Assessment of Pre-hospital Management for Major Trauma Patients at a Tertiary Hospital in Khartoum State, Sudan, 2022

<i>Background: </i>Trauma is defined as physical injury resulting from exposure to external energy. Major trauma poses a significant public health challenge in Sudan, where effective pre-hospital care is critical for survival and better outcomes, yet remains underdeveloped. This study aimed to quantitatively assess the pre-hospital management received by major trauma patients at a tertiary hospital in Khartoum State. <i>Methods: </i>A descriptive, cross-sectional, hospital-based study was conducted at Ibrahim-Malik Hospital in August 2022. We enrolled 308 major trauma patients via consecutive sampling. Data on demographics, trauma characteristics, and the delivery of 14 predefined standard interventions were collected via face-to-face interviews. The primary outcome was the proportion of needed interventions actually delivered. <i>Results: </i>The majority of participants were male (79%) and aged 17-40 years (80%). The most common injury mechanisms were road traffic accidents (24%), being hit by solid objects (24%), and stab wounds (23%). Only 2% of patients were transported by ambulance. While 73% received some form of first aid, merely 3% received it from a trained person. Critically, 81% of patients received less than 40% of their needed interventions. Significant gaps were identified in managing airway obstruction (only 13% of affected patients received care) and controlling bleeding (59%). <i>Conclusion: </i>Pre-hospital trauma care in Khartoum is significantly inadequate, characterized by reliance on untrained laypersons, severely limited ambulance services, and a critical deficit in essential intervention delivery. Urgent establishment of a formal pre-hospital care system, including community first responder training and expanded ambulance coverage, is imperative to mitigate preventable trauma deaths and disabilities.