Download A survey was conducted on assessment of knowledge about first aid

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
Ms. JOTHI. N
Msc (N) 1 ST YEAR
COMMUNITY HEALTH NURSING
SARVODAYA COLLEGE OF NURSING
BANGALORE.
1
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,KARNATAKA, BANGALORE.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1.
NAME OF THE CANDIDATE AND ADDRESS
Ms. JOTHI N
1ST YEAR MSC NURSING
SARVODAYA COLLEGE OF NURSING.
#11/2, MAGADI MAINROAD, AGRAHARA,
DASARAHALLI, BANGALORE -560 079.
2.
NAME OF THE INSTITUTION
Sarvodaya College of Nursing, Bangalore.
3.
COURSE OF THE STUDY AND SUBJECT
1ST year M.Sc. Nursing.
Community health nursing
4.
DATE OF ADMISSION OF COURSE
14/07/2009
5.
TITLE OF THE TOPIC
“A study to asses the knowledge,attitude regarding
selected childhood emergencies among primary
school teachers in selected schools,Bangalore,with
a view to develop an information booklet . ”
6.
BRIEF RESUME OF THE INTENDED WORK
6.0 Introduction
7.
6.1 Need for the study
Enclosed.
6.1.1 Statement of the problem
Enclosed.
6.2 Review of related literature
Enclosed.
6.3 Objectives of the study
Enclosed.
6.3.1 Operational definitions
Enclosed.
6.3.2 Assumptions
Enclosed.
6.3.3 Hypothesis
Enclosed.
6.3.4 Sampling Criteria
Enclosed.
(Inclusion and Exclusion criteria)
Enclosed.
6.3.5 Delimitations
Enclosed.
MATERIALS AND METHODS
7.1. Sources of data: The data will be collected from the primary school teachers from selected schools
7.2. Method of data collection: self administered questionnaire will be used to collect the data.
7.3 Does the study require any investigations or interventions to be conducted on the patients or other humans or animals? YES
7.4. Has ethical clearance been obtained from your institution? YES
8.
LIST OF REFERENCES
Enclosed.
2
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
01
NAME OF THE CANDIDATE AND MS. N. JOTHI
ADDRESS
Sarvodaya College of nursing,
Magadi main road
Agrahara Dasarahalli,
Bangalore-560079.
02
NAME OF THE INSTITUTION
Sarvodaya College of nursing,
Bangalore-560079
03
1ST Year M.sc Nursing
COURSE OF STUDY AND SUBJECT
Community Health Nursing
04
DATE OF
COURSE
ADMISSION
05
TITLE OF THE TOPIC
OF
THE 14/07/2009
“A study to assess the knowledge, attitude
regarding selected childhood emergencies
among primary school teachers in selected
schools, Bangalore, with a view to develop an
information booklet”
3
BRIEF RESUME OF INTENDED WORK
6.0 Introduction:
Timely first aid saves more lives than heroic surgeries!!!
By Dr. Debangshu Dam
First aid to sick and wounded has been practiced since ancient times. In fact ,the famous
German surgeon General Esmarch[1823-1908] is conserved to have conceived the idea of
First aid .But an organised world wide effort at giving first aid came only in the year 1877with
the formation of St.Jonhn ambulance association of England after the great apostle of St John
ambulance association. Since then the universal need and utility of first aid has been increasing
in this modern mechanised civilization.
First aid is the initial assistance or treatment given to a casualty for any injury or sudden
illness before the arrival of an ambulance, doctor or other qualified person. The first aid itself
signifies that the causality is in need of ‘Secondary aid’.
Aims of first aid:
To save the life
To ease the pain
To limit the effects of the condition
To promote recovery
To prevent conditions that might increase the original injury
To arrange for transportation to the hospital1
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Injuries and accidents are the leading causes of death in children world wide . Children
are prone to unintentional injuries and are at a higher risk of experiencing injuries, because
their bodies are developing and they have not yet learned to be aware both of themselves
and various environmental dangers. Unintentional injuries, such as falls, bruises, and bumps
likewise occur in child-care programs. Schools and playgrounds are the most common
location for falls (40.4%), In the United States, annual injury rates range from 0.7 to 5.1
injuries per child. Injury alone accounts for almost one half of all deaths in school-aged
children in the USA. In China, injury accounts for a third of all deaths in children aged 1 to
4 years, and one half of all deaths in children between 5 to 9 years of age. The rate of
accidental injury was 10.94% among
school children in Shanghai; the most common
injuries included falls, collisions and extrusions, and sprains. Most injuries in school
children requires only first aid treatment. Therefore, schools are important locations to
focus on the prevention of injuries and diseases in children, because situations requiring first
aid are often encountered there2.
Leila et al. described the first aid used and resulting clinical outcomes of all patients
who arrived at a children’s hospital with an acute burn injuries. They found that correct first
aid was associated with significantly reduced re-epithelialisation time for children with
contact injuries; likewise, some positive clinical outcomes were associated with correct firstaid use. This shows there is a need for a higher public awareness of correct first-aid
treatments. Administering correct and timely first aid to patients after accidents is vital and
can potentially save lives. In schools, staffs are often first-aid providers it has become
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important to determine the current perceptions held by school staff concerning children’s
accidents2.
Injuries that vary from the petty upto the serious ones. There are cases when some
Parents totally entrust their children to the childcare schools. They rely on the teachers as
their second parents in the institute for learning. They know for a fact that their educators
will want no harm to come their way. While they are busy working, they fully believe that
their little kids are well cared for. On the other hand, the teachers have the responsibility to
keep an eye on their students. They should make sure that they are comfortable and secured
with in the four walls of their school. This then calls for their ability to handle even the most
stressful situations. So much more, the school staffs have to be equipped with the first aid
training. By nature, kids are hard to contain in one place. They are most of the times messy
and playful. This therefore lets them end up getting wounds and of them find it difficult to
breathe especially if they have medically related illnesses. When the school staff doesn't
have any background or so in administering first aid, then the institution often ends up being
sued by the fuming parents3.
