Background Much of the world does not have access to emergency Axim - PDF document

Background ❖ Much of the world does not have access to emergency Axim Government Hospital medical services Axim, Ghana Commercial Vehicle ❖ In Axim, most patients needing transport to a hospital are taken by commercial vehicle drivers Drivers as First Owen Pyke Jr. MPH Responders ❖ In a review of 2,070 trauma patients admitted to an urban hospital in Ghana, Forjuoh et al. found that 71% of admitted trauma patients were transported to the hospital by a commercial vehicle, including taxis (54%), buses (14%), and trucks (3%) Pre-intervention Interview Existing Problems ❖ Communication between commercial vehicle drivers and ❖ Qualitative interviews with 24 commercial vehicle drivers hospital staff ❖ Years of experience ranged from 1 to 35 years ❖ Baseline medical knowledge of commercial vehicle ❖ Number of patients picked up ranged from 0 to >50 drivers

Intervention Planning ❖ Increase hospital preparedness for incoming patients by proving phone numbers and encouraging commercial vehicle drivers to call ahead ❖ First aid training session with commercial vehicle drivers to increase baseline medical knowledge, with a focus on choking, bleeding wounds, shock, burns and scalds, head, neck and back injuries, injuries to bones, muscles and joints, convulsions, and appropriate contents in a first aid kit First Aid Training Survey Instrument ❖ Consisted of 5 questions: ❖ In an unconscious patient which of the following should you do first, gently shake the patient and check for a response or try to give them water to drink? ❖ True of false, in a patient who is bleeding, stopping the bleeding by holding pressure is the right thing to do? ❖ True of false, large burns can cause dehydration? ❖ True of false, you should give a choking person something to drink to help clear the obstruction? ❖ True or false, in a patient who is having convulsions you should place a small stick between their teeth so they don't bite their tongue? Pre-intervention Survey Post-intervention Survey Results Results ❖ In an unconscious patient which of the following should you do first, gently shake the patient and check for a ❖ In an unconscious patient which of the following should you do first, gently shake the patient and check for a response or try to give them water to drink? response or try to give them water to drink? ❖ 7 correct, 14 incorrect (33.3%) ❖ 18 correct, 0 incorrect (100%) ❖ True of false, in a patient who is bleeding, stopping the bleeding by holding pressure is the right thing to do? ❖ True of false, in a patient who is bleeding, stopping the bleeding by holding pressure is the right thing to do? ❖ 25 correct, 0 incorrect (100%) ❖ 18 correct, 0 incorrect (100%) ❖ True of false, large burns can cause dehydration? ❖ True of false, large burns can cause dehydration? ❖ 21 correct, 1 incorrect (95.5%) ❖ 18 correct, 0 incorrect (100%) ❖ True of false, you should give a choking person something to drink to help clear the obstruction? ❖ True of false, you should give a choking person something to drink to help clear the obstruction? ❖ 0 correct, 26 incorrect (0%) ❖ 18 correct, 0 incorrect (100%) ❖ True or false, in a patient who is having convulsions you should place a small stick between their teeth so ❖ True or false, in a patient who is having convulsions you should place a small stick between their teeth so they don't bite their tongue? they don't bite their tongue? ❖ 2 correct, 23 incorrect (8%) ❖ 18 correct, 0 incorrect (100%)

Comparison Incentivizing Taxi Drivers ❖ Log book ❖ FM radio announcements of exemplary performers ❖ End of year gifts P< P< P< .0001 .0001 .0001 Future Recommendations Special Thanks ❖ Dr Hagan ❖ Dr Lawson ❖ Additional first aid training sessions for commercial vehicle drivers in Axim by hospital staff ❖ Nurse Issa ❖ Driver safety educational session ❖ Esther Ampomah ❖ Auntie Vick