Knowledge Attitudes, and Practices on Pre-hospital Handling of Victims with Suspected Traumatic Spinal Cord Injuries among Public Transport Drivers in Colombo District, Sri Lanka

Abstract

Background: Globally, trauma-related injuries result in five million deaths annually, while spinal cord injuries (SCI) account for 10%. Pre-hospital handling plays a crucial role in SCI management. Public transport drivers frequently serve as first responders due to their accessibility, with a lack of adequate training and resources for effective pre-hospital handling. Objective: To assess the knowledge, attitudes, and practices on safe pre-hospital handling of suspected SCI victims among public transport drivers in selected suburban areas of the Colombo District, Sri Lanka Methods: A descriptive cross-sectional study was conducted in Nugegoda, Dehiwala-Mount Lavinia, and Homagama. Public transport drivers aged 20-60 years, possessing a valid driving license and at least one-year driving experience were recruited through convenience sampling (n=422), proportionally distributed across study areas. Data were collected using a newly developed, pre-tested and validated, interviewer-administered questionnaire comprising four sections including socio-demographics, knowledge (MCQs), attitudes (Likert scale), and practices (Binary scale). A 50% threshold, based on prior literature, was used to categorize knowledge and practices. Data were analysed using SPSS version 26.0. Results: The response rate was 97.6%. Most participants (86.9%) were male, 28.9% aged 52-59 years, and 38.6% had education up to G.C.E. O/L. Over half (58.7%) were full-time drivers. Among respondents, 98.1% demonstrated good knowledge. While 97.8% recognized the importance of the golden hour in pre-hospital handling, only 54.9% identified numbness of extremities as a significant symptom in SCI. The mean±SD knowledge score was 76.54±11.37. Reflecting positive attitudes, 98.9% endorsed the need of first-aid training. While 55.3% exhibited poor practices, only 35.7% reported avoiding the use of three-wheelers for transporting SCI victims. Notably, 84.5% had never received first-aid training. Conclusion: Despite good knowledge and attitudes, poor practice highlights the need for first-aid training for public transport drivers in collaboration with healthcare professionals. Integrating SCI-specific first-aid modules into driver licensing procedures could enhance public emergency response.