ABSTRACT
Background: In Nigeria emergency care is not well developed. Apart from some governmental and non-governmental institutions, the emergency care is not well known by the community
Objective to assess the knowledge, attitude and practice of residents about emergency care In Lagos
Methodology: household based cross sectional study was conducted using multi stage random sampling technique from March to April, 2014. The data was collected through structured self- administered questionnaire and interviewing technique among 422 participants. Data was entered, analyzed, and interpreted by using SPSS Software version20.
Result: The findings of this study shows that majority of the respondents 364 (86.3%) knew the presence of emergency care, most respondents 405(96%) believed that emergency care is important and 160 (37.9%) individuals had encountered in different levels of emergency care provision. 411(97.4%) respondents believed that emergency care should be strengthened by increasing number of ambulances (23.7%), by training health professionals (18.7%), by teaching the community about emergency care (26.1%) and a combination of the above methods (31.5%). Regarding the assessment of their practice the common care givers during mass casualty were bystanders 102(24.2%) and the least care givers were paramedics being 18(4.2%).The common emergent problems that occurred in Lagos fall down accident 72(29.2%) and followed by road traffic accident 59(24.1%).
Conclusion: Knowledge, Attitude and Practice investigations provide helpful insight into the level of understanding and utilization of services within the community .The findings show that high proportions of respondents have good knowledge (76.5%) and, positive attitude (69.9%) of emergency care, however, less than half of them have practiced emergency care in mass casualty. Unfortunately 58.8% and 65.2% of the respondents did not know the phone number of Red Cross and fire & emergency dispatch center respectively.
Recommendation: The city administration should teach the community to improve awareness about the advantages of emergency care, ambulance transportation and early visit to a hospital so as to decrease morbidity and mortality of trauma patients. The Red Cross and fire and emergency dispatch center should advertise their phone number to the public and respond immediately to community call and formulate a decision with policy makers about safe and rapid transportation despite the barriers Concerned authorities should be concerned about increasing the number of paramedics and the available Paramedics should actively participate in mass casualty incidents. Based on this study no identified barriers about emergency care so that there should be another study by taking other variables.
CHAPTER ONE
INTRODUCTION
1.1 Background
In a medical emergency, split seconds can make the difference between life and death. Ambulance Service Community Responders are essential to making sure help gets there in time. (1).
„Pre-hospital‟ refers to all environments outside an emergency department resuscitation room or a place specifically designed for resuscitation and/or critical care in a healthcare setting. It usually relates to an incident scene but it includes the ambulance environment. Pre-hospital interventions therefore also range from simple first aid to advanced emergency care and pre- hospital emergency anesthesia (2).
Worldwide, Emergency medicine as field of specialization is a new discipline in general and pre- hospital care in particular. And it is possible to generalize that the development of the field is at its infancy level.
The current EMS system in the United States started with the 1966 National Highway Safety Act, which authorized the U.S. Department of Transportation (DOT) to fund ambulances, communications, and training programs for pre hospital medical services. Coincidentally, in 1967, J. F. Partridges began using a mobile coronary care unit in Belfast, Northern Ireland, to extend coronary care into the pre hospital setting (3).
A study in Australia showed that, considerable lack of knowledge about ambulance cover in a rural town and suggests that public education about ambulance coverage would be beneficial (4).
.In the USA, each state has EMS laws and regulations mainly defined levels of ambulance service capability, training requirements, equipment requirements, and requirements for physician leadership and accountability(5) .In Iraq, it was reported that they considered the best among the Middle East countries, but it had undergone significant deterioration over the last 20 years With a combination of international sanctions, conflicts, invasions, and until recently, minimal institutional support, development of a civilian emergency care system was lacking (6).
The International Red Cross and Red Crescent Movement since its foundation has been associated with the provision of health-care services. Training volunteers, communities and beneficiaries in matters related to health care and first aid is one of the primary activities undertaken by National Societies around the world .The ways in which ambulance and pre- hospital services are employed in risk situations vary with the security environment, the number and condition of the wounded, access to health-care infrastructure (7).
In the year 2000, a meeting of international experts was convened in Geneva, Switzerland, by WHO to discuss how to strengthen emergency care around the world, especially in low-income and middle-income countries. The group decided to write a document that could assist policy- makers in implementing highly economical but effective emergency care systems. Community members in Africa and South America have been successfully trained to provide effective emergency care using locally available resources (8).
. People in cardiac arrest must receive electrical shocks to restart their hearts within four or five minutes to survive. To reach patients in this critical period, a number of cities have trained police officers and firefighters as "first responders" who can initiate resuscitation. .In response to a 911 call, the E.M.S. dispatchers can send out a city ambulance, one from a nearby hospital or, at times of crisis like the World Trade Center bombing, one from one of the 30 volunteer companies that cooperate with the E.M.S (9).
In Nigeria, emergency care (EMS) is not widely developed as in other developed countries .But in Lagos, there are governmental institutions which incorporate by giving part of emergency care. These are national Red Cross and fire and emergency dispatch center which give additional ambulance services. In addition to governmental institution, there are also private institutions which give ambulance services. The fire and emergency dispatch center has 7 ambulance stations within 10 sub cities and it has 15 ambulances which are functional within 24 hours. Thus the study aims to assess KAP on emergency care among residents of Lagos.
1.2 Statement of the problem
Globally, most deaths are due to airway problem, respiratory failure or continuing hemorrhage which can be prevented to a great extent with appropriate pre-hospital emergency care. to Considering the urgency of immediate treatment the „golden hour‟ and „platinum minutes‟ concepts had been developed to minimize the gap between the time of injury and initial medical attention. .Statistics generated from sporting events have shown the incidence of medical problems ranging from 0.12 to 17 per 1000 spectators and cardiac arrests ranging from 0.3 to 4.0 per 1,000,000 spectators(10).
As has been observed in Nigeria, especially in Lagos, the main problem for poor emergency care, especially in trauma patient is when someone is injured on the street, the attendant picks the patient simply and transports him/her to hospital by taxi instead of reporting to call ambulances, without giving first aid and with poor positioning of the patient during transportation instead of reporting to call an ambulance. This increases the complications and mortality of the patient in hospital because of poor position that may affect the cervical-spine.
In Nigeria including Lagos, no previous research was conducted on KAP of emergency care. Hence assessing knowledge, attitude and practice of emergency care among the community has a paramount important to produce a base line data planning interventions as well as creating awareness about emergency care within the community.
1.3 Objectives of study
General Objective
The general objective of the study is to assess knowledge, attitude and practice of residents about emergency care in Lagos City
Specific objective
· Assess the knowledge status of the residents about emergency care,
· Examine the attitudes of residents towards emergency medical service,
· Assess the practice of the residents about patient care given before reaching at hospitals,.
· Assess barriers in emergency care utilization.
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===================================================================Item Type: Project Material | Size: 33 pages | Chapters: 1-5
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