Knowledge of Accident and Emergency Regarding Triage, Initial Assessment of Patients and Resuscitation Among Nurses in Central Region of Ghana

Knowledge of Accident and Emergency Regarding Triage, Initial Assessment of Patients and Resuscitation Among Nurses in Central Region of Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge of Accident and Emergency Regarding Triage, Initial Assessment of Patients and Resuscitation Among Nurses in Central Region of Ghana CHRISTIANA ASIEDU, Monica Mensah, Isaac Aidoo Erzuah This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4022396/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Road traffic accidents represent a global health challenge, with approximately 1.3 million fatalities annually, and a staggering 93% of these incidents occurring in low- and middle-income countries. Purpose This research focuses on evaluating the level of emergency preparedness in trauma management in the Central Region of Ghana, considering the high prevalence of road traffic accidents in low- and middle-income countries. Methods The study utilized a quantitative research design, specifically a cross-sectional survey, to collect data from three public health facilities in the Central Region. All 65 nurses working in the emergency departments of these hospitals were included in the study using a census approach. A structured questionnaire consisting of checklists, true/false items, and multiple-choice questions (MCQs) was used for data collection. The data was analyzed using descriptive statistics and binary logistic regression. Results The results revealed that nurses in the Accident and Emergency department had moderate knowledge in the initial assessment and resuscitation of patients, including CPR. However, the study also identified gaps in CPR knowledge among nurses working in the emergency department. Conclusion The findings highlight the need for further study and training in triaging for nurses, as well as regular refresher courses and hands-on training opportunities to enhance their skills. emergency preparedness emergency departments knowledge nurses road traffic accidents trauma management triaging Background to the Study Instances of traumatic physical injuries are diverse, arising from various causes such as road traffic accidents, contact sports, physical assaults, falls, and burns. Road traffic injuries, in particular, have been identified as a significant global cause of death, with a projected increase in fatalities by 2030 1 . Africa has experienced a consistent rise in road traffic deaths and injuries over the past three decades, with the WHO African Region reporting the highest rate of road traffic injury deaths in 2013. Ghana, in particular, has recorded high numbers of road fatalities and exhibited the highest fatality rate per 100,000 population compared to other countries 2,3 . Efforts have been made to align with the Sustainable Development Goals (SDGs), particularly SDG 3, which aims to reduce road traffic accident deaths and injuries globally. In Ghana, road accidents have resulted in a significant number of fatalities and injuries, with an increase in mortality rates observed over the years. The preparedness of healthcare facilities, particularly emergency departments, is crucial in effectively managing trauma patients. Frontline workers such as emergency department nurses play a vital role in the care of road traffic accident victims, and their preparedness is influenced by their training and periodic in-service training sessions. Facility managers also have a responsibility to ensure that necessary logistics are available to support the care of trauma patients. The burden of road traffic accidents on the healthcare system is evident, with a significant proportion of deaths and injuries attributed to these accidents. Families also face financial and psychological challenges resulting from severe injuries and coping with the consequences of road traffic accidents 2 . Despite comprehensive guidelines provided by the Ministry of Health, many healthcare institutions in Ghana deviate from these guidelines, resulting in inefficiencies in accident and emergency services. Shortcomings in emergency preparedness, insufficient supplies, and a shortage of skilled medical staff have been identified in healthcare facilities, highlighting the urgent need for improved readiness 4 . Proper management of trauma cases caused