Immobilization and evacuation of accident victims by first responders in Delhi, India: a survey

Authors

  • Teena Elsa Joseph Indian Spinal Injuries Centre, Sec-C, Vasant Kunj, New Delhi, India
  • Rajesh Sharawat Indian Spinal Injuries Centre, Sec-C, Vasant Kunj, New Delhi, India
  • Vandana Phadke Indian Spinal Injuries Centre, Sec-C, Vasant Kunj, New Delhi, India
  • Smita Chakraboraty Acharya Indian Spinal Injuries Centre, Sec-C, Vasant Kunj, New Delhi, India
  • Gaurav Sachdev Indian Spinal Injuries Centre, Sec-C, Vasant Kunj, New Delhi, India
  • Harvinder Singh Chhabra Indian Spinal Injuries Centre, Sec-C, Vasant Kunj, New Delhi, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20211988

Keywords:

Emergency medical services, Bystander, Ambulance, Road traffic crashes, Pre-hospital care, First-aid, Injury

Abstract

Background: Despite many improvements, pre-hospital care is known to be inconsistent and inefficient across India. This contributes to high mortality and morbidity of accident and medical emergency victims. Pre-hospital care may be provided by bystanders, but they are known to hesitate due to multiple reasons. The first aiders (ambulance staff or police personnel) who are responsible for providing appropriate initial care are not adequately trained to manage all aspects of emergency situations including extrication, cardiopulmonary resuscitation, management of bleeding, and protection of the spine evacuation and transfer. The current study was conducted to gauge the knowledge of first aid among bystanders and first aiders in Delhi national capital region.

Methods: Two separate surveys with closed-ended questions were formulated for the bystanders and first aiders in english and hindi.  A sample of 511 bystanders and 309 first aiders (108 ambulance and 201 police personnel) completed the survey between February 2019 and April 2019. Data was analysed descriptively. Comparison were made across demographic variables for the bystanders. For first aiders, comparisons were made between ambulance staff and police personnel, and between emergency medical technicians and drivers.

Results: The average total scores for the bystanders were 38.5±14.2%. Slight differences across age and educational qualifications were found. The average total score for the first aiders was 34.3±12.3%. Ambulance personnel scored significantly better than police personnel in evacuation (70.3±26.6% versus 42.6±26.5%) and CPR subdomains (37.6±19.4% versus 21.9±14.7%). The emergency medical technicians scored better than the driver in their total and first aid subdomain scores.

Conclusions: The knowledge amongst first responders including bystanders and first aiders was low and efforts to educate and train them would improve the much-needed quality of pre-hospital care.

References

WHO. Prehospital trauma care systems. Geneva: WHO; 2005.

Wikipedia. Emergency medical services, 2021. Available at: https://en.wikipedia.org/wiki/Emergency_medical_services. Accessed on 01 March 2021.

Solanki HK, Ahamed F, Gupta SK, Nongkynrih B. Road Transport in Urban India: Its Implications on Health. Indian J Community Med. 2016;41(1):16-22.

Joshipura MK, Shah HS, Patel PR, Divatia PA, Desai PM. Trauma care systems in India. Injury. 2003;34(9):686-92.

Gururaj G. Road traffic deaths, injuries and disabilities in India: current scenario. Natl Med J India. 2008;21(1):14-20.

Government of India. Highways mort &, wing tr. Road accidents in India, 2016. Available at: www.morthnic.in. Accessed on 01 March 2021.

Government of India. Road Accidents in India, 2018. Available at: www.morthnic.in. Accessed on 01 March 2021.

Oestern HJ, Garg B, Kotwal P. Trauma care in india and germany. Clin Orthop Relat Res 2013;471:2869-77.

Chhabra HS, Arora M. Demographic profile of traumatic spinal cord injuries admitted at Indian Spinal Injuries Centre with special emphasis on mode of injury: a retrospective study. Spinal Cord. 2012;50(10):745-54.

Abraham S, Krishnan SV, Thaha F, Balakrishnan J, Thomas T, Palatty B. Factors delaying management of acute stroke: An Indian scenario. Int J Crit Illn Inj Sci. 2017;7:224.

Krishna CK. Out of hospital cardiac arrest resuscitation outcome in North India: CARO study. World J Emerg Med. 2017;8:200.

Joshipura MK. Trauma care in India: Current scenario. World J Surg. 2008;32:1613-7.

Rogers FB, Rittenhouse KJ, Gross BW. The golden hour in trauma: dogma or medical folklore?. Injury. 2015;46:525-7.

