Assessment of traffic police's knowledge and skills of trauma care rendered to injured car accident victims in Dar es salaam, Tanzania

Abstract

Background: Injury is one of the leading causes of mortality and morbidity leading to premature death and disability worldwide. In Sub-Saharan African countries, the estimates for road traffic deaths for the year 2000 ranged between 68,500 and 82,200, whereby Tanzania was one of the countries mentioned to have experienced high numbers of road deaths. Pre- hospital emergency care is the initial corner stone in the management of the victims of road accidents because assessment and management commence at the scene of injury before being transported to the facility; and good communication with the receiving hospital has shown improvement in the survival of trauma victims. In Tanzania most of the trauma victims of motor traffic accident are being handled by Traffic Police, however, very little is known about the competencies of traffic police on pre-hospi tal trauma care as first responders. Objective: The study was guided by three objectives, 1.To determine the knowledge of traffic police on pre-hospital trauma care in Dar es Salaam region; 2. To describe the skills of traffic police on pre-hospital trauma care in Dar es Salaam region; 3.To explore participants opinion on what could improve their skills on pre-hospital trauma care to injured victims in relation to our setting (Tanzania). Methodology: A cross-sectional study design was used to assess traffic police knowledge and skill on pre-hospital trauma care to injured patients before transporting them to the health facilities for further management. Knowledge was assessed using open and closed ended questionnaire while practice was assessed using simulation scenarios with guide questions adopted from a study done by Morgan and colleagues in 2004. A descriptive statistical data analysis such as percentage and frequency were used for easy interpretation of findings which were analyzed using window SPSS version 13.0. Results: The mean score knowledge of the study participants on the indicative signs of trauma victims care (Airway, Breathing, blood Circulation) was 1.59. Eighty participants (41 (Yo) had good knowledge while 116 (59%) had fair knowledge on identification of severely injured patient. Sixty nine percent (=136) of the participants had good knowledge on quick and immediate assessment of injured victims. Seventy three percent (=143) of the participants

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could not identify shocked victims. Only 47(Yt) 0 I' the participants mentioned safety of the scene as a first step in case of accident. Seventy two percent (=142) of the participants wen; able to identify care of airway as a first intervention in care of unconscious patient. Sixty percent (=110) of the participants were not able to identify victim with cardiac arrest. Thirty nine percent (=76) of the participants were not able to care for victims with neck and back injuries. Forty seven percent (=88) of the participants reported to use unequipped police patrol car as means of transporting the victims to health facilities while 55% reported to use any available public transport. Only 39% (=76) of the participants reported to have working tools for assisting in caring of trauma victims. Conclusion and Recommendation: Traffic police who participated in this study demonstrated considerable knowledge and skill gaps on assessment and care of trauma victims during pre-hospital care, especially on identification and care of shocked victims, severe bleeding and victims with neck and/or back injuries. This has serious implication in increasing preventable mortalities and disabilities caused by accidents and trauma. This study argued that, the condition under which traffic police are expected to save lives of injured victims needs careful consideration, and suggested an urgent need for pre- and in-service training and support structure necessary to promote required knowledge and skills of traffic police. However, this should go hand in hand with provision of working tools for assessment and care of trauma victims at the scene, including easy to read/follow guidelines that will assist the traffic police to perform his/her immediate life saving activities thoroughly and effectively.