by road traffic accidents is essential in all health facilities. It is crucial for healthcare facilities to be adequately prepared to handle trauma cases to ensure optimal outcomes and save lives. Efforts aligned with the Sustainable Development Goals, particularly SDG 3, are necessary to reduce road traffic accident-related deaths and injuries 5 . This study aims to fill the research gap on emergency preparedness, particularly in trauma management, and has the potential to generate interest in improving the readiness of healthcare facilities to manage the challenges posed by road traffic accidents. The findings have the potential to catalyze state interest in fulfilling the responsibility of ensuring healthcare facilities are well-prepared to manage the challenges posed by road traffic accidents 2 . Research Question. What is the knowledge level of the nurses working in the Accident and Emergency on how to care for trauma victims? What are the socio-demographic factors influencing the knowledge level of nurses working in the accident and emergency regarding the initial assessment of patients and resuscitation. RESEARCH METHODS Research Design The research design employed in this study is a quantitative descriptive cross-sectional design. The quantitative approach is utilized to gather numeric data and analyze it using statistical methods. In this study, the focus is on obtaining information about the knowledge level of nurses, which can be quantified and analyzed to provide objective insights. The descriptive aspect of the design aims to provide a comprehensive overview of the current knowledge level among the target population. By collecting data at a specific point in time, the researchers can capture a snapshot of the knowledge level of the nurses in the A&E department. This allows for an understanding of the prevailing knowledge status within the population at that particular moment. The cross-sectional design enables the researchers to collect data from a sample of participants at a single time point. This approach is practical and efficient, as it does not require following participants over an extended period. It allows for a relatively quick assessment of the knowledge level among the target population, providing valuable information for decision-making and identifying areas for improvement. By employing a quantitative descriptive cross-sectional design, this study aims to provide a quantitative overview of the knowledge of nurses in the A&E department regarding triage, initial patient assessment, and resuscitation. The design allows for the collection of data at a single time point, providing insights into the current knowledge level among the target population. These findings can inform strategies to enhance training, education, and professional development programs for nurses, ultimately improving the quality of care in the A&E department. Population The population of interest for this study is composed of nurses who are actively working in the Accident and Emergency (A&E) departments of healthcare facilities located in the Central Region of Ghana. This includes nurses from various healthcare facilities that have dedicated accident and emergency units. By focusing on nurses in the A&E departments, the study aims to gather insights specifically from healthcare professionals who are directly involved in the critical care and initial assessment of patients in emergency situations. These nurses play a crucial role in providing immediate and life-saving interventions, triaging patients, and conducting initial assessments. The inclusion of nurses from healthcare facilities with accident and emergency units ensures that the study captures a diverse range of experiences and knowledge levels. It allows for a comprehensive understanding of the factors influencing the knowledge and practices of nurses in different healthcare settings within the Central Region of Ghana. By targeting this specific population, the study can provide valuable insights into the knowledge gaps, training needs, and areas for improvement among nurses in the A&E departments. The findings can inform healthcare policies, educational programs, and professional development initiatives that aim to enhance the quality of care provided in emergency settings in the Central Region of Ghana. Study Area The study area for this research project was the Central Region of Ghana, specifically focusing