An investigation of the knowledge and attitudes of emergency care practitioners in the management of common orofacial traumas.

Abstract

Introduction: Some of the worst injuries suffered by patients are facial scars and disfigurement (Zadik, 2007). Whilst certain scars on a patient may be covered by clothing or other methods, facial scars, disfigurement and loss of function remain obvious to victims of serious vehicle accidents, sports injuries or other miscellaneous activities (Levin and Zadik, 2012 et al., Zadik, 2007). It is essential to provide timeous and appropriate treatment in cases of orofacial trauma, and this prehospital care is usually provided by first responders such as emergency care practitioners (Pozner et al., 2004). However; there is inadequate knowledge in the management of orofacial trauma amongst emergency care practitioners (ECPs). Moreover, orofacial trauma is often not included in medical courses and first aid trainings or in first-aid text books and manuals (Levin and Zadik, 2012 et al., Zadik, 2007). Research on an international level in regards to orofacial trauma and the knowledge of ECPs in managing orofacial trauma is substantial. However, in South Africa, there is paucity of epidemiological studies in the field of oral and facial trauma, and in an understanding of the knowledge of emergency care practitioners in the management of these conditions. Improved knowledge and treatment protocols could assist emergency care practitioners to improve in the management of casualties that present with orofacial trauma. Aim: The aim of the study is to determine the knowledge and attitudes of ECPs of the eThekwini District of KwaZulu-Natal, South Africa in the management of patients presenting with common traumatic orofacial injuries and medical emergencies in order to identify any gaps in their training regarding management of these injuries. Methods: This was an exploratory, descriptive study using both quantitative and qualitative methods. The advantage of using mixed methods is that it allows for triangulation of the literature and results, thus strengthening the reliability and validity of the study. The study was conducted in two phases, with each phase having a different data collection tool and process. In phase 1 the research participants, being a random sample of 288 Emergency Care Practitioners were given a self-administered questionnaire to complete. The questions were designed to elicit the required information, and simultaneously allow the research participants to forward any other information or comments that they may have wanted to. In phase 2 of the study, an interview was conducted with the relevant ECPs using a structured interview schedule. A list of seven questions was posed to these participants, and they had the opportunity to provide additional input. Results: The results revealed that there were poor levels of education, training, and understanding of the emergency medical management of common orofacial traumas by ECPs. There was poor initial training, with a significant portion of the participants (44.9%, p 0.233) having not received any training at all in the management of orofacial traumas. There was also a significant majority (78.3%, < 0.001) having no further education and training. Most ECPs indicated a desire to receive such training. Conclusions: The study suggests that there is inadequate knowledge, education and training levels of ECPs abilities to appropriately manage common orofacial emergencies. There is a need for a curriculum review to include basic and advanced training and education that would equip ECPs to deal with these emergencies.