Chandrasekharan A, Nanavati AJ, Prabhakar S, Prabhakar S. Factors Impacting Mortality in the Pre-Hospital Period After Road Traffic Accidents in Urban India. Trauma Mon. 2016;21(3):22456.

Mehmood A, Rowther AA, Kobusingye O, Hyder AA. Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach. Int J Emerg Med. 2018;11:53.

National Institute of Mental Health and Neuro Sciences. Study on Impediments to bystander care in India, 2013. Available at: http://savelifefoundation.org/wpcontent/uploadsNational-Study-on-Impediments-to-Bystander-Care-in-India.pdf. Accessed on 01 March 2021.

Bhalla K, Sriram V, Arora R, Ahuja R, Varghese M, Agrawal G, et al. The care and transport of trauma victims by layperson emergency medical systems: a qualitative study in Delhi, India. BMJ Glob Health. 2019;4:001963.

Larsson EM, Martensson NL, Alexanderson KA. First-aid training and bystander actions at traffic crashes-a population study. Prehosp Disaster Med. 2002;17(3):134-41.

Garg R. Who killed Rambhor?: The state of emergency medical services in India. J Emerg Trauma Shock. 2012;5:49.

Nielsen K, Mock C, Joshipura M, Rubiano AM, Zakariah A, Rivara F. Assessment of the Status of Prehospital Care in 13 Low- and Middle-Income Countries. Prehospital Emerg Care. 2012;16:381-9.

Sriram V, Gururaj G, Razzak JA, Naseer R, Hyder AA. Comparative analysis of three prehospital emergency medical services organizations in India and Pakistan. Public Health. 2016;137:169-75.

Department of Social Welfare. About Centralised Accident & Trauma, 2020. Available at: http://www.socialwelfare.delhigovt.nic.in/content/about-centralised-accident-trauma-services. Accessed on 01 March 2021.

Sahdev P, Lacqua MJ, Singh B, Dogra TD. Road traffic fatalities in Delhi: Causes, injury patterns, and incidence of preventable deaths. Accid Anal Prev. 1994;26:377-84.

Vasudevan V, Singh P, Basu S. Importance of awareness in improving performance of emergency medical services (EMS) systems in enhancing traffic safety: A lesson from India. Traffic Inj Prev. 2016;17:699-704.

Pallavisarji U, Gururaj G, Nagaraja GR. Practice and Perception of First Aid Among Lay First Responders in a Southern District of India. Arch Trauma Res. 2013;1:155-60.

Tannvik TD, Bakke HK, Wisborg T. A systematic literature review on first aid provided by laypeople to trauma victims. Acta Anaesthesiol Scand. 2012;56:1222-7.

Vyas D, Hollis M, Abraham R, Rustagi N, Chandra S, Malhotra A, et al. Prehospital care training in a rapidly developing economy: A multi-institutional study. J Surg Res. 2016;203:22-7.

Chandrachood MV, Acharya S. A study to assess the effectiveness of training on first aid among students of industrial training institute in tribal area of Thane district, Maharashtra. Int J Community Med Public Health. 2019;6:1573.

Joseph N, Kumar G, Babu Y, Nelliyanil M, Bhaskaran U. Knowledge of first aid skills among students of a medical college in Mangalore city of South India. Ann Med Health Sci Res. 2014;4(2):162-6.

Sonavane RS, Kasturi A, Kiran A, Chikkaraju, Kumari R. Knowledge and assessed practice regarding first aid among mothers of under 15 years children-a community based study in a rural area of south India. Al Ameen J Med Sci. 2014;7(4):284-90.

Government of NCT of Delhi. CATS Training, 2016. Available at: http://web.delhi.gov.in/wps/wcm/connect/doit_cats/CATS/Home/Training. Accessed on 01 March 2021.

Nigam V, Goyal T, Chhabra H, Pandey V. Care of post-traumatic spinal cord injury patients in India: An analysis. Indian J Orthop. 2007;41:295.

Singh PK, Shrivastva S, Dulani R. Pre-hospital care of spinal cord injury in a rural Indian setting. Rural Remote Health. 2011;11:1760.

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Published

2021-05-25

How to Cite

Joseph, T. E., Sharawat, R., Phadke, V., Acharya, S. C., Sachdev, G., & Chhabra, H. S. (2021). Immobilization and evacuation of accident victims by first responders in Delhi, India: a survey. International Journal Of Community Medicine And Public Health, 8(6), 2874–2880. https://doi.org/10.18203/2394-6040.ijcmph20211988

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Original Research Articles