on the emergency care services provided by Kasoa, Winneba, and Cape Coast Teaching Hospitals. The Central Region is located in southern Ghana and is known for its historical significance and coastal attractions. It is one of the sixteen administrative regions of Ghana and has a diverse population. Kasoa, Winneba, and Cape Coast Teaching Hospitals are significant healthcare facilities in the region, offering specialized emergency care services to patients. These hospitals play a crucial role in providing medical attention and treatment to individuals who require immediate medical assistance due to accidents, injuries, or severe illnesses. They have dedicated Accident and Emergency (A&E) departments where nurses and other healthcare professionals work together to provide timely and effective care. The Central Region's healthcare infrastructure and facilities make it an appropriate setting for studying the knowledge of nurses in the A&E department regarding triage, initial patient assessment, and resuscitation. By conducting the research in this region, the study aimed to gain insights into the preparedness and competency of nurses in delivering emergency care services in a specific geographical context. Sampling Procedure The sampling procedure for this study involved a census approach, where all eligible nurses operating in the Accident and Emergency (A&E) departments of the selected hospitals were included in the study. The total number of nurses in these departments was 82. The decision to use a census approach was made due to the relatively small size of the nursing population in the A&E departments. By including all eligible participants, this approach ensured that there was no sampling error and that the study captured the perspectives and experiences of every nurse working in these departments. The use of a census approach eliminated the need for sampling techniques that could introduce potential biases or errors in participant selection. Data Collection Instrument To gather data on the knowledge of nurses regarding triage, initial patient assessment, and resuscitation, a structured questionnaire was utilized. The questionnaire incorporated a combination of closed-ended and open-ended questions to capture quantitative data. It was developed based on pertinent literature and established guidelines that outline best practices in emergency care. The questionnaire consisted of two sections, labeled as Section A and Section B. Section A focused on gathering information specifically related to nurses' knowledge concerning triage, initial patient assessment, and resuscitation. On the other hand, Section B aimed to explore socio-demographic factors that might influence the level of knowledge among nurses working in the accident and emergency department regarding the initial assessment of patients and resuscitation. Data Collection Procedure The data collection process included distributing questionnaires to the nurses working in the Accident and Emergency (A&E) departments. To obtain permission to collect background information, an introductory letter was obtained and presented to the three selected healthcare facilities. Ethical clearance was sought from the Cape Coast Teaching Hospital (CCTH) and the Ethics Review Committee (ERC) of the Ghana Health Service (GHS) to conduct the data collection at Winneba Trauma and Specialist Hospital, Kasoa Polyclinic, and CCTH. The questionnaires were designed to be self-administered by the participants, but the researchers also provided assistance and facilitation as needed, depending on the preference and convenience of the participants. Data Processing and Analysis The collected data is carefully reviewed and checked for any errors, inconsistencies, or missing values. Any necessary corrections or adjustments were made to ensure the accuracy and integrity of the data. The data collected were coded and entered into SPSS version 26 for analysis. This process involves assigning numerical codes or labels to different response options to facilitate quantitative analysis. Descriptive and inferential statistics were used to analysis the data. Frequency tables and percentages were generated to describe the distribution of responses on knowledge. Regression analysis was done to assess the socio-demographic factors influencing the knowledge level of nurses working in the accident and emergency regarding the initial assessment of patients