The very goal of the first aid course is not confined to educating the learners of the
necessary skills that will promote the saving of lives. It is likewise focused on emphasizing
the preventive measures that can lessen the occurrence of accidents. Those who are
encouraged to take up the course include the childcare providers such as babysitters and
teachers. They are the people with whom the little kids are going to spend most of their time
with so they better get learned on how to properly handle them3.
6
Children are the future of every country and all societies strive to ensure their health
and safety. India is home to nearly 500 million young people among whom children less
than 15 years are 37% (370 million). Since India's independence, continuous efforts have
been made to improve the status of children. The large burden of communicable, infectious
and nutritional disorders is gradually on the decline due to massive efforts and investments
by successive Indian governments, even though it is an unfinished agenda. Parallel to these
changes, it is also becoming apparent that children saved from diseases of yesterday and are
becoming victims of injury on road at home and in public recreational places. As per WHO
estimates, nearly 950,000 children die in the world due to an injury each year. The burden of
child injuries in India is not clearly known9.
National Crime Records Bureau data and few independent studies reveal that nearly
15 - 20 % of injury deaths occur among children. For every death, nearly 30 to 40 children
are hospitalized and are discharged with varying level of disabilities. The number of
children sustaining minor injuries can only be guessed, as the problem is huge and
phenomenal. The outcome from injuries is significant since it occurs in the younger age,
thereby affecting long-term growth and development of children. Children with disabilities
after an injury lead life with persistent disabilities for the rest of their life. Injuries lead to
poor academic performance at a time when education is receiving a major thrust. The
socioeconomic hardships and psychosocial disabilities are huge and largely unmeasured. As
injury burden, pattern, determinants and outcome varies from region to region, it is essential
to understand these characteristics to formulate effective child safety and programmes9.
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The various stages of growth and development in children are associated with
particular types of injuries, based on the milestones they achieve at different ages. Due to the
rapidly changing lifestyles and increasing motorization, children like all others come in
contact with large number of motorized vehicles on roads that are designed and built without
keeping their needs in mind. The body parts of children being in a phase of growth and due
to relative softness of tissues, are more vulnerable to the impact of injury. Some of the
characteristics of children like smaller body size, vision, hearing, and limited risk
perception, makes them more susceptible to be involved in traffic crashes, burns, poisoning,
drowning & others and also affects the injury outcomes.
Larger policies and programmes in transport, housing, environment, education, urban
and rural development and others do not consider needs and limitations of children.
Consequently, children share the same environment9.
6.1 NEED FOR STUDY
INCIDENCE OF EPILEPSY:
According to epilepsy society 2011, Epilepsy is the commonest neurological condition
affecting people of all ages, race and social class. There are an estimated 50 million people with
epilepsy in the world, of whom up to 75% live in resource-poor countries with little to or no
access to medical services or treatment.
The incidence of epilepsy in developed countries is taken to be around 50 per 100,000
(range 40−70 per 100,000/year) while the incidence has been shown that people from a socioeconomically deprived background are at higher risk of developing epilepsy. The median
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incidence rate of epilepsy and unprovoked seizures was 47.4 and 56 per 100,000. In a systematic
review of European epidemiological studies, annual incidence rates in studies of all ages ranged
from 43−47 per 100,000 person years.
Studies have shown prevalence rates for active epilepsy in developed countries of between
4 and 10 per 1000, although most studies give a prevalence rate of active epilepsy of 4−7 per
1000. In a systematic review it was found that the range for prevalence rates in Europe was
3.3−7.8 per 1000 with a median prevalence rate of active epilepsy 5.2 per 1000. Studies with the
lowest prevalence rates reported were from Italy; 3.3 per 1000 in Sicily 3.01 per 1000 in the
More recent studies using patient reports from Norway (crude prevalence rate 11.7 per 100;
active epilepsy 6.7 per 1000) and Ireland (life prevalence 10 per 1000; treated e
per 1000) suggest higher prevalence rates in western countries. The median life time prevalence
prevalence of active epilepsy of 4.9 per 1000 (range
4
.
According to National Institute of Health and Clinical Excellence 2012 march:Epilepsy is
the most common chronic disabling neurological condition in the UK. In case of older people it
is estimated to be 7.5 per 1000 population. . The incidence of epilepsy is estimated to be about
50 per 100,000 populations per annum. Incidence is high in the child population, decreases in the
adult population and rises again in the old age.5
Based on the total projected population of India in the year 2001, the estimated number of
people with epilepsy would be 5.5 million. Based on a single study on the incidence of epilepsy,
the number of new cases of epilepsy each year would be close to half a million. Because rural
population constitutes 74% of the Indian population, the number of people with epilepsy in rural
9
areas will be approximately 4.1 million, three fourths of whom will not be getting any specific
treatment as per the present standard.6
INCIDENCE OF INJURIES:
According to the National Vital Statistics System and the National Electronic Injury
Surveillance System ,2000-2006 report :Injury Deaths• On average, 12,175 children 0 to 19
years of age died each year in the U.S. from an unintentional injury.• Males had higher injury
death rates than females. Injuries due to transportation were the leading cause of death for
children. Combining all unintentional injury deaths among those between 0 and 19 years, motor
vehicle traffic -related deaths were the leading cause. • The leading causes of injury death
differed by age group. For children less than 1 year of age, two-thirds of injury deaths were due
to suffocation. Drowning was the leading cause of injury death for those 1 to 4 years of age. For
children 5 to 19 years of age, the most injury deaths were due to being an occupant in a motor
vehicle traffic crash. • Risk for injury death varied by race. Injury death rates were highest for
American Indian and Alaska Natives and were lowest for Asian or Pacific Islanders. Overall
death rates for whites and African-Americans were approximately the same. • Injury death rates
varied by state depending upon the cause of death. Overall, states with the lowest injury death
rates were in the northeast. Fire and burn death rates were highest in some of the southern east.
