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Local study reveals lack of awareness among mothers of child injuries

10 Jun 2022

  • Mothers had better knowledge regarding children suffering from poisoning or burns, and related first aid practices, than on the same for choking 
BY Ruwan Laknath Jayakody Mothers had better knowledge regarding children suffering from poisoning and burns, and the related first aid practices, compared to children suffering from choking and the relevant first aid for the same, a local study found. Of the factors influencing the mothers’ knowledge regarding the same, only the mothers’ age and working status were statistically significant associations while the education level and prior experience of a similar situation were not statistically significant, the same study revealed. These findings were made in an original article on “A study of the knowledge of choking, burns, acute poisoning, and their first aid practices among mothers of children below 14 years of age attending the District General Hospital, Kalutara” which was authored by N.K. Edirisinghe, S.A.C. Dalpadatu, and T.S. Dissanayake (all three attached to the General Sir John Kotelawala Defence University while Dalpadatu is additionally attached to the same university’s hospital) and published in the Sri Lanka Journal of Child Health 51 (2) in June, 2022. It is important, therefore, to introduce community empowerment through educating the general public, especially the parents, through awareness programmes. The effectiveness of such programmes was observed in U. Senarath, D.N. Fernando, and I. Rodrigo’s “Newborn care practices at home: Effect of a hospital-based intervention in Sri Lanka” where the intervention was a four-day-long training programme primarily aimed at increasing the knowledge and skills of essential newborn care among healthcare providers. “It is undeniable that emergencies such as choking, burns, and acute poisoning need to be addressed in a timely and appropriate manner. Mothers need to be vigilant and smart to identify them and provide first contact care. For this purpose, it is of importance that they possess a basic understanding of the common clinical presentations of these emergencies and their appropriate first aid management,” Edirisinghe et al. explained. Edirisinghe et al. carried out a descriptive, cross-sectional study from 1 August 2020 to 1 September 2020 in the out-patient department, paediatric clinics, paediatric wards, and surgical wards of the District General Hospital, Kalutara. Mothers of children below 14 years of age being treated at the said hospital were deemed as eligible participants. A sample of 103 mothers was chosen using the systematic sampling method. An interviewer administered questionnaire was designed to collect data. Those scoring more than 50% were categorised as having good knowledge and the others as having poor knowledge. Of the mothers, 68% were above the age of 28 years and 76.7% were below the age of 28 years when their first child was born, and 99% were married. In terms of their education, 64% had only studied up to the General Certificate of Education (GCE) Ordinary Level (O/L) or below and 74.8% were not working. The responses of the mothers for symptom identification and first aid methods are the following: choking (during choking, the object gets stuck in the windpipe; symptom identification – clutching the throat, difficulty in breathing, coughing, and wheezing; regarding first aid for choking – if the child is choking and coughing effectively, let them cough, if the child is choking and not coughing, give back blows and chest thrust [both with the correct technique], if the child is choking and not coughing, immediately take to a hospital, if the child is unconscious, call for help and start cardiopulmonary resuscitation [correct technique], and blindly finger sweep to get the object out); burns (can burns be fatal?; symptoms of mild burn – pain, redness, swelling, and blisters; symptoms of a severe burn – leathery appearance, black/brown/whitish appearance, and numbness; scarring from a burn causes – movement restriction, and breathing problems; should you be concerned if the child develops a fever after a burn?; regarding first aid for burns – keep the burn under cool water, use running water, duration: 20 minutes, keep the burnt area warm, if the burnt area is large, keep the child warm with a blanket when bringing to the hospital, give paracetamol to reduce the pain, cover the burn with a clean dressing, and if the eyes are involved, do eye irrigation); poisoning (symptom identification – vomiting, diarrhoea, loss of consciousness, and dizziness; first aid for poisoning – if poison is ingested, bring the child immediately to a hospital, forcefully make the child vomit and is it harmful?, and can taking the poison sample to the hospital be useful in the management of the child?). Of the study sample, 33% had experienced a previous episode of choking in their child, with 21.4% for burns and 10.7% for acute poisoning. The common sources of knowledge were family and friends (45.6%), the media (30.1%), and school (13.6%). Only 5.8% had gained knowledge from a healthcare professional. However, 98.1% reported being interested in learning further about the first aid for common paediatric emergencies and their commonly preferred modes of learning were television (TV) programmes (30.1%), a first aid course (27.2%), and healthcare professionals (26.2%). None of the participants had correctly responded to all the questions. While the knowledge regarding burns and acute poisoning, and their first aid was satisfactory, there was a striking deficit in the knowledge of choking and its first aid. Only 11.7% scored above 50% in their knowledge score for choking-related first aid. Moreover, 45.7% had agreed to harmful methods like “blindly finger sweeping for the object”. “These incorrect measures taken by caregivers will delay proper management as well as cause additional harm to the child,” Edirisinghe et al. pointed out. Only 7.8% identified wheezing as a symptom of choking. While the majority claimed that they knew the proper technique for back blows, less than half knew the correct technique for chest thrusts. Only one participant claimed to know the correct technique of cardiopulmonary resuscitation. Of the participants, 88.3% had scores above 50% for their knowledge on first aid for burns, the average score being 66.34. Although the majority knew to keep the burnt area under running water, a significantly less percentage (21.4%) knew to keep it for a duration of 20 minutes. M. Stander and L.A. Wallis’s “The emergency management and treatment of severe burns” emphasised that in the case of a severe burn, the patient should be covered with a blanket during transportation to a healthcare facility in order to prevent hypothermia (a dangerous drop in body temperature below 35 Celsius) and related consequences. Less than half were aware of this. A significant proportion could not identify symptoms of severe burns and were not aware that burn-related scars could lead to movement restriction and breathing problems. The study revealed that vomiting was the commonly identified symptom of acute poisoning. A significant majority did not recognise diarrhoea, the loss of consciousness, and dizziness as symptoms. While the most common response for poisoning-related first aid was “bring the child immediately to a hospital”, 26.7% responded with “make the child vomit forcefully”. This figure is slightly less than that shown in Dayasiri et al.’s study on “Kerosene oil poisoning” where it was reported that 30.1% practised harmful first aid measures such as the administration of coconut milk to induce vomiting. In the present study, almost half of the participants believed that it was harmful to induce vomiting in acute poisoning. Comparatively older and non-working mothers scored slightly better in their level of knowledge for choking. None of the participants had followed a course on first aid. Edirisinghe et al. also added that a further study, including the demonstration of skills in first aid practices, in given scenarios by participants, would help identify significant gaps in the knowledge and practices. “Educational programmes targeting first aid on common paediatric emergencies can significantly bridge the gap seen in the knowledge and first aid. These could be conducted via TV programmes, educational sessions at paediatric clinics, child welfare, and antenatal clinics. Incorporating first aid education in the school syllabus could also improve the existing level of knowledge.”


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