INTRODUCTION:

World Health Organization (WHO) defines, RTA as it is an accident which happened on a way or street open to public traffic; resulted in one or more persons being killed or injured [1]. One of the most important roles of pre-hospital services is life support and prevention of future disabilities in the post-crash phase a comprehensive emergency medical system.

Road traffic accidents (RTA) are a major public health problem worldwide, accounting for almost 1.24 million deaths per year and it is number one cause for the death among those aged 15-29 years [2,3,4].

Road traffic injury (RTI) is estimated to be the fifth largest killer worldwide by 2030. Most of those deaths are from low- and middle-income countries (LMIC). Studies found that increasing the number of emergency dispatch units and pre-hospital personnel training, increased the use of emergency medical devices anddecreased the percentage of patients who die on the way to the hospital. In Ethiopia, fromthe emergency medical services, pre-hospital care is not widely developed [5,7].

OBJECTIVES:

· To determine the pre hospital care of road traffic accident inDessie referral hospital at Dessie town, south wollozone, Amhararegion, Northeast Ethiopia 2019.

· To identify the injury characteristics of road traffic accidents among injured patients in Dessie referral hospital.

METHODS:

Research Approach:

Qualitative research approach was used for the present study

Research Design:

An Institution based cross-sectional study was conducted.

Setting:

The study was done from government referral hospital as setting.

Population:

All road traffic accident patients admitted in surgical, Intensive Care Unit (ICU) and orthopedics ward were considered as study population.

Sample:

All patients and attendants found in surgical, ICU and orthopedics ward were included and critically ill and unconscious patients as well children’s less than 12 years old and the patient those immediately referred were excluded from the study.

Sample Size:

Sample size was determined by using a single population proportion formula with sample size of 270.Sampled patients were selected by probability simple random sampling technique.

Sampling Technique:

Systematic random sampling was used

Data Collection Tool:

Data was collected by face to face interview and a well-structured questioner using registration case sheets.

Quality Assurance:

To keep quality of data, pretest was done onBoru media hospital the 5% of patients. Also training for data collectors how & where to collect data. Principle investigators were checked the collected data for consistence, completeness & editing.

Data Analysis:

The collected data was entered, edited, cleaned and analyzed by SPSS version 20. The outcome was presented by using tables, graphs and figure.

RESULTS:

The total number of respondents who were included in the study was 270, with a response rate of 100%. The participants who did not have any prehospital care account 232(85.9%).The rest respondent’s 38(14.1%)out of this 34.21% bystander,21% ambulance personal got pre hospital care before reaching to the health facility.

The highest number 177 (66%) of victims who came to facilities were between 25-40 years of age. About 49 (18%) of the victims were between 15-24 years age group, and almost all the rest participants were above the age of 40.

More than half of the participants 194(71.85 %) have been found to be male and 76(28.15%) were female participants, giving a ratio of 2:1. Respondents who had no formal education were 49(18.15%), whereas, 112 (41.48%) were had engaged university or college education [Table 1].

Fig 1. Educational status of respondents

Table 1: Description of socio-demographic characteristics.

Age	Frequency	Percent
<15	2	1
15-24	49	18
25-40	177	66
40	42	15
Total	270	100
Sex
Male	194	71.85
Female	76	28.15
Total	270	100

Description of injury characteristics:

Major accidents 258(95.6%) were occurred on the streets and 5(1.9%) were commercial area. 204(75%) were injured during traveling from place to place and also 29(10%) travel to and from unpaid works. Broken bone was abundant type ofinjury accounts 112(41.5%). Contusion orbrain injury was the 2^ndmost mentioned injury 47(17.4%). Cut or other open wound injuries being the third which account of 33(12.2%).

Table 2 description of injury characteristics at Dessie Referral Hospital 2019

Description of injury characteristics	Frequency	Percent
Fracture/broken bone	112	41.5
Sprain/strain	12	4.4
Dislocation	19	7
cut or open wound	33	12.2
Bruise or superficial injury	20	7.4
Contusion/head injury	47	17.4
Internal organ injury	27	10
Total	270	100
Where were you when the accident happened
Street/highway	258	95.6
Sports and athletics area	2	0.7
Commercial area	5	1.9
Other	5	1.9
Total	270	100
Activity doing when the accident happened
Paid work/travel to and from work	19	7
Unpaid work/travel to and from work	29	10.7
Sport	1	0.4
Travelling	204	75.6
Unspecified	14	5.2
Others	3	1.1
Total	270	100

Traffic related findings:

People who were vehicles with less than 10 seats accounted higher percentage 107 (39.6%), also people who used bus accounted for a number of 88 (32.6%). Bajaj being the 3^rd in the category accounts for 27 (10%) of the transportation methods.