and resuscitation. The logistic regression model enabled the researchers to identify factors or variables that are associated with the outcome of interest and quantify their impact. Ethical Considerations The study underwent a thorough ethical approval process, starting with obtaining ethical clearance from the Ghana Health Service (GHS), Central Regional Health Directorate (CR/G-263/608), and the Cape Coast Teaching Hospital ethical review committee. Additionally, approval was obtained from the GHS Ethics Review Committee (GHS-ERC: 020/02/23) in order to conduct the study. The researcher strictly adhered to all necessary ethical standards and conducted the study within the established guidelines set forth by the review boards. Informed consent was obtained from each participant, ensuring their voluntary participation, as well as guaranteeing confidentiality and anonymity. Participants were provided with detailed information regarding the purpose of the study, their rights to withdraw at any time, and the utilization of their data solely for research purposes. All identifiable information was treated with utmost confidentiality, and the data was reported in aggregate form to maintain anonymity. Results Knowledge on triaging, initial assessment of patients and resuscitation including cardiopulmonary resuscitation Table 1 presents the findings on the knowledge levels of triaging, initial patient assessment, and resuscitation, specifically cardiopulmonary resuscitation (CPR). All 65 nurses (100%) in the study agreed with the defined concept of triage. A significant majority of 87.7% (n = 57) acknowledged the triage color codes as red, orange, yellow, green, and black. Regarding the versions of the triage scale, 100% (n = 65) of the nurses recognized the existence of three versions for adults, children, and infants, and 96.9% (n = 63) identified the two components of the triage scale as the triage early warning score and the discriminator list. Concerning the triage early warning score (TEWS), 92.3% (n = 60) of the nurses agreed that the total score is derived from observing the basic vital signs of the patient. In terms of basic resuscitation operations following the 2020 American Heart Association guidelines, 47.7% (n = 31) of the nurses indicated that the algorithm includes clearing the airway, checking breathing, and assessing the pulse. When encountering an unconscious person on the road, 73.8% (n = 48) of the nurses expressed their priority as ensuring both their safety and that of the unconscious person. Regarding the correct hand placement for chest compression in an adult, 49.2% (n = 32) identified the center of the chest. Additionally, 64.6% (n = 42) recognized the recommended compression rate as 120 compressions per minute. Concerning the algorithm for basic resuscitation in an adult, 49.25% (n = 32) highlighted ensuring safety, calling an ambulance, checking for a pulse, and initiating CPR. When checking the pulse on an adult, 72.3% (n = 47) of the nurses correctly identified the carotid artery. Regarding the chest compression-to-breath ratio in adults, 81.5% (n = 53) agreed on 30 compressions followed by 2 rescue breaths, and 87.7% (n = 57) acknowledged the need to assess the victim's condition every 5 cycles (30 chest compressions and 2 rescue breaths) during basic resuscitation. Regarding the use of an AED defibrillator, 72.3% (n = 47) of the nurses agreed with the correct steps: switching on the AED, applying the electrodes, analyzing the rhythm, ensuring no one touches the victim, and delivering a discharge. Moreover, 76.9% (n = 50) of the nurses affirmed that fluid restriction is crucial in the initial resuscitation of a trauma patient with a suspected head injury. Similarly, 75.4% (n = 49) agreed on avoiding Dextrose Normal Saline in suspected head injury patients. Table 1 Knowledge on triaging, initial assessment of patients and resuscitation including cardiopulmonary resuscitation Name of facility Total n(%) CCTH n(%) TSH n(%) KASOA n(%) Triage means “to sort out” the sick or injured people according to the severity of their sickness or injury in order to ensure that medical and nursing staff and facilities are used most efficiently; assessment of injury intensity and the immediacy or urgency 47(100.0) 8(100.0) 10(100.0) 65(100.0) 83(100) Using the SATS protocol, the triage colour codes include red, orange, yellow, green and black. I agree 43(91.5) 5(62.5) 9(90.0) 57(87.7) I disagree 4(8.5) 2(25.0) 1(10.0) 7(10.8) I do not know 0(0.0) 1(12.5) 0(0.0) 1(1.5) There are three versions of the triage scale namely adults, children and infants. 