Injuries are among the most under-recognized public health problems facing the United
States today. About 20 children die every day from a preventable injury – more than die from all
diseases combined.(1) Injuries requiring medical attention or resulting in restricted activity affect
approximately 20 million children and adolescents and cost $17 billion annually in medical
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costs.(2) Today we recognize that these injuries, like the diseases that once killed children, are
predictable, preventable and controllable.
The U.S. Centres for Disease Control and Prevention works closely with other federal and
state agencies, national, state and local organizations and research institutions to reduce deaths
and nonfatal injuries, disabilities and costs of childhood injuries in the United States. The release
of this CDC Childhood Injury Report coincides with the launch of the World Report on Child
Injury Prevention (2008) developed by the World Health Organization and UNICEF.The report
complements the World Report and highlights the nature of the problem in the United States.
The CDC report can inform the work of practitioners, policy-makers, elected officials, and
researchers to better understand the problem and take the necessary steps to reduce the
devastating burden childhood injuries place on this nation7.
Injuries are worldwide health problem in terms of high morbidity and mortality. However,
most of the research of childhood injuries in India and abroad has focussed on major and fatal
injuries. Minor injuries are quite common in children because of the range and extent of their
activities which expose them to such episodes. It is vital to understand the epidemiology of
minor injuries for development of an educational campaign for prevention and proper
management of minor injuries. In view of this , study was conducted to estimate the prevalence
and pattern of minor injuries among under five children of Dadu Majra Colony, Chandigarh.This
survey was conducted by a nursing student (CT) in Dadu Majra Colony, Chandi-garh during
January to February, 1997. A sample size of 217 was estimated for the study at 95% level of
confidence and 5% level of error. The study was confined to under five (0-5 year) children. Most
of the children were asked about history of minor injury (superficial abrasions/contusions) at
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present or during preceding 15 days. A brief physical examination was also done. Overall 147
(66.8%) under fives had minor injury during the specified period. The maximum prevalence was
noted in age group 49-60 months. Prevalence of minor injury was the highest among children of
illiterate mothers as compared to literate ones (p <0.01). Significantly more of children from
nuclear families(73%)had injury than in joint families(60%) . The most common site of injury
was head and trunk. Head and trunk had maximum of scratch injuries (53%) followed by
abrasion (28%).Upper limb and fingers had maximum of scratch and cut injuries (27% each).
Lower limb and toes had maximum of abrasions (67%)8.
According to statistics in the recently released report titled Accidental Death and Suicides
in India (ADSI 2011), prepared by the National Crime Records Bureau, Chennai has recorded
the highest number of road accidents. The number is a staggering 9,845 cases in the year 2011.
This is the highest among 53 cities in the country last year, and has almost doubled from 2010
when 5,123 road accidents were recorded. Followed by Chennai is Delhi, distant second with
6,065 road accidents, while Bangalore clocked 6,031. Against the backdrop of these figures, the
number of deaths in road accidents in Chennai might give a little relief to the motorists. A total
of 1,399 lives were lost in road mishaps in Chennai, while Delhi recorded 1,679 fatalities. The
biggest concern for Chennai’s road users though seems to be freak accidents, which accounted
for the highest number of injuries. Accidents on the Chennai’s roads left 7,898 persons injured –
6,280 males and 1618 females. This only goes to show that motorists and pedestrians not only
need to be aware of traffic rules but also follow them. Other major cities in Tamil Nadu do not
even come close to Chennai as far as road mishaps go. Coimbatore reported 1,131 cases while
Madurai recorded 685 and Trichy 781. (Source accessed by July 2012).27
12
The burden of child injuries in India is not clearly known. As per NCRB report of 2006,
there were 22,766 deaths (<14years) due to injuries among children. However, a recent national
review on burden of injuries in India revealed that, nearly 8.2% of deaths and 20-25% of
hospitalizations occur among children, based on few hospital and population based studies. In
the same year, there were deaths among1, 133 children in Karnataka. As child injuries are not
examined separately in Bangalore, the problem is unclear One-year data from Bangalore injury
surveillance programme showed that: 209 children below the age of 18 years died in Bangalore
due to an injury. In the same period, there were 5,505 children brought to hospitals with an
injury. The ratio of fatal to non fatal injuries was 1:27. The male to female ratio was 3:1 among
deaths and 2:1 in hospital registered children. Highest number deaths and injuries occurred in 17
– 18yrs age groups to the extent of 26% in fatal and 13% in non – fatal cases. Majority of the
children The WHO intimates that variety belonged to average socioeconomic households and
was studying in schools.9
INCIDENCE OF EPISTAXIS:-
Epistaxis is one of the commonest ENT emergencies. Although most patients can be treated
within an accident and emergency setting, some are complex and may require specialist
intervention. There are multiple risk factors for the development of epistaxis and it can affect any
age group. Treatment strategies have been broadly similar for decades. However, with the
evolution of endoscopic technology, new ways of actively managing epistaxis are now available.
Recent evidence suggests that this, combined with the use of stepwise management plans, should
limit patient complications and the need for admission. This review discusses the various
treatment options and integrates the traditional methods with modern techniques. Epistaxis,
13
whether spontaneous or otherwise, is experienced by up to 60% of people in their lifetime, with
6% requiring medical attention.16
The incidence of epistaxis varies greatly with age. There is a bimodal distribution with
peaks in children and young adults and the older adult (45–65 years). Anecdotal evidence
suggests that certain stereotypical groups are more prone (for example, elderly women or young
boys)16. There are few recent data on the prevalence of nosebleeds in children. One 1979 study
found that 30 percent of children younger than five years and 56 percent of children aged 6 to 10
years had had at least one nosebleed . The incidence of epistaxis declines in adulthood, but
approximately one-half of all adults with epistaxis had nosebleeds during childhood. Epistaxis is
rare in children younger than two years (approximately 1 per 10,000) and should have prompt
consideration of trauma (intentional or unintentional) or serious illness (eg, thrombocytopenia).
