Research Article | | Peer-Reviewed

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

Received: 9 November 2025     Accepted: 22 November 2025     Published: 20 December 2025
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Abstract

Background: 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. Methods: 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. Results: 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%). Conclusion: 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.

Published in Science Journal of Public Health (Volume 13, Issue 6)
DOI 10.11648/j.sjph.20251306.14
Page(s) 348-353
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Pre-hospital Care, Trauma Management, Sudan, First Aid, Epidemiology, Critical Care

References
[1] World Health Organization. Injury and violence. 2021. Available from:
[2] Federal Ministry of Health - Sudan. Annual Health Statistical Report. Khartoum; 2020.
[3] Gauss T, Ageron FX, Devaud ML, et al. Association of Prehospital Time to In-Hospital Trauma Mortality in a Physician-Staffed Emergency Medicine System. JAMA Surgery. 2019, 154(12), 1117-1124.
[4] National Association of Emergency Medical Technicians. PHTLS: Prehospital Trauma Life Support. 9th ed. Jones & Bartlett Learning; 2021.
[5] American College of Surgeons Committee on Trauma. Advanced Trauma Life Support (ATLS) Student Course Manual. 10th ed. American College of Surgeons; 2018.
[6] Elsayed DEM, Eltayeb EM. Pre-hospital and in-hospital Management of Non-fatal Road Traffic Injuries in Khartoum State: A Case Study. Sudanese Journal of Public Health. 2012, 7(3), 98-103.
[7] Tsegaye G, Sultan M, Zemede B, Zewdie A. Pre-hospital Care to Trauma Patients in Addis Ababa, Ethiopia: Hospital-based Cross-sectional Study. Ethiopian Journal of Health Sciences. 2021, 31(5), 1019-1024.
[8] Mulima G, Purcell LN, Maine R, Bjornstad EC, Charles A. Epidemiology of prehospital trauma deaths in Malawi: A retrospective cohort study. African Journal of Emergency Medicine. 2021, 11(2), 258-262.
[9] Mock C, Joshipura M, Arreola-Risa C, Quansah R. An estimate of the number of lives that could be saved through improvements in trauma care globally. World Journal of Surgery. 2012, 36(5), 959-963.
[10] Mould-Millman, N. K., et al. (2021). State of Emergency Medical Services (EMS) Systems in Africa: A Scoping Review. Prehospital Emergency Care, 25(5), 697-711.
[11] Olotu, A., et al. (2023). The Burden and Outcomes of Road Traffic Injury Management in East Africa: A Scoping Review. Injury Prevention, 29(2), 180-188.
[12] Jayaraman, S., et al. (2022). Training Layperson First Responders in Trauma Care: A Systematic Review. The Lancet Global Health, 10(12), e1773-e1783.
[13] World Health Organization. (2023). Global Status Report on Road Safety 2023. Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO.
[14] Kobusingye, O., et al. (2022). Effective Pre-hospital Trauma Care in Low-Resource Settings: A Comprehensive Framework. BMJ Global Health, 7(4), e008490.
[15] Murad, M. K., et al. (2021). A Prospective Study of Trauma Triage and Transport in a Conflict Setting. Journal of Trauma and Acute Care Surgery, 91(5S), S89-S95.
[16] Zogg, C. K., et al. (2024). Gaps in Prehospital Care for Trauma Patients in Low- and Middle-Income Countries: A Call for Standardized Data Collection. Injury, 55(1), 111-119.
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  • APA Style

    Abosror, S., Izzoddeen, A., Elsayed, D. (2025). Assessment of Pre-hospital Management for Major Trauma Patients at a Tertiary Hospital in Khartoum State, Sudan, 2022. Science Journal of Public Health, 13(6), 348-353. https://doi.org/10.11648/j.sjph.20251306.14

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    ACS Style

    Abosror, S.; Izzoddeen, A.; Elsayed, D. Assessment of Pre-hospital Management for Major Trauma Patients at a Tertiary Hospital in Khartoum State, Sudan, 2022. Sci. J. Public Health 2025, 13(6), 348-353. doi: 10.11648/j.sjph.20251306.14

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    AMA Style

    Abosror S, Izzoddeen A, Elsayed D. Assessment of Pre-hospital Management for Major Trauma Patients at a Tertiary Hospital in Khartoum State, Sudan, 2022. Sci J Public Health. 2025;13(6):348-353. doi: 10.11648/j.sjph.20251306.14

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  • @article{10.11648/j.sjph.20251306.14,
      author = {Sabir Abosror and Ahmad Izzoddeen and Dyaeldin Elsayed},
      title = {Assessment of Pre-hospital Management for Major Trauma Patients at a Tertiary Hospital in Khartoum State, Sudan, 2022},
      journal = {Science Journal of Public Health},
      volume = {13},
      number = {6},
      pages = {348-353},
      doi = {10.11648/j.sjph.20251306.14},
      url = {https://doi.org/10.11648/j.sjph.20251306.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20251306.14},
      abstract = {Background: 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. Methods: 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. Results: 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%). Conclusion: 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.},
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Assessment of Pre-hospital Management for Major Trauma Patients at a Tertiary Hospital in Khartoum State, Sudan, 2022
    AU  - Sabir Abosror
    AU  - Ahmad Izzoddeen
    AU  - Dyaeldin Elsayed
    Y1  - 2025/12/20
    PY  - 2025
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    DO  - 10.11648/j.sjph.20251306.14
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 348
    EP  - 353
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20251306.14
    AB  - Background: 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. Methods: 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. Results: 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%). Conclusion: 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.
    VL  - 13
    IS  - 6
    ER  - 

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Author Information
  • General Directorate of Emergency and Epidemic Control, Federal Ministry of Health, Khartoum, Sudan;Field Epidemiology Training Program, Federal Ministry of Health, Khartoum, Sudan

  • General Directorate of Emergency and Epidemic Control, Federal Ministry of Health, Khartoum, Sudan;Field Epidemiology Training Program, Federal Ministry of Health, Khartoum, Sudan

  • Faculty of Medicine, Alzaiem Alazhari University, Khartoum, Sudan

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