1 agree 47(100.0) 8(100.0) 10(100.0) 65(100.0) I disagree 0(0.0) 0(0.0) 0(0.0) 0(0.0) I do not know 0(0.0) 0(0.0) 0(0.0) 0(0.0) The two parts of the triage scale are the Triage Early Warning Score (TEWS) and the Discriminator list. 1 agree 46(97.9) 8(100.0) 9(90.0) 63(96.9) I disagree 1(2.1) 0(0.0) 0(0.0) 1(1.5) I do not know 0() 0(0.0) 1(10.0) 1(1.5) The total score for the triage early warning score (TEWS) is generated by observing the basic vital signs of the patient I agree 42(89.4) 8(100.0) 10(100.0) 60(92.3) I disagree 2(4.2) 0(0.0) 0(0.0) 2(3.1) I do not agree 3(6.4) 0(0.0) 0(0.0) 3(4.6) The 2020 American Heart Association (AHA) guidelines concerning basic resuscitation operations recommend the following algorithm of procedure. Compress the chest, clear the airway, check the breathing. 3(6.4) 1(12.5) 7(70.0) 11(16.9) Clear the airway, check the breathing, check the pulse 26(55.3) 2(250) 3(30.0) 31(47.7) Check the breathing, clear the airway, check the pulse 18(38.3) 5(62.5) 0(0.0) 23(35.4) You find your friend in the middle of the road- he is unconscious, does not react, and does not breathe properly. What do you do first? I will clear his airways 5(10.6) 1(12.5) 3(30.0) 9(13.8) I will make sure we are both safe 36(76.6) 5(62.5) 7(70.0) 48(73.8) Begin to give him chest compressions 6(12.8) 2(25.0) 0(0.0) 8(12.3) What is the correct place for the compression of the chest in an adult? The left side of the chest 10(21.3) 4(50.0) 1(10.0) 15(23.1) The right side of the chest 0(0.0) 0(0.0) 1(10.0) 1(1.5) The centre of the chest 25(53.2) 4(50.0) 3(30.0) 32(49.2) The xiphoid process 12(25.5) 0(0.0) 5(50.0) 17(26.2) The correct frequency of chest compressions during CPR for adults and children is At least 100 compressions per minute. 2(4.3) 4(50.0) 5(50.0) 11(16.9) More than 100 compressions per minute. 5(10.6) 1(12.5) 2(20.0) 8(12.3) 80 compressions per minute 2(4.3) 1(12.5) 1(10.0) 4(6.2) 120 compressions per minute 38(80.9) 2(25.0) 2(20.0) 42(64.6) Which of the following is the algorithm for basic resuscitation in an adult? Make sure both you and the victim are safe, give two rescue breaths, perform defibrillation, and begin CPR 2(4.3) 1(12.5) 1(10.0) 4(6.2) Make sure both you and the victim is safe, call an ambulance, check for a pulse, begin CPR 19(40.4) 4(50.0) 9(90.0) 32(49.2) Check for a pulse, give two rescue breaths, make sure both you and the victim is safe, perform defibrillation 2(4.3) 0(0.0) 0(0.0) 2(3.1) Make sure both you and victim are safe, begin CPR, give two rescue breaths, perform defibrillation 24(51.1) 3(37.5) 0(0.0) 27(41.5) We check for a pulse in an adult on the … Carotid artery 32(68.1) 7(87.0) 8(80.0) 47(72.3) Brachial artery 6(12.8) 0(0.0) 2(20.0) 8(12.3) Femoral artery 7(14.9) 0(0.0) 0(0.0) 7(10.7) Temporal artery 2(4.3) 1(13.0) 0(0.0) 3(4.6) The ratio of chest compressions to breaths during CPR in adults is… 15:2 4(8.5) 2(25.5) 0(0.0) 6(9.2) 15:1 0(0.0) 1(12.5) 1(10.0) 2(3.1) 30:1 2(4.3) 1(12.5) 1(10.0) 4(6.2) 30:2 41(87.2) 4(50.0) 8(20.0) 53(81.5) During the basic resuscitation procedure, the condition of the victim should be assessed: Every minute 4(8.5) 2(25) 0(0.0) 6(9.2) Every 5 cycles (30 compressions and 2 recue breaths) 42(89.4) 5(62.5) 10(100.0) 57(87.7) When the victim starts to breathe incorrectly 0(0.0) 1(12.5) 0(0.0) 1(1.5) Before the attachment of the AED electrodes 1(2.1) 0(0.0) 0(0.0) 1(1.5) Which of the following is the correct sequence of the use of AED defibrillator? Switch on the AED, apply the electrodes, discharge, and analyse the rhythm 4(8.5) 1(12.5) 1(10.0) 6(9.2) Switch on the AED, apply the electrodes, analyse the rhythm, make sure no one touches the victim, and discharge. 39(83.0) 2(25.0) 6(60.0) 47(72.3) Apply the electrodes, check the pulse, discharge, and analyse the rhythm. 1(2.1) 1(12.5) 2(20.0) 4(6.2) Check the pulse, apply the electrodes, analyse the rhythm, and discharge. 