Incidence data from the National Hospital Ambulatory Medical Care Survey indicate that
epistaxis accounted for <1 percent of all emergency department visits between 1992 and 2001.
Overall, there were approximately two emergency department visits for epistaxis per 1000
population annually17. Frequency of epistaxis is difficult to determine because most episodes
resolve with self-treatment and, therefore, are not reported. However, when multiple sources are
reviewed, the lifelong incidence of epistaxis in the general population is about 60%, with fewer
than 10% seeking medical attention .
Up to 60% of the population have experienced an episode of epistaxis, but only 6% have
sought medical attention for it .The incidence of epistaxis changes with age .Peaks in incidence
occur in children younger than 10 years of age, and in adults older than 45 years of age. Epistaxis
14
in children younger than 2 years of age is unusual and may be associated with injury or serious
illness. Posterior Epistaxis is one of the commonest ENT emergencies. Although most patients
can be treated epistaxis is more common in older people compared with younger people18.
Emergency otorhinolaryngological cases in medical college ,Kolkata, a statistical
analysis(from1997-2001) .The department of ENT medical college ,Kolkata runs a 24 hours
emergency service,4 years data obtained from emergency registrar was analysed ,a total number
of 15317 patients in the 4 years study period ,sino-nasal emergency cases were observed in
34.4% patients among the sino-nasal cases epistaxis was the chief complaint in 52.3% of cases19.
INCIDENCE OF FOREIGN BODY ASPIRATION:-
Foreign body aspirations comprise the majority of accidental deaths in childhood. Diagnostic
delay may cause an increase in mortality and morbidity21 .
According to the National Safety Council, choking remained the fourth leading cause of
unintentional injury death in the United States as of 2004. In 2006, a total of 4,100 deaths (1.4
deaths per 100,000 population) from unintentional ingestion or inhalation of food or other
objects resulting in airway obstruction was reported. The incidence rate was 0.5 deaths per
100,000 population aged 0-4 years. It was lower for adolescents and young adults. The incidence
15
rate then increased steadily with age beginning in the sixth decade (2.6 deaths per 100,000
population aged 65-75 y) and rise rapidly after age 70 years (13.6 deaths per 100,000 population
older than 75 y). The overall risk of death from the café coronary aspiration is estimated to be
0.66 deaths per 100,000 people. Even if the patient does not die, symptoms often develop
immediately. Morbidity increases if extraction of the object is delayed beyond 24 hours. The
male-to-female ratio is 2:1.20
Children, especially those aged 1-3 years, are at risk for foreign body aspiration because
of their tendency to put everything in their mouths and because of the way they chew. Young
children chew their food incompletely with incisors before their molars erupt. Objects or
fragments may be propelled posteriorly, triggering a reflex inhalation.20
Upper airway obstruction is one of the leading causes of pediatric emergencies. According
to the National Safety Council, mechanical suffocation accounted for 5% of all unintentional
deaths among children younger than 4 years in 1995 in the United States. Most of these deaths
involved children younger than 12 months occur in those younger than 3 years. Most children
of this age are learning to explore their world via the oral route and tend to put everything in
their mouth. The absence of the molars makes them unable to chew adequately. However these
factors increase the risk of foreign-body aspiration. Other predisposing factors include older
siblings who may place food or objects in the mouth of infants or toddlers; neurologic
disorders, such as cerebral palsy; loss of consciousness; and swallowing dysfunction.21
During infancy, the incidence of foreign-body aspiration episodes is equal in boys and
girls. After infancy, however, boys are more likely to experience aspiration than girls: the male16
to-female ratio varies from 1.5:1 to 2.4:121.
Food items (nuts, seeds, food particles) have been implicated in 70% to 90% cases
involving infants and toddlers. Various types of nuts top the list of aspirated foreign bodies:
peanuts are the most common (36% to 55%). Melon and sunflower seeds are also commonly
aspirated.21
Older children tend to aspirate non-food items, such as paper clips, coins, balls, marbles,
and pins. Balloon aspiration is frequently fatal. Balloons can pass through the vocal cords and
lodge in the carina; they prevent air passage through to the lungs. As a result, balloons have
been banned in many day-care centers and schools .unintentional deaths occurred in this age
group)21.
Children as they are in growing stage and all organs and body parts need to be matured
enough, they are more vulnerable for injuries and diseases as a community nurse we need to
play a important role to prevent injuries and diseases. Hence the researcher is intended to do a
study on childhood emergencies in selected schools, Bangalore.
17
6.2 Review of Related Literature:Review of relevant literature serves as essential background for any research. Critical
examination of previous studies will help the researcher to formulate & delimit the problem, to
minimize the possibility of duplication of research, to suggest a theoretical framework for the
study, to learn from the reported experience of others about its feasibility to critically evaluate
the various methods used by others & choose the most appropriate design for the investigation &
so on. Such a review also helps to discuss the results & draw conclusion.
A study was conducted on assessment of knowledge practice regarding first aid measures
among the school teachers in selected areas of Mangalore with a view to develop information
module, the aim of this study is to assess the knowledge on first aid measures among school
teachers. The study was a descriptive study, conducted in selected community areas of Natekal
PHC. The sample for the study comprised of 100 self help group members selected by purposive
sampling technique. The data was collected between 2 October 2011 and 13 November 2011 by
using structured questionnaires. The data was analyzed using descriptive and inferential
statistics. The study finding revealed that majority of the samples 55% were in the age group of
25-30 years, 64% were females, 44% of them were males and 39 % received information from
the teaching programs, 20% from mass media 13% from friends and 17% of them do not have
exposure to any source of information about the first aid practices. The results showed that
majority of the samples 62% had good knowledge, and 38% had a average knowledge about the
first aid practice. Among the seven areas of the knowledge assessment on first aid measures the
mean percentage score of the samples were highest (70%) in the area of poisoning and lowest
score (28.8%) in the area of bleeding11.
