|Year : 2019 | Volume
| Issue : 4 | Page : 216-221
A study on awareness of road traffic accidents and their basic management among medical students of Government Medical College, Maharashtra, India
Abhay Srivastava1, Shruti Gaikwad2, Pallavi Pagdal2, Sudip Bhattacharya1
1 Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
2 Resident, Department of Community Medicine, GMCH, Aurangabad, Maharashtra, India
|Date of Submission||19-Jan-2019|
|Date of Decision||05-May-2019|
|Date of Acceptance||25-Jun-2019|
|Date of Web Publication||21-Nov-2019|
Source of Support: None, Conflict of Interest: None
Background: India contributes to one in every ten road traffic accident (RTA) deaths across the world. Aim: The present study was conducted to assess the knowledge and practice toward road safety protocol and the basic life support among medical students. Settings and Design: A descriptive, cross-sectional study was conducted among the undergraduate medical students of 5th and 7th semesters studying in Government Medical College, Maharashtra, India. Materials and Methods: A descriptive, cross-sectional study was conducted during May 2018 to September 2018 among 265 undergraduate medical students in Government Medical College, Maharashtra, India, using a pretested questionnaire. Statistical Analysis: Frequency analysis of data was done, and Chi-square test was applied for the categorical variables using Statistical Package for the Social Sciences(SPSS version-22) Chicago, USA. Results and Conclusion: Our participants belonged to the age group of 19 to 22 years, and 46% of students were female and 54% were male. Majority (57.35%) of the students commute to college by bikes. It was found that nearly half (48.67%) participants wore a helmet occasionally while riding. 9.43% of students admitted that they only carry it with for avoiding traffic police. Nearly one-third (35.84%) of participants were fined in the past for traffic rule violations. The most common traffic violation was driving without a helmet (7.16%). Most (94.33%) of the participants had a good knowledge of road traffic signs. 69.81% of participants responded that they should stop the vehicle and then attend the call. Nearly half (47.16%) of the study participants wrongly interpreted the traffic signals. Only 5.2% of participants knew the correct method to secure the airway in a road traffic accident. Young drivers are a vulnerable age group of drivers worldwide. Our study revealed that only 33 participants rode two-wheelers, who knew about wearing helmets, and practiced it regularly. This is not a good sign at all. About 35.84% of participants were fined in the past for traffic rule violations. These reflected poor practice of traffic rules. Only 5.2% of participants knew the airway management in an RTA. This poor knowledge may be due to the lack of induction training about basic life support. The overall knowledge about RTA and basic management was very poor.
Keywords: Knowledge, practice, road traffic accidents
|How to cite this article:|
Srivastava A, Gaikwad S, Pagdal P, Bhattacharya S. A study on awareness of road traffic accidents and their basic management among medical students of Government Medical College, Maharashtra, India. CHRISMED J Health Res 2019;6:216-21
|How to cite this URL:|
Srivastava A, Gaikwad S, Pagdal P, Bhattacharya S. A study on awareness of road traffic accidents and their basic management among medical students of Government Medical College, Maharashtra, India. CHRISMED J Health Res [serial online] 2019 [cited 2019 Dec 14];6:216-21. Available from: http://www.cjhr.org/text.asp?2019/6/4/216/271320
| Introduction|| |
Road traffic accidents (RTAs) are a leading and preventable cause of death and morbidity. The magnitude of the problem is widespread, with nearly 1.3 million people dying on the world's roads every year and 20–50 million victims sustaining nonfatal injuries. RTAs are a leading cause of death among the 15–29 years' age group, costing countries about 1%–3% of their GDP as per the Global Status Report on Road Safety 2015. Tragically, young deaths result not just from ignorance but often from carelessness and overconfidence. In case of failure to take concrete actions, around 1.9 million lives are predicted to be lost due to road traffic.
The main risk factors responsible for injuries are vehicles, human, road, and environmental; this is described in Haddon's Matrix. Human practice is a main or contributory risk factor in 90%–95% of road traffic injuries as a result of speeding, the nonuse of seatbelts, and distraction.
Recent reports revealed that nearly 1/3 of drivers in fatal crashes and 12% of drivers with serious injuries did not wear a seatbelt. Speed has been described in different ways including driving over the speed limit, driving too fast for the weather conditions, or racing. Younger drivers are more likely to be involved in fatal collisions as a result of distracted driving than adults.