3(6.4) 4(50.0) 1(10.0) 8(12.3) In initial resuscitation of a trauma patient with a suspected Head injury, fluids should be restricted as much as possible True 34(72.3) 7(70.0) 9(90.0) 50(76.9) False 13(27.7) 1(10.0) 1(10.0) 15(23.1) Which of these fluids is not to be given to a suspected head injury patient? Dextrose Normal Saline 38(80.9) 5(62.5) 6(60.0) 49(75.4) Normal Saline 7(14.9) 2(25.0) 1(10.0) 10(15.4) Ringers Lactate 1(2.1) 1(12.5) 0(0.0) 2(3.1) Blood 1(2.1) 0(0.0) 3(30.0) 4(6.2) Source: Field data Association between knowledge on the initial assessment of patients and resuscitation and demographic factors Table 2 displays the outcomes of the binary logistic regression analysis, which examined the relationship between knowledge of initial patient assessment and resuscitation and various demographic factors. The goodness-of-fit test, using Hosmer and Lemeshow's chi-square test, yielded a non-significant result (p = 0.839) with a value of 2.753 and 6 degrees of freedom. This suggests that the logistic regression model fits the data well. The Nagelkerke R Square, indicating the proportion of explained variance by the model, was 0.539, representing a moderate level of predictive accuracy. These results indicate that the logistic regression model adequately fits the data, and the included variables significantly contribute to the prediction of knowledge on the initial assessment of patients and resuscitation among the participants in the study. In terms of demographic factors, female healthcare providers exhibited significantly higher odds of possessing adequate resuscitation knowledge (AOR = 23.631, p = 0.000; 95% CI: 2.88–193.68). Regarding length of stay at the facility, respondents with 2–3 years (AOR = 0.137, p = 0.034; 95% CI: 0.022–0.859), 4–5 years (AOR = 0.045, p = 0.013, 95% CI: 0.004–0.526), and over 5 years (AOR = 0.022, p = 0.005; 95% CI: 0.002–0.317) demonstrated significantly lower odds of having sufficient knowledge on the initial patient assessment and resuscitation compared to those with 0–1 year. However, the education level of healthcare workers was not a significant predictor of knowledge of the initial patient assessment and resuscitation in the regression analysis. Table 2 Binary logistic regression of the association between knowledge on the initial assessment of patients and resuscitation and demographic factors Variable Categories B Wald AOR 95% Confidence Interval Lower Upper Sex Male Ref Ref Ref Ref Ref Female 3.16 8.681 23.631*** 2.88 193.68 Length of stay at facility 0–1 year Ref Ref Ref Ref Ref 2–3 years -1.99 4.516 0.137* 0.022 0.859 4–5 years -3.10 6.123 0.045* 0.004 0.526 > 5 years -3.80 7.809 0.022** 0.002 0.317 Education Certificate Ref Ref Ref Ref Ref Diploma -0.53 0.286 0.587 0.083 Degree -1.99 2.269 0.137 0.010 Masters -19.56 0.000 0.01 0.000 0.010 Hosmer and Lemeshow 2.753 ( 6 ) = 0.839 Nagelkerke R Square 0.539 *** p-value < 0.001; ** p-value < 0.01; * p-value < 0.05 Discussion Knowledge on triage, initial assessment of patient and resuscitation including CPR All 65 participants unanimously agreed on the definition of triage, indicating a shared understanding of the concept. However, only 57 nurses (87.7%) recognized the triage color codes as red, orange, yellow, green, and black, which demonstrates a significant understanding of the SATS protocol. All nurses (n = 65) acknowledged the existence of three versions of the triage scale for adults, children, and infants. However, only 63 nurses (96.9%) agreed that the triage scale consists of two parts, namely the triage early warning score and the discriminator list. Furthermore, 60 nurses (92.3%) agreed that the total score for the triage early warning score is derived from observing the basic vital signs of a patient. Overall, the majority of respondents demonstrated proficiency in triage, as indicated by the cumulative score for CCTH, KPC, and TSH, suggesting that participants had sufficient knowledge ( 4 – 5 ) in triage. These findings align with previous studies by 6,7 , which also found that nurses generally possess knowledge in triage. However, these findings contrast with the results of 8 , which concluded that nurses had inadequate knowledge in triage. The difference in results may be attributed to the introduction of the NURSMID protocol, which enhances knowledge and the effective use of the triage tool in many emergency departments (EDs) in Ghana. The study revealed a diverse range of educational qualifications among the nurses, ranging from diplomas to master's degrees, indicating varied academic backgrounds within the emergency department. While the majority of nurses hold diplomas, the presence of degree holders and those with advanced qualifications suggests a mix of educational experiences. This