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Scarf Injury: a qualitative examination of the emergency response and acute care pathway from a unique mechanism of road traffic injury in Bangladesh.

Publication ,  Journal Article
Tupetz, A; Strand, E; Hoque, KI; Sultana, M; Vissoci, JRN; Staton, C; Landry, MD
Published in: BMC Emerg Med
August 4, 2022

BACKGROUND: Road traffic injuries (RTI) are the leading cause of death worldwide in children over 5 and adults aged 18-29. Nonfatal RTIs result in 20-50 million annual injuries. In Bangladesh, a new mechanism of RTI has emerged over the past decade known as a 'scarf injury.' Scarf injuries occur when scarves, part of traditional female dress, are caught in the driveshaft of an autorickshaw. The mechanism of injury results in novel, strangulation-like cervical spine trauma. This study aimed to understand the immediate emergency response, acute care pathway, and subsequent functional and health outcomes for survivors of scarf injuries. METHODS: Key informant interviews were conducted with female scarf injury survivors (n = 12), caregivers (n = 6), and health care workers (n = 15). Themes and subthemes were identified via inductive content analysis, then applied to the three-delay model to examine specific breakdowns in pre-hospital care and provide a basis for future interventions. FINDINGS: Over half of the scarf injury patients were between the ages of 10 and 15. All but two were tetraplegic. Participants emphasized less than optimal patient outcomes were due to unawareness of scarf injuries and spinal cord injuries among the general public and health professionals; unsafe and inefficient bystander first aid and transportation; and high cost of acute health care. CONCLUSIONS: Females in Bangladesh are at significant risk of sustaining serious and life-threatening trauma through scarf injuries in autorickshaws, further worsened through inadequate care along the trauma care pathway. Interventions designed to increase awareness and knowledge of basic SCI care at the community and provider level would likely improve health and functional outcomes.

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Published In

BMC Emerg Med

DOI

EISSN

1471-227X

Publication Date

August 4, 2022

Volume

22

Issue

1

Start / End Page

141

Location

England

Related Subject Headings

  • Wounds and Injuries
  • Neck Injuries
  • Humans
  • First Aid
  • Female
  • Emergency & Critical Care Medicine
  • Critical Pathways
  • Child
  • Bangladesh
  • Adult
 

Citation

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Tupetz, A., Strand, E., Hoque, K. I., Sultana, M., Vissoci, J. R. N., Staton, C., & Landry, M. D. (2022). Scarf Injury: a qualitative examination of the emergency response and acute care pathway from a unique mechanism of road traffic injury in Bangladesh. BMC Emerg Med, 22(1), 141. https://doi.org/10.1186/s12873-022-00698-2
Tupetz, Anna, Eleanor Strand, Kazi Imdadul Hoque, Mohsina Sultana, Joao Ricardo Nickenig Vissoci, Catherine Staton, and Michel D. Landry. “Scarf Injury: a qualitative examination of the emergency response and acute care pathway from a unique mechanism of road traffic injury in Bangladesh.BMC Emerg Med 22, no. 1 (August 4, 2022): 141. https://doi.org/10.1186/s12873-022-00698-2.
Tupetz A, Strand E, Hoque KI, Sultana M, Vissoci JRN, Staton C, et al. Scarf Injury: a qualitative examination of the emergency response and acute care pathway from a unique mechanism of road traffic injury in Bangladesh. BMC Emerg Med. 2022 Aug 4;22(1):141.
Tupetz, Anna, et al. “Scarf Injury: a qualitative examination of the emergency response and acute care pathway from a unique mechanism of road traffic injury in Bangladesh.BMC Emerg Med, vol. 22, no. 1, Aug. 2022, p. 141. Pubmed, doi:10.1186/s12873-022-00698-2.
Tupetz A, Strand E, Hoque KI, Sultana M, Vissoci JRN, Staton C, Landry MD. Scarf Injury: a qualitative examination of the emergency response and acute care pathway from a unique mechanism of road traffic injury in Bangladesh. BMC Emerg Med. 2022 Aug 4;22(1):141.
Journal cover image

Published In

BMC Emerg Med

DOI

EISSN

1471-227X

Publication Date

August 4, 2022

Volume

22

Issue

1

Start / End Page

141

Location

England

Related Subject Headings

  • Wounds and Injuries
  • Neck Injuries
  • Humans
  • First Aid
  • Female
  • Emergency & Critical Care Medicine
  • Critical Pathways
  • Child
  • Bangladesh
  • Adult