18
A survey was conducted on assessment of knowledge about first aid among the teachers of
chosen high schools in the Western Pomerania region; the aim of this study is to reduce the
frequency of trauma and its unfavourable consequences. The survey was carried out among 100
teachers from two high schools of which one is situated in a city of Szczecin and the other in a
smaller town . A standardized questionnaire, which was previously applied to investigate a
problem of giving the first aid among Polish society, was used as a diagnostic tool. Although
majority of respondents took part in first aid courses while acquiring different ranks and
qualifications, the survey has confirmed that the level of knowledge about giving the first aid is
insufficient. The half of respondents knows rules of giving first aid, and one third declares that
can put these rules into the practice. A large part of respondents demonstrates rather passive
attitude towards giving the first aid in case of emergency. There are no major differences in the
level of knowledge about first aid between teachers from a large city and a small town. Systemic
solutions for improvement of the knowledge of rules of giving the first aid among teachers and
pupils are mandatory. The authors of this paper propose cyclical training courses for teachers led
by medical professionals, and further courses for pupils led by those teachers in collaboration
with students of the last year of paramedical studies10.
A study was conducted on Physical injury among the municipal primary school children of
Siliguri, Darjeeling District from February – may2009 with the objective to find out profile of
injuries among municipal primary school children in siliguri, West Bengal and to identify the
related factor associated with injury, it is a cohort study. 20% of total primary schools under
municipal corporation of the town were selected and a pre-designed, pre-tested schedule was
used to assess the profile of injury and associated factors. The Chi square test was used to
19
determine statistical significance at the 0.05 significance level. Out of 956 participants, a
significantly higher injury was observed among males (68%). Open wound injuries were
commonest (59.6%) occurring mainly at the extremities. Falls were mainly responsible for
overall injuries. Injury at home (41.8%) was also found to be more. Mother education, number of
siblings and presence of care giver were significant related factors to injury.12.
A study was conducted to estimate the prevalence of epilepsy in India by meta-analysis of
previously published and unpublished studies and to determine patterns of epilepsy by using
community-based studies. They attempted to identify as many previously published and
unpublished studies as possible on the prevalence of epilepsy in India. The studies were assessed
with regard to methods and definitions. The prevalence rates for rural and urban populations and
for men and women were calculated with a 95% confidence interval (CI). The studies that
provided details on age structure, age-specific rates, and patterns of epilepsy were chosen for
meta-analysis. Both crude values and age-standardized prevalence rates were calculated after
accounting for heterogeneity. Based on the total projected population of India in the year 2001,
the estimated number of people with epilepsy would be 5.5 million. Based on a single study on
the incidence of epilepsy, the number of new cases of epilepsy each year would be close to half a
million. Because rural population constitutes 74% of the Indian population, the number of people
with epilepsy in rural areas will be approximately 4.1 million, three fourths of whom will not be
getting any specific treatment as per the present standard15.
A study was conducted on awareness and attitude of teachers on epilepsy in Istanbul. The
aim of this study is both to investigate and to improve the present awareness, knowledge, and
attitude of elementary school teachers about epilepsy in Istanbul. In the pre- and post-seminar
20
tests teachers who attended the seminar on a voluntary basis, were asked 29 questions. There
were 346 male and female participants aged (mean +/- S.D.) 32.19 +/- 7.25. 69.3% of the
participating teachers had either read or heard about epilepsy, while 71.9% had seen someone
having a seizure and 59.4% knew someone with epilepsy. Although they had some prior
misconceptions, like considering epilepsy a contagious (2.3%) or a psychological disease
(17.8%), the teachers' knowledge and awareness improved after the seminar due to their special
interest in the subject. Consequently, their negative attitude toward the participation of people
with epilepsy in sports and social activities diminished in post seminar. However, it should be
noted that further education not only of teachers but also of family members is always required13.
A study was conducted on Perception of epilepsy among the urban secondary school
children of Bareilly district Knowledge in 2012. The aim is to assess the behaviour, attitude and
myth toward epilepsy among urban school children in Bareilly district. A cross-sectional survey
was conducted among students of 10 randomly selected secondary schools of the urban areas in
Bareilly district. A structured, pretested questionnaire was used to collect data regarding socio
demographic characteristics and assess the subject's knowledge, behaviour, attitude and myth
toward epilepsy. Of the 798 students (533 boys and 265 girls) studied, around 98.6% had heard
of epilepsy. About 63.7% correctly thought that epilepsy is a brain disorder while 81.8%
believed it to be a psychiatric disorder. Other prevalent misconceptions were that epilepsy is an
inherited disorder (71.55%) and that the disease is transmitted by eating a non vegetarian diet
(49%). Most of them thought that epilepsy can be cured (69.3) and that an epileptic patient needs
lifelong treatment (77.2). On witnessing a seizure, about 51.5% of the students would take the
person to the hospital. Majority (72.31%) of the students thought that children with epilepsy
21
should study in a special school. Although majority of the students had reasonable knowledge of
epilepsy, myths and superstitions about the condition still prevail in a significant proportion of
the urban school children. It may be worthwhile including awareness programs about epilepsy in
school education to dispel misconceptions about epilepsy.15
A study was conducted to assess the Knowledge, attitude and practice of epilepsy in
Uttarakhand, India. The objective of this study was to find out knowledge, attitude and practice
(KAP) of epilepsy among 12th -class students in Uttarakhand state. Secondly data of Uttarakhand
was compared with KAP study from other parts of the country. All
12th - class students
studying in six schools of randomly selected 36 villages in Chakrata block of Dehradun district
of Uttarakhand state were provided a printed questionnaire having answer as "yes or no". This
questionnaire used was used previously by various authors and validated for KAP analysis.
