Current Patterns of Prehospital Trauma Care in Kampala, Uganda and the Feasibility of a Lay-First-Responder Training Program
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Uganda currently has no organized prehospital emergency system. We sought to measure the current burden of injury seen by lay people in Kampala, Uganda and to determine the feasibility of a lay first-responder training program.
We conducted a cross-sectional survey of current prehospital care providers in Kampala: police officers, minibus taxi drivers, and Local Council officials, and collected data on types and frequencies of emergencies witnessed, barriers to aid provision, history of training, and current availability of first-aid supplies. A context-appropriate course on basic first-aid for trauma was designed and implemented. We measured changes in trainees’ fund of knowledge before and after training.
A total of 309 lay people participated in the study, and during the previous 6 months saw 18 traumatic emergencies each; 39% saw an injury-related death. The most common injury mechanisms were road crashes, assault, and burns. In these cases, 90% of trainees provided some aid, most commonly lifting (82%) or transport (76%). Fifty-two percent of trainees had previous first-aid training, 44% had some access to equipment, and 32% had ever purchased a first-aid kit. Before training, participants answered 45% of test questions correctly (mean %) and this increased to 86% after training (p < 0.0001).
Lay people witness many emergencies and deaths in Kampala, Uganda and provide much needed care but are ill-prepared to do so. A context-appropriate prehospital trauma care course can be developed and improve lay people’s knowledge of basic trauma care. The effectiveness of such a training program needs to be evaluated prospectively.
KeywordsBleeding Control Taxi Driver Road Traffic Injury Universal Precaution Mulago Hospital
The authors are grateful for unrestricted project funding from the Hellman Foundation and The Laura Case Trust to pursue this study, and sincerely thank the following contributors who gave valuable assistance at during various stages of this project: Dr. James Suozzi, Moses Dumba from the Ugandan Taxi Operators and Drivers Association; Red Cross First-Aid Instructors: Robert Okuyat, Juliet Kiyimba, Ivan Luwaga, and Daniel Nsubuga; Red Cross Volunteer: Yusuf Kimbowa; Sarah Nakitto, Research Coordinator, Chris Hartley-Sharpe from London Ambulance Service; Dr. Charles Mock and Dr. Olive Kobusingye. The authors also thank the UCSF Department of Surgery Scientific Publications Manager, Pamela Derish, for editorial support. This project was conducted using an unrestricted gift from the Hellman Family Foundation, which had no role in study design, analysis, writing of the report, or decision to submit for publication.
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