INTRODUCTION.
In Tanzania road traffic injuries causes almost 42% of all death due road traft accident ( TPF, 2016). Apart from deaths also leads to high burden of disability adjusted life years. Many of injuries and deaths are preventable. Many road traffic death occurs in pre hospital setting. It happens only because we lack some medical emergency systems which I will elaborate later.
Deaths due road traffic accident occurs in different categories as follows;
1. Occurs immediately/quickly as results of overwhelming injury.
2. Intermediate or sub acute phase. Occurs within several hours of the events and are frequently the result of treatable conditions.
3. Are delayed. Occurs after days or weeks after the initial injury as a result of late complications.
SUGGESTED SOLUTION:
DEVELOPMENT OF EFFECTIVE AND FUNCTIONAL PRE HOSPITAL CARE SYSTEM IN TANZANIA.
Evidence based science says that there is a most valuable time interval between accident occuring time and initiation of care. That is known as GOLDEN HOUR. It is the initial time from within which an injured person if not saved within it the chances of survival become low. It is about initial 60 minutes.
In Tanzania many deaths occurs because, injured people receives medical care at hospital (out golden hour) which leads to many preventable deaths at accident scene. Many of them could be prevented by promptly providing effective pre hospital care. The best pre hospital care in Tanzania should comprises of the following categories:
A. Establishment and training of layperson first responders.
Currently you may evidence huge crowd of people at accident scene they are only looking injured people or sometime giving unappropriate aid. In this category we should include and train the most available people who are usually available at risk areas. This group in our setting will include group of motorcycle drivers( bodaboda), taxi drivers, community leaders, public servant and volunteers.
Currently bystander includes relatives, untrained bystanders, police officers and bodaboda (motorcycle drivers). Due to lack of medical skills many victims needlessly die at the scene or during first hour following injury. Many death in first hour after injury are the results of AIRWAY COMPROMISE, RESPIRATORY FAILURE and UNCONTROLLED BLEEDING. All these fatal condition needs at least little skills from first bystanders before formal trained person arrive at scene.
Skills and roles to be provided to suggested layperson responders;
After being trained this group should every one provided with basic equipment for first aid like groves and other full packaged equipment for basic pre hospital care.
B. ESTABLISHMENT OF PRE HOSPITAL FORMAL TRAINED TEAM (TRAINED PROFESSIONAL).
These are required to be easily accessible at the accident scene and not as it is now days you wait for ambulance for more than 2 hours to arrive and thereafter people start treatment at hospital. Current system in not favorable for lives of people involved in road traffic accident.
This will constitute formal medical professional Nurses and Doctors. The team should receive training of basic and advanced pre hospital care for at least 6 months. The team should work under government employment or privately sponsored. There should be establishment of pre hospital care station (office) in all different risk ares where these personnel would stay standby for any accident case, to make them easily accessible. Stations could be either located by following the fashion of police station establishment.
Skills and roles of this formal trained pre hospital team.
C. LEGAL AND ETHICAL CONSIDERATIONS
This is the most important part in pre hospital care system. It enable the system to function effectively. Currently even people who witness accident in the first minutes fear to do anything by fear of consequences from legal issues, including fear of destroying evidence for police exploration, thus people are fearing legal issues than fear to loose people's lives. This part is important because it empowers bystanders or first responders to act with confidence without fear to suffer from legal liability. Most legal and ethical concept should be amended to safeguard and prioritize injured people's lives for pre hospital care for provided.
CONCLUSION.
Generally if this system I suggested will be established in our nation it will saves lives of people whom in absence of it would die or got life disability. Thus bringing happy to family, social and nation at large by saving a person who is important in all that levels.
In Tanzania road traffic injuries causes almost 42% of all death due road traft accident ( TPF, 2016). Apart from deaths also leads to high burden of disability adjusted life years. Many of injuries and deaths are preventable. Many road traffic death occurs in pre hospital setting. It happens only because we lack some medical emergency systems which I will elaborate later.
Deaths due road traffic accident occurs in different categories as follows;
1. Occurs immediately/quickly as results of overwhelming injury.
2. Intermediate or sub acute phase. Occurs within several hours of the events and are frequently the result of treatable conditions.
3. Are delayed. Occurs after days or weeks after the initial injury as a result of late complications.
SUGGESTED SOLUTION:
DEVELOPMENT OF EFFECTIVE AND FUNCTIONAL PRE HOSPITAL CARE SYSTEM IN TANZANIA.
Evidence based science says that there is a most valuable time interval between accident occuring time and initiation of care. That is known as GOLDEN HOUR. It is the initial time from within which an injured person if not saved within it the chances of survival become low. It is about initial 60 minutes.
In Tanzania many deaths occurs because, injured people receives medical care at hospital (out golden hour) which leads to many preventable deaths at accident scene. Many of them could be prevented by promptly providing effective pre hospital care. The best pre hospital care in Tanzania should comprises of the following categories:
A. Establishment and training of layperson first responders.
Currently you may evidence huge crowd of people at accident scene they are only looking injured people or sometime giving unappropriate aid. In this category we should include and train the most available people who are usually available at risk areas. This group in our setting will include group of motorcycle drivers( bodaboda), taxi drivers, community leaders, public servant and volunteers.
Currently bystander includes relatives, untrained bystanders, police officers and bodaboda (motorcycle drivers). Due to lack of medical skills many victims needlessly die at the scene or during first hour following injury. Many death in first hour after injury are the results of AIRWAY COMPROMISE, RESPIRATORY FAILURE and UNCONTROLLED BLEEDING. All these fatal condition needs at least little skills from first bystanders before formal trained person arrive at scene.
Skills and roles to be provided to suggested layperson responders;
After being trained this group should every one provided with basic equipment for first aid like groves and other full packaged equipment for basic pre hospital care.
B. ESTABLISHMENT OF PRE HOSPITAL FORMAL TRAINED TEAM (TRAINED PROFESSIONAL).
These are required to be easily accessible at the accident scene and not as it is now days you wait for ambulance for more than 2 hours to arrive and thereafter people start treatment at hospital. Current system in not favorable for lives of people involved in road traffic accident.
This will constitute formal medical professional Nurses and Doctors. The team should receive training of basic and advanced pre hospital care for at least 6 months. The team should work under government employment or privately sponsored. There should be establishment of pre hospital care station (office) in all different risk ares where these personnel would stay standby for any accident case, to make them easily accessible. Stations could be either located by following the fashion of police station establishment.
Skills and roles of this formal trained pre hospital team.
C. LEGAL AND ETHICAL CONSIDERATIONS
This is the most important part in pre hospital care system. It enable the system to function effectively. Currently even people who witness accident in the first minutes fear to do anything by fear of consequences from legal issues, including fear of destroying evidence for police exploration, thus people are fearing legal issues than fear to loose people's lives. This part is important because it empowers bystanders or first responders to act with confidence without fear to suffer from legal liability. Most legal and ethical concept should be amended to safeguard and prioritize injured people's lives for pre hospital care for provided.
CONCLUSION.
Generally if this system I suggested will be established in our nation it will saves lives of people whom in absence of it would die or got life disability. Thus bringing happy to family, social and nation at large by saving a person who is important in all that levels.
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