Abstract
Injuries account for 9.2% of all deaths and 9.9% of the total disability-adjusted life years in Nepal. To date, there has not been a systematic assessment of the status of first response systems in Nepal. An online survey was cascaded through government, non-governmental organisations and academic networks to identify first response providers across Nepal. Identified organisations were invited to complete a questionnaire to explore the services, personnel, equipment, and resources in these organisations, their first aid training activities and whether the organisation evaluated their first response services and training. Of 28 organisations identified, 17 (61%) completed the questionnaire. The range of services offered varied considerably; 15 (88.2%) provided first aid training, 9 (52.9%) provided treatment at the scene and 5 (29.4%) provided full emergency medical services with assessment, treatment and transport to a health facility. Only 8 (47.1%) of providers had an ambulance, with 6 (35.3%) offering transportation without an ambulance. Of 13 first aid training providers, 7 (53.8%) evaluated skill retention and 6 (46.2%) assessed health outcomes of patients. The length of a training course varied from 1 to 16 days and costs from US$4.0 to 430.0 per participant. There was a variation among training providers in who they train, how they train, and whether they evaluate that training. No standardisation existed for either first aid training or provision of care at the scene of an injury. This survey suggests that coordination and leadership will be required to develop an effective first response system across the country.
Highlights
Many Low- and Middle-Income Countries (LMICs) have inadequate pre-hospital trauma care [1,2,3], despite such countries carrying the greatest proportion of global trauma events
This study aimed to investigate the current state of the first response system for trauma in Nepal, by identifying organisations providing the first response and assessing the distribution, activities and performance of these organisations
First response organisations were available in all seven provinces and covered all 77 districts of Nepal, though province 3 ( Kathmandu District) was best served, with 13 (76.5%) providers providing a service in this district
Summary
Many Low- and Middle-Income Countries (LMICs) have inadequate pre-hospital trauma care [1,2,3], despite such countries carrying the greatest proportion of global trauma events. First response at the scene of an injury event is vital to improve outcomes, in settings where Emergency Medical Services (EMS) are absent or limited [1]. Improving access to high-quality first response care to victims of injury followed by good medical treatment has the potential to save lives, reduce injury severity and avert disability [4]. Despite the importance of first response in reducing morbidity and mortality, it is only relatively recently that there has been evidence on such systems published from LMICs [5,6,7,8]. The World Health Assembly has urged member states to assess comprehensively their pre-hospital care context and includes it in emergency response plans [9, 10]. This study aimed to investigate the current state of the first response system for trauma in Nepal, by identifying organisations providing the first response and assessing the distribution, activities and performance of these organisations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