India has the highest number of road deaths across the globe. The country contributes to one in every ten RTA deaths across the world. In the state of Maharashtra alone, 2 lakh people were injured due to RTAs in the past 4 years. With Pune being the worst offender, Aurangabad ranks 4th in largest number of accidental emergencies served in 2017 in Maharashtra at 2939 emergencies. Medical students represent an important sector of the youth population. Being the doctors of the future, they have the responsibility of increasing awareness of the youth population about different healthy behaviors including road safety and they will be responsible for emergency care. As per our knowledge, in Aurangabad, there has been no available research to assess drivers' (medical students) behavior in this important age group using a semi-structured questionnaire. The present study was conducted to assess the knowledge and practice toward road safety protocol and the basic management of RTAs using a semi-structured questionnaire among medical students.
| Materials and Methods|| |
A descriptive, cross-sectional study was conducted among the undergraduate medical students of 5th and 7th semesters studying in Government Medical College, Maharashtra, India. This study was conducted during May 2018 to September 2018. A universal sample of all the students in the 5th and 7th semesters, omitting those who were sick, not available, and did not consent, was taken. A total of 265 students, who were explained in brief the objectives of the study and instructions regarding filling the questionnaire by the author, gave their verbal consent to be included in the study. Name and roll numbers of the study participants were omitted to preserve anonymity, and they were assured regarding the confidentiality of their responses. Data were collected through a pretested, semi-structured, self-administered questionnaire. Personal data regarding age, sex, and semester in which the student is currently studying were collected. The questionnaire consisted of 15 questions, about the knowledge and practice of road safety protocol and basic life support and management of cases of RTAs. The data were compiled, checked, and rechecked for its completeness and missing item. The data were entered into MS Excel 2010 (Redmond, Washington, USA) and were analyzed in OpenEpi version 3.1 (Centers for Disease Control and Prevention, Atlanta, USA) by applying appropriate statistical tools. Appropriate statistical tests were applied.
The permission was taken from Institutional Ethics Committee prior to starting the project. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
| Results|| |
Of 265 students, 22 (8.3%) were 19 years old, 91 (34.43%) were 20 years old, 114 (43.01%) were 21 years old, and 28 (10.56%) were 22 years old. Among them, 46% of students were female and 54% were male [Table 1]. Of a total of 265 study participants, majority (57.35%) commute to college by two-wheelers, 75 (28.3%) either use a bicycle or walk, only 1 participant uses four-wheeler, and the rest (13.96%) of the study participants use public transport [Figure 1]. The proportion of males (66.42%) riding two-wheelers is more than that of females (42.4%), and this difference is statistically significant (P ≤ 0.05). Regarding practice of road safety protocol among the study participants, it was found that maximum participants (129, i.e., 48.67%) only wore a helmet occasionally while riding on a two-wheeler. 9.43% of participants admitted that they only carry it with them in case they get caught, and 11.6% of participants never carry it. Only 29.43% of participants admit to wear a helmet every time they ride a two-wheeler. The number of male students carrying a driving license was significantly more than that of females (P ≤ 0.5). While 143 (53.96%) participants have a valid driving license and carry it with them regularly, 20.37% do not have a driving license at all, 12.83% have a license but rarely carry it, and 12.45% say they do not need a license at all [Table 2]. As compared to females, the number of male students carrying a driving license with them is significantly more (P = 0.00469).
About 35.84% of participants admitted to have been fined in the past for road traffic rule violations, of which 51.57% kept the details hidden. The most common traffic violation was driving without a helmet (7.16%), followed by driving triple seat (6.31%), driving on the wrong side (5.26%), breaking the traffic signal (4.15%), driving without a driving license (3.15%), parking in no parking zone (1.05%), and driving without the vehicle's RC book (1.05%).
The association of traffic rule violation with gender was found to be statistically significant, with the proportion of male students who were fined for breaking traffic rules (47.85%) being more than that of females (20.8%) (P < 0.05) [Figure 2]. Most of the participants had a good knowledge of road traffic signs, with 94.33% of the participants answering correctly about the response of the driver when they see a road sign of “school ahead.” However, when asked about mobile usage by doctors while driving, only 69.81% of participants responded that the doctor should stop the vehicle and then attend the call. 5.6% of participants felt that the doctor must take the call as it could be an emergency, 14.33% felt the doctor may attend the call using a handsfree device, and 9.05% were of the opinion that the doctor should wait to reach an uncrowded area to attend the call [Figure 3]. 47.16% of the study participants wrongly answered that a yellow traffic light meant “proceed with caution,” only 35.09% answered the question correctly. While 80.37% of participants knew that both the driver and the pillion rider must wear a helmet, 15.09% believed that it is mandatory only for the driver, while 1.13% believed that a helmet is not needed at all. The knowledge about the legal limit of blood alcohol concentration (BAC) and the maximum grace period within which a driver may renew his/her driving license was really poor with only 21.5% (57 participants) and 14.33% (38 participants) knowing the correct answers to the said questions, respectively. Knowledge about road traffic signs, grace period for license renewal, mobile phone usage by doctors while driving, and legal limit blood alcohol content (BAC) while driving was significantly higher in the 5th semester students as compared to their 7th semester counterparts. [Table 3] shows the participant responses to the questions relating to basic life support and the general management of RTA. The knowledge regarding securing airway was dismal in both sexes; only 5.2% of participants knew which method needed to be chosen to secure the airway in an RTA case with a suspected spinal cord injury. 26.5% of participants correctly answered which triage color code to treat first while prioritizing patients. The knowledge was significantly more in 5th semester students. Only 29 students knew the correct sequence of management (circulation followed by breathing followed by airway), and 7th semester students were significantly more knowledgeable as compared to the 5th semester students.
|Table 3: Participant responses to the questions related to basic life support and the general management of road traffic accidents|
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| Discussion|| |
Young drivers are a vulnerable age group of drivers worldwide, with a significantly higher risk of being involved in a road traffic injury compared with other age groups of drivers.
