383 Knowledge and practice of communities on emergency medical services for injury-related events during floods in Bangladesh: an epidemiological study

<h3>Background</h3> Recent floods in Bangladesh have experienced increased incident of injury-related events, even deaths mostly by drowning and snakebite. Exploration of community knowledge and practice for these emerging injury-related events during floods is essential to improve emergency medical services. <h3>Objective</h3> The objective of the study was to identify existing community knowledge and practice for selected injury-related events (drowning, snakebite, dog bite, electrocution and lightning) including possible interventions for improving accessibility of emergency medical services during flood. <h3>Methods</h3> A mixed-method design was adopted including document review, quantitative and qualitative component. Two flood-prone Upazilas (Islampur and Dewanganj) of Jamalpur were selected as a study area. 2103 households from both Upazilas were surveyed from randomly selected 42 villages in both Upazilas. 34 qualitative interviews were conducted with stakeholders, traditional healers, and community people by trained research assistants with pre-tested questionnaires. Data collection took place between August to October 2022. Descriptive type of analysis was done for quantitative and thematic analysis approach was followed for qualitative data. <h3>Results</h3> A significant proportion of community people (above 60%) adopt harmful practices in drowning, snakebite, dog bite, electrocution and lightning incidents according to community belief. Only 20% of respondents opined that the victims should be transferred to the nearest health facility immediately after the incident. About 28% of the respondent thought that a drowning victim should be kept spinning over the head after rescuing. About 30% of the respondents preferred bringing snakebite victims to traditional healers while nearly 32% voted for tying the limb with rope. Knowledge of first response of dog bite, electrocution and lightning were also found in low frequency. Customary belief, lack of awareness and transport including inadequate trained personnel near community found as contributing factors for these injury-related deaths. Training on life-saving skills and awareness programs were suggested by the respondents to improve the accessibility of emergency medical care during floods. <h3>Conclusions</h3> The study indicates that the community still engages in detrimental activities related to injury-related incidents. Therefore, skilled community first-responders and awareness programs are recommended solutions for improving emergency medical services during floods. Thus, community-led emergency response could be effective in preventing injury-related deaths in Bangladesh and similar settings.