These filled questionnaires were collected by village health workers and medical officer. This
study conducted on 219, 12th -class students revealed that epilepsy was heard by 98%, 74.9%
thought epilepsy a mental disease and 4.8% believed that it is contagious. Negative attitude
showed as nearly 2/3
rd
students stated that epilepsy is hindrance in marriage and occupation.
Nearly 41% would use onion or shoe for terminating seizure attack. Ayurvedic treatment was
preferred over allopathic drugs. Study on 12th -class students of Uttarakhand revealed poor
knowledge, attitude and practice for epilepsy and needs special education program to dispel these
misconceptions14
Nepal is a landlocked and developing country with 34.6% children under 14 years of age
as well a big population under the line of poverty. A study was undertaken to determine hospital
prevalence of ENT disorders in paediatric population and their relationship with socio22
demographic factors. This study was undertaken to determine the hospital prevalence of ENT
disorders in paediatric population and their relationship with socio-demographic factors in a
tertiary care hospital in Nepal. This is a prospective analytic study, conducted at Department of
ENT, Head & Neck Surgery between January 2010 and December 2010 in the Ear, Nose and
Throat (ENT) Department, Gandaki Medical College Charak Hospital, Pokhara, Nepal. All
patients aged 16 years or younger presented ear diseases to the ENT clinic of the hospital seen by
ENT surgeons were enrolled into the study. Among 1632 children, ENT diseases were found to
be more common among male children (60%). The male to female ratio is 1.5:1. Most of the
children were living in joint family (64.16%). Diseases of auditory system (57.84%) were the
most common group of ENT problems among the paediatric population, f ollowed by pharyngoesophageal (23.53%) and nasal disorders (18.63%). Most common otologic disorder was ear wax
(40.9%). Among problems associated with nose, rhinitis (23.4%),epistaxis(13.5%) was most
common. Pharyngitis was troubling (44.8%) of study population. Improvement of health
education, socioeconomic status and health facilities will be helpful in reducing the prevalence of
ENT disease22
A study was conducted for the implementation of an educational programme in first aid for
newly graduated school teachers at Zagazig city ,Egypt .Aim of this study was to develop,
implement and evaluate an educational training programme for 60 newly appointed graduate
school teachers about first aid of some emergency situations occurring to school children .It is a
intervention study. In first part of the study data were collected using questionnaire to test
teachers’ knowledge, the second part was health education programme, third part was an
evaluation .An observation check list was used to assess their practice towards first aid for
wounds, fractures, epilepsy and epistaxis. Through this study there was high significant
23
improvement of knowledge and practice regarding first aid and dealing with emergency
situations among school children.23
A study was conducted by the Department of Medical college, Kolkata with aim of
evaluating the type of cases attending ENT emergency services and their outcome.4 years data
obtained from emergency registrar total number of 15317 patients in the 4 years study period ,so
on an average about 3829 patients attended the ENT emergency of Medical college Kolkata.
Throat related emergency were maximum in number in this study (41.8%).Ear related emergency
cases and sino nasal cases were observed in 34.4% . Among the sino nasal emergencies epistaxis
was the chief complaint in 52.53%.19
A study was conducted in Apadana clinical research in Iran to evaluate the effectiveness of
broncoscopy on removal of foreign body aspiration. The aim of this study is to illustrate the
importance of early identification of foreign bodies by using the broncoscopy. Bronchoscopy
was performed on 1015 patients with the diagnosis of foreign body aspirations (from 1998 to
2008). Of these cases, 63.5% were male and 36.5% female. Their ages ranged from 2 months to
9 years (mean 2.3 years). Diagnosis was made on history, physical examination, radiological
methods and bronchoscopy. Foreign bodies were localized in the right main bronchus in 560
(55.1%) patients followed by left main bronchus in 191 (18.8%), trachea in 173 (17.1%), vocal
cord in 75(7.4%) and both bronchus in 16 (1.6%). Foreign body was not found during
bronchoscopy in 48 cases (8.7%). The majority of the foreign bodies were seeds. Foreign bodies
were removed with bronchoscopy in all cases. Pneumonia occurs in only 2.9% (29/1015)
patients out of our cases. Rigid bronchoscopy is very effective procedure for inhaled foreign
body removal with fewer complications. Proper use of diagnostic techniques provides a high
24
degree success, and the treatment modality to be used depending on the type of the foreign body
is mostly satisfactory.24
A study was conducted by Dicle University of school of medicine ,the aim of this study was
to find out the effective treatment modalities for removal of foreign bodies. Hospital records of
1160 children <or=15 years old referred for suspected foreign body aspiration were reviewed.
Bronchoscopy under general anaesthesia was performed on all patients. Foreign bodies were
successfully removed in 1068 (92%) children. The majority,883(76.3%), presented with a
definite history of foreign body aspiration. Bronchoscopy was negative in 85 (7.3%) children.
Watermelon seeds, found in 414 (38.7%) children, were the most commonly aspirated foreign
bodies. Open surgical procedures were required for 21 (1.8%) children. Bronchial rupture related
to bronchoscopy occurred in four children, two of whom died post-operatively. The overall
mortality rate was 0.8%25.
A study was conducted to assess the diagnostic and therapeutic role of Broncoscopy in
foreign body aspiration. The purpose of this study is assessment of bronchoscopy usefulness for
diagnosis and treatment in children suspected of foreign body aspiration .It is a retrospective
study. There were 27 boys and 18 girls in the age from 15 month to 14 years (average 5.5 years).