Most injured were passengers 190 (70.4%). The pedestrians were the 2^nd most seen people to come across the road traffic injury 46(17%). Drivers also accounted for 34 numbers from the participants with having proportion of (12.4%). Higher number of injury was seen with the day light environment accounted 238(88.1). 102 (37.8%) participants, collision was with a motorized vehicle. Others were collided with fixed objects 71 (26.3%), bicycle or motorcycle was also the counterpart in 62 (22.9%) of the participants.

Table 3: Description of Traffic related factors of road traffic injury respondents in Dessie referral hospital

Mode of transport	Frequency	Percent
Walking	15	0.6
Bicycle	2	0.7
Motor cycle	8	3
Personal car	5	1.9
Vehicles with less than 10 seats	107	39.6
Truck/Lorry	18	6.7
Bus	88	32.6
Bajaj	27	10
Total	270	100
Role of the victim
Pedestrian	46	17
Driver	34	12.6
Passenger	190	70.4
Total	270	100
Counterpart What did you (or your vehicle) collide with
Pedestrian	34	12.6
Bicycle	1	0.4
Motorcycle	6	2.2
Motorized vehicle	56	20.7
Fixed object	102	37.8
Other	71	26.3
Total	270	100
lighting condition
Day light	238	88.1
Dark	16	5.9
Dust/Down	16	5.9
Total	270	100

Pre-hospital care related findings:

232 (85.9%) participants do not receive prehospital care. 38 (14.1%) out of this 34.21% bystander, 21% ambulance personal got pre hospital care before reaching to the health facility.

The reasons for not getting prehospitalcare werepoor knowledge or fear of procedure 150 (55.5%), 85 (31.5%) respond as due to lack of equipment. Other reasons mentioned were fear of medico legal issues and unavailability of personnel.

Bystander, friend or families were the most mentioned people to help the victim from scene accounting for 249(92.1%). The 2^ndmentioned people to have helped the victim having a number of 13(4.8%) ambulance personnel accounted for 8(3.1%).

Mostly mentioned care given was removed from wreck (85.9%), then the next abundant care was immobilized the fracture ofthe victim (5.2%). Resuscitation was also mentioned in (4.4%) of the cases. More than half 138 (51.1%) of respondents reached the first health facility less than one hour after injury and 43 (15.9%) between 1 to 2 hours, the rest of the participants came late after two hours and not known exact time.

233(86.2) were transported to the health facility by motorized vehicles like private cars, taxi, ambulance and bus. Only 37(13.8%) don’t know transport methods.

Hospital has played a major role bygiving prehospital care for more than half of the participant 177(65.6).

RECOMMENDATIONS:

This study has shown most of the victims were young and in the productive age, therefore
engaging teaching traffic rules through Universities and Colleges at young ages might be beneficial. Being a passenger has been seen to increase the chance of being injured, it would be advantageous if passengers were advocated to be careful and choose appropriate vehicles and obey to rules and regulations like proper belt use. We recommend that health institutions should give pre hospital care and first aid service trainings for drivers and transport workers with in collaboration with concerned bodies (universities, red cross, colleges non-governmental organization, hospital and health center.

CONCLUSIONS:

According to this study almost all road traffic accident victims were not gate pre hospital care before reaching the hospital and male respondents aged 25-40 and passengers have been found to beabundant; and were the most vulnerable groups.

Almost half of the victims were passengers whereas, more than half of the accidents happened in major streets and day time. Bystanders were among the people who mostly gave pre hospital care for injured patient from the scene indicating for the fact that to integrate and organize pre-hospital care is beneficial. Very few percentage of victims receive treatment at the crash scene and even fewer receive safe transport to the hospital by an ambulance.

ACKNOWLEDGEMENT:

We want to say thanks to Wollo University finance office for their provision of budget to run this research paper.

REFERENCES:

1. Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, et al. World report on road traffic injury prevention. World Health Organization Geneva; 2004.

2. Alinia S, Khankeh H, Maddah SSB, Negarandeh R. Barriers of pre-hospital services in road traffic injuries in Tehran: the viewpoint of service providers. International journal of community based nursing and midwifery. 2015; 3(4):272.

3. Sebsbie AK. Road Traffic Accident related Fatalities in Addis Ababa City, Ethiopia: An Analysis of Police Report 2013/14. 2015.

4. Organization WH. Global status report on road safety 2015: World Health Organization; 2015.

5. Mannering FL, Bhat CR. Analytic methods in accident research: Methodological frontier and future directions. Analytic methods in accident research. 2014; 1:1-22.

6. Varghese M, Sasser S, Kellermann A, Lormand J-D, Organization WH. Prehospital trauma care systems: Geneva: World Health Organization; 2005.

7. ABEBE A. Assessment of Knowledge Attitude and Practice of Residents about pre hospital care in Addis Ababa ADDIS Ababa University; 2014.

Received on 13.08.2019 Modified on 01.09.2019

Int. J. Nur. Edu. and Research. 2019; 7(4):547-550.

DOI: 10.5958/2454-2660.2019.00121.2