, becoming, in effect, the first responders to RTI victims. Therefore, the study aimed to explore the experiences of traffic police officers in regard to the provision of care to RTI victims in the prehospital environment, including the role of traffic police upon arriving at the crash scene, the challenges they face, and their opinions about how to improve care to RTI victims.Method The study used a qualitative approach in which data were obtained from 10 individual interviews and three focus group discussions. There were 41 participants, 27 of them were male and 14 were female. About half (48.7%) of the study participants were aged between 30 to 39 years. Qualitative content analysis was used to analyse all the materials.Results Three themes emerged from the analysis. The theme “Maintain safety while saving injured victims’ lives and facilitating access to a health facility” was comprised of safety, sorting, initial help, and assisting access to hospital care. “Overwhelmed working with limited resources and support” included limited care and transport resources, police fatigue, and little or no support. “Improving supportive system and empowering frontline personnel” included the need for an emergency care system, availability of resources and an emergency medical support system, and training for police and drivers regarding victims’ first-aid care, and road safety.Conclusion The study findings characterize an environment in which the police first responders have no knowledge or skills and no equipment and supplies to provide care to RTI victims at the scene before rushing them to definitive care. The results suggest a favorable climate for training and equipping officers so that they can deliver competent postcrash care at the scene while emergency medical services are yet to be established. However, more research will be needed to determine the efficacy of such training and its acceptability in the Tanzanian context.

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“…Prehospital trauma care on the scene of an accident—whether that is roadside care after a traffic collision, initial at-the-worksite care for serious traumas sustained at industrial workplaces, or first aid provided at other places where people have sustained traumatic injuries prior to transporting the victims to a healthcare facility—is typically offered by first responders who have no training and therefore lack the knowledge and skills to appropriately provide first aid to moderately or severely wounded people. 9 The lack of trained emergency medical technicians, ambulances, and other tools for providing skilled prehospital care means that some injured people who could have survived instead end up dying at the site where their injury occurred. Others end up with lengthy hospital stays and severe disabilities that could have been shorter and milder if they had received better first aid at the site of a trauma, such as having steps taken to support breathing, stop bleeding, and safely extricate people from damaged vehicles without causing greater physical damage.…”

Section: Injuries and Trauma Care In Malawimentioning

confidence: 99%

“…27 , 28 At present, none of these structures for prehospital care—first aid training, a national hotline for calling for help, ambulances, and paramedics—is available in Malawi. 9 This lack of prehospital care is causing many unnecessary deaths each year. Deaths from preventable causes at any age are a tragedy, and there is an especially high societal cost from injuries because the majority of injury deaths occur among young people who would otherwise have expected to live for several more decades while contributing to economic productivity through work and as caregivers for young children and older adults.…”

Section: Prehospital Carementioning

confidence: 99%

Trauma care in Malawi: A call to action

Mulwafu¹,

Chokotho²,

Mkandawire³

et al. 2017

Mal. Med. J

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Injuries are a global public health concern because most are preventable yet they continue to be a major cause of death and disability, especially among children, adolescents, and young adults. This enormous loss of human potential has numerous negative social and economic consequences. Malawi has no formal system of prehospital trauma care, and there is limited access to hospital-based trauma care, orthopaedic surgery, and rehabilitation. While some hospitals and research teams have established local trauma registries and quantified the burden of injuries in parts of Malawi, there is no national injury surveillance database compiling the data needed in order to develop and implement evidence-based prevention initiatives and guidelines to improve the quality of clinical care. Studies in other low- and middle-income countries (LMICs) have demonstrated cost-effective methods for enhancing prehospital, in-hospital, and post-discharge care of trauma patients. We encourage health sectors leaders from across Malawi to take action to improve trauma care and reduce the burden from injury in this country.

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First Responders and Prehospital Care for Road Traffic Injuries in Malawi

Cited by 49 publications

References 22 publications

Traffic Police Officers’ Experience of Post-crash Care to Road Traffic Injury Victims: A Qualitative Study in Dar es Salaam, Tanzania

Traffic Police Officers’ Experience of Post-crash Care to Road Traffic Injury Victims: A Qualitative Study in Dar es Salaam, Tanzania

Traffic Police Officers’ Experience of Post-crash Care to Road Traffic Injury Victims: A Qualitative Study in Tanzania

Trauma care in Malawi: A call to action

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