Rigid
bronchoscopy was performed under general anaesthesia. Assessment of the respiratory
tract was done and in cases with foreign body bronchoscopic evacuation was executed. Medical
records and video recordings of bronchoscopy procedures were subjected to retrospective
analysis. In 28 children (62.2%) during bronchoscopy, foreign body aspiration recognized in 17
(37.8%) bronchoscopy cases was negative. In 27 patients, foreign bodies were removed. In one
child, foreign body was evacuated during second bronchoscopy after preparing proper
25
instrumentation. There were no complications in post-bronchoscopic period. Operating time was
from 5 to 90 min, average time was noted to be 24 min. Average time of hospital stay was 2–
3 days .Aspiration of foreign body should be suspected in all cases of bronchopulmonary
infection with atypical course. Bronchoscopy is the best diagnostic and therapeutic method in all
suspicions of foreign body. In children rigid bronchoscopy is still the method of choice26.
6.2.1 STATEMENT OF THE PROBLEM:“A study to assess the knowledge and attitude regarding selected childhood emergencies among
primary school teachers in selected schools, Bangalore, with a view to develop an information
booklet.”
6.3. OBJECTIVES OF THE STUDY
1. To assess the knowledge of primary school teachers regarding management of
childhood emergencies.
2. To assess the attitude of primary school teachers regarding management of childhood
emergencies.
3. To find out the relationship between knowledge and attitude regarding management of
childhood emergencies.
4. To find out the association between knowledge, attitude and selected variables.
5. To develop an information booklet on management of childhood emergencies.
26
6.3.1.OPERATIONAL DEFINITION:Knowledge: It refers to the awareness of teachers regarding management of childhood
emergencies as assessed by their response to structured questionnaire
Attitude : It refers to the expressed feelings and perception of primary school teachers regarding
management of childhood emergencies as assessed by response to rating scale.
Primary school teachers:- The male and female teachers with qualification of D.Ed or B.Ed
working in selected private schools in Vijayanagar , Bangalore and teaching to children between
the age group of 6-12 years.
School: - It refers to selected private schools in vijayanagar in Bangalore and giving
education
based on state and central syllabus.
Management of childhood emergencies:-It refers to action that is taken immediately after an
episode of fits , minor injuries ,epistaxis and foreign body aspiration
Information booklet: It refers to educational material which highlights information on
management of childhood emergencies.
6.3.2. ASSUMPTION
1. It is assumed that school teachers have less knowledge regarding management of childhood
emergencies.
2. It is assumed that teachers have a positive attitude regarding management of childhood
emergencies.
27
6.3.3 HYPOTHESIS
 H0 There will be no significant association between knowledge ,attitude and demographic
variables.
6.3.4 Sampling criteria
Inclusion criteria
a. All the primary school teachers of children of age group of 6-12 years.
b. School teachers who are willing to participate in study.
c. School teachers who know Kannada orEnglish.
Exclusion criteria:
School teachers who have already attended programmes on management of childhood
emergencies.
6.3.5 Delimitation
The study will be limited to 4 weeks
7.Materials and methods
7.1 Sources of data :The data will be collected from the primary school teachers of selected
schools,Bangalore.
7.2. Reasearch approach: In this study the researcher will follow exploratory approach
7.2.1 Research design: The researcher will follow descriptive design for the undertaken study.
7.2.2 Setting of the study : In this study the researcher will select private Schools located in
vijaynagar, Bangalore
28
.
7.2.3 Population: The population of present the Study comprises all the teachers of selected
private Primary School at Bangalore.
7.2.4 Sample : Primary school teachers who will fulfill the inclusion criteria
7.2.5 Sample Size :The sample size of the present study comprises 200 primary School teachers
7.2.6 Sampling Technique: The samples of the study will be selected by using non probability
convenient sampling method.
7.2.7 Method of data collection: self administered questionnaire.
7.2.8 Tool for data collection: 1. In this study the researcher will use structured questionnaire to
assess the knowledge on childhood emergencies.
2. Rating scale will be used to assess the attitude regarding
management of childhood emergencies
7.2.9 Duration of study: 4 weeks
7.2.10 Method of data analysis and interpretation;
The researcher will use descriptive and inferential statistics for data analysis
and present in the form of tables and diagrams.
29
1. Descriptive statistics:
A. Demographic variables will be analysed by frequency and percentage distribution.
B. The knowledge and attitude will be analysed by mean, median and standard deviation.
C. The correlation between knowledge and attitude will be analysed by correlation-coefficient.
2. Inferential statistics:
The association between knowledge, attitude on management of childhood emergencies and
selected variables will be analysed by chi-square test.
7.2.11 Selected Variables
A.Research variable: knowledge, attitude regarding management of childhood emergencies.
B.Demographic variables :Age, gender, religion, educational status, income, number of years of
Experience, type of family, marital status, place of residence.
7.2.12Projected outcome:
The study will help to determine the knowledge, attitude of primary school teachers regarding
management of childhood emergencies. The information booklet will help the teachers to take
timely proper action during emergency situation and thus helps to reduce the morbidity and
absenteeism to school.
7.3 Does the study require any investigation or intervention to be conducted on the
Patient or other human beings or animals. If so please describe briefly
Yes.
30
7.4 Has ethical clearance has been obtained from your institution in case of the
Above?
Yes, Ethical clearance has been obtained from the institutions ethical committee.
31
8.LIST OF REFERENCE
1.Ajay singh,’Text book of first aid emergency care”,NR Brothers PVT LTD,17thedition,2000.
2.Feng Li, Fan Jiang, Xingming Jin, Yulan Qiuand Xiaoming ShenPediatric first aid knowledge
and attitudes among staff in the preschools of Shanghai, .China Pediatric first aid
knowledge and
attitudes among staff in the preschools of Shanghai,China,Cell and
bioscience,2012.
Available at: www.biomedcentral.com/1471-2431/12/121by F Li - 2012
3.The Importance of First Aid Training among the Childcare School Staff Nov 24, 2012
Available at:first-aid-training.bafree.net/the-importance-of-first-aid-training-amon...
