Analysis of Prehospital Transport Use for Trauma Patients in Lusaka, Zambia

• Published in: World journal of surgery Vol. 40; no. 12; pp. 2868 - 2874
• Main Authors: Mowafi, Hani, Oranmore-Brown, Rae, Hopkins, Kathryn L., White, Emily E., Mulla, Yacob F., Seidenberg, Phil
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-12-2016; Springer Nature B.V
• Subjects: Abdominal Surgery; Ambulances; Cardiac Surgery; Emergency Medical Services; General Surgery; Hospitals, University; Humans; Medicine; Medicine & Public Health; Original Scientific Report; Prehospital Care; Private Vehicle; Prospective Studies; Public Transport; Surgery; Thoracic Surgery; Transport Method; Trauma Patient; Trauma Severity Indices; Vascular Surgery; Wounds and Injuries - therapy; Zambia; Trauma Patient; Private Vehicle; Prehospital Care; Public Transport; Transport Method
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-016-3629-4

Despite an increasing burden of injuries, prehospital transport systems remain underdeveloped in many low- and middle-income countries. Little information exists on the use of prehospital services for trauma patients in Zambia.
Method
A prospective, observational study of trauma presentations was undertaken for 6 months in Lusaka, Zambia, to establish the epidemiology and outcomes of injury in the region. In addition to demographics and mechanism of injury, data were collected on prehospital transport as well as inpatient resources utilization. Trained study personnel gathered data on trauma presentations 24 h a day. Statistical analysis was conducted using SAS 9.3 from a Microsoft
®
Access database.
Results
3498 trauma patients were enrolled in the study on arrival to University Teaching Hospital (UTH). 3264 patients had a transport means recorded (95.3 %). Two-thirds (66 %) arrived within 6 h of injury, and 23 % arrived within the first hour after injury. A majority arrived by private vehicle (53.4 %) or public transport (37.7 %); only 5.9 % were transported by public or private ambulance. Of those arriving within the first hour after injury, 69.1 % came by private car, 24.6 % by public transport and 3.1 % by ambulance. There was a small statistical increase in Kampala Trauma Score II among ambulance arrivals.
Conclusion
Trauma patient use
a variety of transport methods to get to UTH. A majority of patients use no formal ambulance transport. Despite this fact, a majority arrives within 6 h of injury but receive no formal prehospital care. An integrated, multilayered prehospital care and transport system may be the most effective approach for Zambia.