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Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study

Background: Road traffic injuries are a significant and increasing public health burden in Nepal, but there is no national coverage of regulated and standardized emergency medical service systems. Therefore, this study was designed to develop a first responder trauma training program for the Nepal t...

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Autores principales: Smart, Gary, Banstola, Amrit, Raut, Raju, Ghimire, Krishna, Mytton, Julie, Joshi, Elisha, Joshi, Sunil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323792/
https://www.ncbi.nlm.nih.gov/pubmed/35886332
http://dx.doi.org/10.3390/ijerph19148481
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author Smart, Gary
Banstola, Amrit
Raut, Raju
Ghimire, Krishna
Mytton, Julie
Joshi, Elisha
Joshi, Sunil
author_facet Smart, Gary
Banstola, Amrit
Raut, Raju
Ghimire, Krishna
Mytton, Julie
Joshi, Elisha
Joshi, Sunil
author_sort Smart, Gary
collection PubMed
description Background: Road traffic injuries are a significant and increasing public health burden in Nepal, but there is no national coverage of regulated and standardized emergency medical service systems. Therefore, this study was designed to develop a first responder trauma training program for the Nepal traffic police and to evaluate the feasibility of its delivery and follow up. Methods: A training needs assessment with traffic-police officers in a single district of Nepal informed the development of a 3-day first-response course which was provided to officers in May 2019. Participants were supplied with a trauma-pack and asked to complete a report form when first-responder skills were used. Knowledge and confidence face-to-face surveys were used before and after training to assess learning, and were repeated at 6 months to assess retention of knowledge. The surveys at 6 months assessed the factors affecting application of first response skills. Results: Most (97%) participants believed giving first-aid was part of their responsibilities and 95% had experience of transporting road crash victims to hospital with a range of injuries. Low levels of first-aid training and variable course content were reported. Knowledge and confidence scores improved post-intervention but were reduced at 6-months. During attendance at 303 road crashes in the 6-months follow-up period, 44% of the participants self-reported using at least one skill from the course; applying them on 92 occasions. Incident report-forms were frequently not completed. Barriers to providing treatment included: the patient already en-route to hospital when police arrived at scene; resistance to providing care from relatives or bystanders; and competing police duties (e.g., traffic management). Conclusions: Delivering a first-response training program for traffic-police in Nepal is feasible. Knowledge was retained and used, and skills were in frequent demand. A study of effectiveness and cost-effectiveness appears warranted to determine if extending the training to other districts can improve outcomes in road traffic injury patients in the absence of formal emergency medical services.
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spelling pubmed-93237922022-07-27 Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study Smart, Gary Banstola, Amrit Raut, Raju Ghimire, Krishna Mytton, Julie Joshi, Elisha Joshi, Sunil Int J Environ Res Public Health Article Background: Road traffic injuries are a significant and increasing public health burden in Nepal, but there is no national coverage of regulated and standardized emergency medical service systems. Therefore, this study was designed to develop a first responder trauma training program for the Nepal traffic police and to evaluate the feasibility of its delivery and follow up. Methods: A training needs assessment with traffic-police officers in a single district of Nepal informed the development of a 3-day first-response course which was provided to officers in May 2019. Participants were supplied with a trauma-pack and asked to complete a report form when first-responder skills were used. Knowledge and confidence face-to-face surveys were used before and after training to assess learning, and were repeated at 6 months to assess retention of knowledge. The surveys at 6 months assessed the factors affecting application of first response skills. Results: Most (97%) participants believed giving first-aid was part of their responsibilities and 95% had experience of transporting road crash victims to hospital with a range of injuries. Low levels of first-aid training and variable course content were reported. Knowledge and confidence scores improved post-intervention but were reduced at 6-months. During attendance at 303 road crashes in the 6-months follow-up period, 44% of the participants self-reported using at least one skill from the course; applying them on 92 occasions. Incident report-forms were frequently not completed. Barriers to providing treatment included: the patient already en-route to hospital when police arrived at scene; resistance to providing care from relatives or bystanders; and competing police duties (e.g., traffic management). Conclusions: Delivering a first-response training program for traffic-police in Nepal is feasible. Knowledge was retained and used, and skills were in frequent demand. A study of effectiveness and cost-effectiveness appears warranted to determine if extending the training to other districts can improve outcomes in road traffic injury patients in the absence of formal emergency medical services. MDPI 2022-07-11 /pmc/articles/PMC9323792/ /pubmed/35886332 http://dx.doi.org/10.3390/ijerph19148481 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Smart, Gary
Banstola, Amrit
Raut, Raju
Ghimire, Krishna
Mytton, Julie
Joshi, Elisha
Joshi, Sunil
Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study
title Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study
title_full Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study
title_fullStr Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study
title_full_unstemmed Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study
title_short Post-Crash First Response by Traffic Police in Nepal: A Feasibility Study
title_sort post-crash first response by traffic police in nepal: a feasibility study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323792/
https://www.ncbi.nlm.nih.gov/pubmed/35886332
http://dx.doi.org/10.3390/ijerph19148481
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