4.AIDAN NELIGAN and J.W. SANDER The incidence and prevalence of epilepsy 2o11.
Available at www.epilepsysociety.org.uk/.../01-the-incidence-and-prevalence-of-e...
5.Stokes T, Shaw EJ, Juarez-Garcia A et al, “Assumptions used in estimating a population
benchmark,”: 02 March 2012
Available at: www.nice.org.uk/.../assumptionspopulationbenchmark.jsp
6.Sridharan R, Murthy BN ,” Prevalence and pattern of epilepsy in India’,2o11.
Available at:www ncbi.nlm.nih.gov/pubmed/10386533
7.Nagesh N. Borse, Ph.D. M.S.Julie Gilchrist, MDAnn M. Dellinger, Ph.D.Rose A. Rudd,
MSPHMichael F. Ballesteros, Ph.D.David A. Sleet, Ph.D,”.CDC Childhood Injury
32
Report”
December 2008
Available at:www.cdc.gov/safechild/images/CDC childhoodinjury.pdf
8.Chandini Tiagi,Inderjit Walia,Amarjeet Singh,” Prevalence of minor injuries among underfives
in Chandigarh slum “e july2000.sppp
Available at:www.indianpediatrics.net/july2000/july-755-758.htm
9.NIMHANAS BISP fact sheet,”child injury”2006
Available at:WWW.nimhans.kar.nic.in/epidemiology/bisp/Fs2.pdf
10.Wisniewski j,Majewski WD,”Assessment of knowledge about first aid among the teachers of
choosen high schools in the Western Pomerania region”2007,p.no;114-23
Available at:www.nchi.nlm.nih.gov/pubmed/18557385.
11. Deepak,m,”A study on assessment of knowledge practice regarding first aid measures
among the self help groups in selected areas of mangalore with a view to develop
information module”Nitte University journal of health sciences,volume:2,sep:2012.
Available at:nitte.edu.in/journal/sep split.
12.Kuntala Ray,”Physical injury;a profile among the municipal primary school children of
Siliguri Darjeeling district,”Indian journal of public health ,volume 56,2012,p.no;49-52.
Available at;www.ijph.in /article.asp? issn=oo19-557x.
33
13.Bekiroglu N,ozkan R Arpacib,”A study on awareness attitude of teachers on epilepsy in
Istanbul ,”2004,oct,p.no;517-22.
Available at:www.epilepsy.com/info/family-kids-education.
14.Deepak Goel,”Knowledge,attitude,and practice of epilepsy in Uttarakhand,india,”
Volume;14,2011.p.no;116-119.
Available at:http://www.annal sofian.org/text.asp?2011/14/2/116/82799.
15.Harishankar joshi,”Perception of epilepsy among the urban secondary school children of
Bareily”,Annals of Indian academy of Neurology,2012 Apr-jun,p.no:125-127.
Available at:www.ncbi.nlm.nih.gov/pmc/article/pmc 33455891.
16.EER.Pope,”Epistaxis an update on current management”,post graduate medical
journal,2005,p.no:81-309.
Available at:pmj:bmj.com/content/8119581309.
17.Anna H Messer,MD,Wolter Kluwar”,Epidemiology and etiology of epistaxis in children” ,
Health upto dat,Dec 2012.
Available at:http://www.uptodate.com/contents/epidemiology-etiology-of epistaxis in
children.
34
18.Quoc A Nguyen,”Epistaxis background information and prevalence”,Medscape drugs and
disease procedure,24 May 2011.
Available at:http://www.cks.nhs.uk/epistaxis/background information/prevalence.
19 .Dr.GB Nwaoragu”,Epistaxis an over view” , Indian journal of otolaryngology and head and
neck surgery,vol:1,2005,June.
Available at:http:www.a emergency of otorhinolaryngological cases in medical
college.med ind.
20.Anntrop paediatr,”Foreign body Aspiration”,emedicine,2003,Mar,23,p.no:31-7.
Available at:emedicine,medscape.com/article/298940.
21.D Seth,”Foreign body Aspiration,A guide to early detection optimal therapy,”Improving
health awards,vol:6,p.no:13-18.
Available at:www.pediatrics consultant360.com/..../foreign body aspiration guide.
22.R.Nepali,B.Sigdal,”Prevalence of ENT diseases in children”,The International journal of
otorhinolaryngology,vol:14,2012,nov 2.
Available:http://www.ispub.com/journal.
23.Saah,”Implementation of an educational training programme in first aid for newly graduated
school teachers at Zagazig city,”Zagazig journal of occupational health and
safety,vol:3,Nov,2010.
35
Available at:www.ajol.infoldex.php/zjohs/view/57947-18k.
24.Nader saki,”Foreign body aspiration 20 years experience,”International journal of medical
science,2009.
Available at :www.medsci.org/vo6p0322.html.
25.S.Eren,”foreign body aspiration in children experience of 1160 cases,”Pediatric surgery
international,2011,Aug 27,
Available at:www.ncbi,nlm.nih.gov/pubmed/12648322.
26.Wojcieh korlacki,”Foreign body in children : diagnostic and therapeutic role of
broncoscopy,”Springer open choice,2011.
Available at:www.ncbi.nlm.nih.gov>Journallist>.
27.NCRB Report ,”Chennai roads are most dangerous in India,”New india express,july ,2012.
Available at :ibnlive.in.com/news/Chennai-roads/269355-62-130html.
36
09
SIGNATURE OF THE CANDIDATE
10
REMARKS OF THE GUIDE
11
NAME AND
LETTERS)
DESIGNATION(IN
BLOCK
11.1 GUIDE
11.2 SIGNATURE
11.3 HEAD OF THE DEPARTMENT
11.4 SIGNATURE
12
12.1 REMARKS OF THE CHAIRMAN AND
PRINCIPAL
12.2 SIGNATURE
37