Pre-Hospital Care For Severely Injured Patients In Myanmar

In a collaborative effort by the WHO and the Ministry of Health, national injury surveillance system has been implementing in Myanmar with the objectives of utilization of data for injury prevention and improving the quality of acute trauma care. Surveillance data has been collected from severe injury cases admitted to five sentinel hospitals using modified trauma registry forms where data on receiving first aids care during transport were also collected. Injury surveillance findings revealed that transport injury, unintentional fall and assaults were top three leading causes of severe injury and deaths during last 12 months. Out of 1036 deaths, 35% was brought in dead cases. Among 11 559 reported severe injury cases on first aids care, nearly 60% of cases were brought to the hospitals by their family members, siblings, relatives, neighbors or friends. About one-fifth of the cases (21%) were brought to the hospital by volunteers. Only small percentage (3%) was brought to the hospitals by Emergency Medical Services (EMS) personnel. Among severely injured cases brought to the sentinel hospitals from the place of occurrences and needed first aid, only less than 10% got proper first aid and necessary care. For the severely injured cases that had been referred from other health facilities and needed first aid/care, airway/breathing care and splint slab to immobilize the trauma bones or joints were the most common type of first aid/necessary procedure that were not provided up to 62% and 55% respectively. Findings reflects the urgent needs for improving prehospital care system by providing trainings to official workers and vilunteers for alleviating the lack of manpower in health and strengthening the health workforce. Moreover, a national standard curriculum for training health workers, regulation and accreditation system are also needed for promoting pre-hospital trauma care quality.