In the present study, majority of the students commuted by two-wheelers; similar results were found in the studies conducted by Ramya et al. and Kalbandkeri et al., where 68.18% and 82.5% of study participants used two-wheelers, respectively.
Regarding practice of helmet usage, only one-third (29.43%) of study participants wore a helmet regularly and 48.67% used one occasionally. Low helmet usage was also reported by studies carried out by Sharma and Saini, where it was reported that 41% of the participants always wore a helmet, 55% occasionally, and 54% never wore a helmet. Ramya et al. reported 36.2% regular use of helmets, 57.6% occasional use, and 6% never used a helmet. The same study shows a high level of awareness regarding helmet use among the study participants, which is comparable to the results of the current study; however, it did not translate into practice as evidenced by the findings that only 33 of 265 participants rode two-wheelers, also knew about wearing helmets, and practiced it regularly. This is not a good sign at all. Being the doctors of the future, they have the responsibility of increasing awareness of the youth population about different healthy behaviors including road safety.
About 35.84% of participants admitted to have been fined in the past for road traffic rule violations in the current study. This number is much higher than the one reported by Reang and Tripura, which is 13.7% of all participants having been previously fined. The study also found that knowledge of road traffic safety protocol was significantly better in the male participants. No such association with gender was found in the present study. However, knowledge about road traffic signs, grace period for license renewal, mobile phone usage by doctors while driving, and legal limit BAC while driving was significantly higher in the 5th semester students as compared to their 7th semester counterparts.
In our study, only 14.33% of participants knew about the maximum grace period to renew an expired driving license. Similar results were reported by Manjula et al. who found that 17.7% of participants knew about renewal of a driving license. Regarding knowledge of maximum BAC, only 21.5% of participants answered correctly, similar results were found by Manjula et al. in a study carried out at S. N. Medical College, Karnataka.
While 143 participants (53.96%) have a valid driving license and carry it with them regularly in our study, a study by Helal et al. reported only 9.6% of participants having a driving license. 3.15% of participants in the present study admitted to have been fined for not carrying a valid driving license, a similar study carried out by Ramya et al. in Bangalore Medical College and Research Institute, Bengaluru, found 11.11% of study participants had been fined for not having a driving license. 40.3% of students sometimes used helmet and 34% always used helmet. However, 25.7% never used helmet. 53% have been caught without helmet. These results are in accordance with the results of the present study viz., poor practice regarding helmet and driving license.
Regarding the general management of RTA, the knowledge regarding securing airway was poor in both sexes; only 5.2% of participants knew which method needed to be chosen to secure the airway in an RTA case with a suspected spinal cord injury. This poor knowledge may be due to lack of induction training program for basic life support in the medical college in the early phase of MBBS students. Only 26.5% of participants correctly replied triage color coding to treat first while prioritizing patients. This shows the knowledge gap among the students. Only 29% of students knew the correct sequence of management (circulation followed by breathing followed by airway); 7th semester students were significantly more knowledgeable as compared to the 5th semester students. This may be due to they get opportunity to work in the emergency at the later stage of MBBS (7th Semester) and all clinical subjects are taught in 7th semester.
| Conclusion|| |
We observed that the overall knowledge about RTA and basic management was very poor among medical students. Necessity of wearing a self-protective safety gear was observed to be low. Although male students had fairly good knowledge about traffic rules still, they were prone to violate traffic rules. Because all the students were from medical college, it was expected that they will have knowledge about basic management of RTA case, but it was also lacking.
Changing human behavior is a complex process. Our health related skills, behaviour and practices are based on what we learn in Medical Colleges. So training regarding ALS and BLS in Medical Colleges also has an important role to play in shaping the mind set and skills of young budding doctors towards life saving procedures like ALS and BLS. We have too consider the cultural aspects during designing these training programmes.,,,,,,
Basic lifesaving training programs such as ALS and BLS are conducted in the medical institutions as optional, but now, time has come that we should make it mandatory in the existing teaching curriculum for empowering our future doctors. The training may be conducted on regular basis in the skill lab, and a certificate can be issued, and renewal can be done after a specific time interval so that our future doctors become confident to deal lifesaving procedures in future.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2], [Table 3]