Ibrahim Nasiru A, Ajani Abdul Wahab O, Mustafa Ibrahim A, Balogun Rufai A, Oludara Mobolaji A, Idowu Olufemi E, Solagberu Babatunde A
Department of Surgery,Lagos State University Teaching Hospital,Ikeja,Lagos,Nigeria.
Prehosp Disaster Med. 2017 Aug;32(4):424-430. doi: 10.1017/S1049023X17006410. Epub 2017 May 2.
Introduction Injuries are the third most important cause of overall deaths globally with one-quarter resulting from road traffic crashes. Majority of these deaths occur before arrival in the hospital and can be reduced with prompt and efficient prehospital care. The aim of this study was to highlight the burden of road traffic injury (RTI) in Lagos, Nigeria and assess the effectiveness of prehospital care, especially the role of Lagos State Ambulance Service (LASAMBUS) in providing initial care and transportation of the injured to the hospital.
A three-year, retrospective review of road traffic injured patients seen at the Surgical Emergency Room (SER) of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria, from January 1, 2012 to December 31, 2014 was conducted. Parameters extracted from the Institution Trauma Registry included bio-data, date and time of injury, date and time of arrival in SER, host status, type of vehicle involved, and region(s) injured. Information on how patients came to the hospital and outcome in SER also were recorded. Results were analyzed using Statistical Package for Social Sciences (SPSS; IBM Corporation; Armonk, New York USA) version 16.
A total of 23,537 patients were seen during the study period. Among them, 16,024 (68.1%) had trauma. Road traffic crashes were responsible in 5,629 (35.0%) of trauma cases. Passengers constituted 42.0% of the injured, followed by pedestrians (34.0%). Four wheelers were the most frequent vehicle type involved (54.0%), followed by motor cycles (30.0%). Regions mainly affected were head and neck (40.0%) and lower limb (29.0%). Less than one-quarter (24.0%) presented to the emergency room within an hour, while one-third arrived between one and six hours following injury. Relatives brought 55.4%, followed by bystanders (21.4%). Only 2.3% had formal prehospital care and were brought to the hospital by LASAMBUS. They also had significantly shorter arrival time. One hundred and nine patients (1.9%) died in the emergency room while 235 bodies were brought in dead.
Less than three percent among the victims of road crashes had formal prehospital care and shorter hospital arrival time. Current facilities for emergency prehospital care in Lagos are inadequate and require improvement. Training lay first-responders, who bring the majority of the injured to hospital, in basic first-aid may improve prehospital care in Lagos. Ibrahim NA , Ajani AWO , Mustafa IA , Balogun RA , Oludara MA , Idowu OE , Solagberu BA . Road traffic injury in Lagos, Nigeria: assessing prehospital care. Prehosp Disaster Med. 2017;32(4):424-430.
引言
伤害是全球总体死亡的第三大重要原因，其中四分之一由道路交通事故导致。这些死亡中的大多数发生在抵达医院之前，而及时有效的院前护理可以减少死亡人数。本研究的目的是强调尼日利亚拉各斯道路交通伤害（RTI）的负担，并评估院前护理的有效性，特别是拉各斯州救护车服务（LASAMBUS）在为伤者提供初始护理和送往医院方面的作用。
对2012年1月1日至2014年12月31日在尼日利亚伊凯贾拉各斯州立大学教学医院（LASUTH）外科急诊室（SER）就诊的道路交通受伤患者进行了为期三年的回顾性研究。从机构创伤登记处提取的参数包括生物数据、受伤日期和时间、抵达SER的日期和时间、宿主状态、涉及的车辆类型以及受伤部位。还记录了患者前往医院的方式以及在SER的结局。使用社会科学统计软件包（SPSS；IBM公司；美国纽约州阿蒙克）第16版对结果进行分析。
研究期间共诊治了23537名患者。其中，16024名（68.1%）有创伤。道路交通碰撞导致了5629例（35.0%）创伤病例。乘客占伤者的42.0%，其次是行人（34.0%）。四轮车是最常涉及的车辆类型（54.0%），其次是摩托车（30.0%）。主要受影响的部位是头部和颈部（40.0%）和下肢（29.0%）。不到四分之一（24.0%）的患者在一小时内到达急诊室，而三分之一的患者在受伤后一至六小时到达。亲属送来的占55.4%，其次是旁观者（21.4%）。只有2.3%的患者接受了正规的院前护理并由LASAMBUS送往医院。他们的到达时间也明显更短。109名患者（1.9%）在急诊室死亡，235具尸体被送来时已死亡。
道路交通事故受害者中不到3%的人接受了正规的院前护理且医院到达时间较短。拉各斯目前的急诊院前护理设施不足，需要改进。对将大多数伤者送往医院的非专业急救人员进行基本急救培训，可能会改善拉各斯州的院前护理。易卜拉欣·纳、阿贾尼·阿沃、穆斯塔法·伊亚、巴洛贡·拉、奥卢达拉·马、伊多武·奥、索拉格贝鲁·巴。尼日利亚拉各斯的道路交通伤害：评估院前护理。院前灾难医学。2017；32(4):424 - 430。
