Introduction of the Cardiff Trauma Pack in Road Traffic Accidents in Namibia for use by First-Responders: An early phase study

道路交通伤害是世界上第八大人类杀手，因此是一个重大的公共卫生问题。它们是世界上15岁和29岁年轻人的最大杀手，每年在全球造成120万人死亡，每年至少有100万人致残，至少有1 000万人受伤。生命的丧失、收入潜力的丧失（由于所涉及的年龄范围）、对家庭的贫困影响以及对我们全球社会的照顾负担是巨大的。联合国的目标是稳定并随后降低世界各地道路交通死亡率的预测水平。卡迪夫创伤包研究与开发小组开发了一种解决方案，直接响应联合国“2011-2020年道路安全行动十年”。我们开发了一个创伤包，通过在纳米比亚第一反应者的“黄金时间”提供必要护理的基本要素，最大限度地减少重大创伤和事故中的生命损失和残疾。创伤包的设计和制造符合世界卫生组织的4a标准：可及性、可获得性、可负担性和适当性。我们创新的卡迪夫创伤包干预措施包括：1 .采用“Tear and Wear”概念，节省重量和空间；2、解剖上正确、直观地放置颈领；3 .可互换的腿和手臂支架，也可防撕裂，节省重量和空间；直观、逻辑：ABCDE，需要时也可在CABCDE中使用；负担得起：使用容易获得和廉价的材料建造（即使在发展中国家，特别是在赞比亚试验）；重量轻（形状和内容适应性强）。因此，我们建议在一个道路交通事故问题严重的撒哈拉以南非洲国家进行小规模的早期阶段研究。这将发生在纳米比亚，因为首席研究员朱迪思·霍尔教授在纳米比亚有一个长期、有效、产出和结果驱动的项目，凤凰项目。她正在与纳米比亚大学（公共卫生学院）、纳米比亚科技大学（护理学院）以及卫生和社会服务部密切合作。她还通过纳米比亚大学在纳米比亚交通警察部门有很好的联系。在进行主要的全面研究（将卡迪夫创伤包引入纳米比亚的人口水平）之前，需要进行早期阶段的研究，因为我们的小组最近已经实现了卡迪夫创伤包的设计锁定，我们现在必须：1。在最初的网络建设演习中确定纳米比亚的第一响应者（如警察、护理人员、司机、高级村民和酋长）编写教育材料，培训使用卡迪夫创伤包，这些材料包括：b.提供适当的教育水平，供纳米比亚道路交通事故第一反应者使用；民族志上适当;c。语言上合适，或者有合适的插图/漫画来支持使用。3 .在纳米比亚的地理背景下，评估第一响应者对该包的可用性；4 .评估包装内容是否适合纳米比亚及其第一响应者；评估最佳的卡迪夫创伤包社区/响应者安置，以确保主要研究的最佳可及性；6. 评估包在现场的成功表现。我们将使用50个卡迪夫创伤包，在纳米比亚的Rehoboth或Oshakati进行第一反应者的大型训练演习，以实现这一目标。之后，在获得适当的道德认可后，我们会使用200个“道路交通意外”资料袋，以评估其是否易于使用、内容是否合适、是否适合特定的急救人员及道路交通意外伤亡者。一旦实现这一目标，我们将利用这些信息来规划将卡迪夫创伤包引入纳米比亚的主要人口水平研究。

Road traffic injuries are world's eighth leading killer of human beings and thus a major Public Health issue. They are the biggest killer in the world of young people aged 15 and 29 years, and globally account for 1.2 million deaths/year, with at least 1 million people disabled and a minimum of 10 million people suffering injury, annually. The loss of life, the loss of earning potential (because of age-range involved) and poverty implications for families, and the burden of care for our global society is tremendous.The United Nations aims to stabilise and then reduce forecast level of road traffic fatalities around the world. The Cardiff Trauma Pack Research and Development Team have developed a solution which directly responds to the United Nation's 'decade of action for road safety, 2011-2020'. We have developed a Trauma Pack to minimise loss of life and disability in major trauma and accidents, by providing the essential elements of necessary care for the 'golden hour' by Namibian First-Responders. The Trauma Pack is designed and manufactured in accordance with the World Health Organisation's 4 A's: accessibility, availability, affordability, appropriateness.Our innovative Cardiff Trauma Pack interventions include:1. The Tear and Wear concept, saving on weight and space;2. An anatomically correct and intuitive to place neck collar;3. An interchangeable leg and arm brace, also Tear and Wear, saving weight and space;4. Being intuitive and logical: ABCDE, also available when required in CABCDE;5. Affordable: construction from easily available and cheap materials (even in developing world, specifically trialed in Zambia);6. Light weight (adaptable shape and content).Consequently, we propose a small scale early phase study in a sub-Saharan African Country, with a major Road Traffic Accident problem. This will happen in Namibia, as Professor Judith Hall the Primary Investigator has a long term, effective, output and outcome driven project in Namibia, The Phoenix Project. She is working closely with the University of Namibia (School of Public Health), Namibian University of Science and Technology (Paramedic School) and the Ministry of Health and Social Services. She also has excellent contacts in the Namibian Traffic Police through the University of Namibia.An early phase study is required, prior to proceeding to a major full study (a population level introduction of the Cardiff Trauma Pack into Namibia), because our group has recently achieved design lock for the Cardiff Trauma Pack, and we must now:1. Identify First-Responders in Namibia during the initial networking building exercise (eg police, paramedics, drivers, senior villagers and chiefs)2. Develop educational materials to train in the use of the Cardiff Trauma Pack, materials which are:a. At an appropriate educational level for use by Namibian First-Responders in Road Traffic Accidents;b. Ethnographically appropriate;c. Linguistically appropriate, or that appropriate illustrations/cartoons are available to support use.3. Assess usability of the pack by first responders in the geographical Namibian context;4. Assess pack content is correct for the Namibian context and its First-Responders;5. Assess best Cardiff Trauma Pack community/responder placement to ensure optimum accessibility in the major study; 6. Assess that the pack performs successfully in the field.We will achieve this using a major training exercise of First-Responders in either Rehoboth or Oshakati in Namibia using 50 Cardiff Trauma Packs. After which, with appropriate ethical approval, we will utilise 200 packs in Road Traffic Accidents to assess their ease of use, suitability of contents, appropriateness to the specific First-Responders and the Road Traffic Casualties. Once this is achieved, we will use this information to plan the major population-level study for the introduction of the Cardiff Trauma Pack into Namibia.