An assessment of knowledge, attitude and practice in first aid management of epistaxis by accident and emergency clinical staff at Kenyatta National Hospital
Background: Epistaxis is one of the commonest emergencies in Accident and Emergency (A&E), and Ear, Nose and Throat (ENT) departments. A vast majority of these patients settle with simple standard first aid measures. The measures that are widely accepted were formulated by St. John's Ambulance and they include: (1) Position -sitting and leaning forward, (2) Pressure -applied to the fleshy part of the nose (alae nasi) for 10-15 minutes, (3) Swallowing -breathing gently through mouth, avoiding swallowing any blood, and (4) Referral if nose bleeding persists. Due to the high incidence of epistaxis, it's essential that the medical staffs who have the first encounter with the patients possess appropriate knowledge on its immediate management. Low levels of knowledge on first aid measures have been demonstrated in the medical staff and general public. This study therefore aimed at evaluating the knowledge, attitude and practice (KAP) of these measures by Accident and Emergency clinical staff at KNH. Materials and methods: - The study design was descriptive cross- sectional. The principal researcher administered a questionnaire to the clinical staffs and data collected was analyzed by use of SPSS version 12.0 and chi square tests. Results: Data was collected from 70 clinical staff between October and December 2010. Nurses were the most respondents (68.6%); 17.1% were medical officers and 14.3% were SHOs. Majority of the respondents had worked for over 10 years after highest qualification. The commonest first aid measures reported to be known by respondents included pinching the nose (94%), nasal packing (80.6%) and sitting leaning forward position (76.1%). Only 38.1% of respondents demonstrated the correct site for pinching the nose. The main source of information for first aid measures was the curriculum in training (64.2%) while 16.4% sourced from a first aid course they had done. On positioning of patient with epistaxis, 60% gave correct responses while 51 % correctly said patient should be referred if epistaxis persists. All the 70 respondents felt that first aid was necessary in treatment of epistaxis. Majority (72.9%) of the respondents said they had ever given first aid to a patient with epistaxis. Conclusion: The clinical staffs in the A & E department have inadequate knowledge on the standard first aid measures of epistaxis. However, most had good attitude and had provided first aid to patients presenting with epistaxis. There is need for training the staff on these measures.