diversity in educational background may have contributed to their ability to appropriately triage patients since triage workshops often involve in-service training and practical sessions that benefit from a certain level of formal education for understanding and implementation. The diverse mix of nurses with varied skills and perspectives can contribute to a well-rounded team, which is essential in patient management, particularly during critical situations such as road traffic accidents. This finding is positive, as proper triaging of patients enables timely management of polytrauma patients 8,9 . Less than half of the nurses (n = 31) demonstrated knowledge of the 2020 American Heart Association (AHA) guidelines, specifically the algorithm for clearing the airway, checking breathing, and checking the pulse. The responses indicated that a significant number of emergency department nurses were not familiar with the current AHA recommendations. This finding is consistent with a previous study by 9 , which found that a considerable proportion of respondents lacked knowledge of AHA guidelines. The lack of comprehensive staff training, often due to financial constraints in some facilities, as well as limited personal funds for participating in courses, may contribute to this knowledge gap. Currently, a single course on Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) can cost between 2,500 to 3,500 Ghana Cedis. The limited awareness of the 2020 AHA guidelines among emergency department nurses, combined with financial limitations for training courses, can impede the effective implementation of updated life support protocols and compromise patient care in critical situations. This knowledge gap emphasizes the importance of financial support and organizational investment in ongoing training for emergency department nurses to ensure they stay updated with the latest life support guidelines. Addressing these constraints is crucial for improving patient outcomes and maintaining a high standard of care in emergency settings. A majority of nurses (n = 48) expressed that their priority would be to ensure both their own safety and the safety of an unconscious person before initiating CPR. However, 17 nurses lacked knowledge about when to start CPR, which can be dangerous and potentially decrease the survival rate of cardiac arrest patients. In terms of the correct hand placement for chest compressions in adults, 32 nurses correctly identified the center of the chest, while the remaining 33 nurses chose incorrect sites for compression. This suggests that more than half of the emergency department nurses lack knowledge about the appropriate hand placement during chest compressions. Proper hand placement is crucial for the effectiveness of CPR, and an incorrect approach can significantly impact the survival rate of cardiac arrest patients. This finding aligns with previous studies that emphasize the importance of continuous training and periodic refresher courses in CPR 10,11 . The significant number of emergency department nurses with inconsistent knowledge about the initiation and correct technique of CPR highlights the need for targeted training programs. Improved education on CPR protocols is essential to enhance nurses' preparedness and competence, ultimately leading to better outcomes for cardiac arrest patients in emergency settings. Only 11 respondents correctly indicated that the recommended compression frequency during CPR for adults and children should be at least 100 compressions per minute, while the majority of nurses (42) believed it should be 120 compressions per minute. This finding is noteworthy across all three facilities, as a large portion of respondents selected the incorrect response. Nurses with inadequate knowledge of chest compressions may produce suboptimal results, leading to lower survival rates for cardiac arrest patients. The American Heart Association (AHA) recommends that, during CPR, compressions should be firm and fast but at least 100 compressions per minute to allow for complete chest recoil and ensure sufficient blood flow to vital organs like the brain. Chest compressions that are too rapid can undermine this objective. This result aligns with findings from pre-test surveys conducted by 11 − 10 where the majority of respondents provided incorrect responses regarding the frequency of chest compressions in CPR, indicating a lack of knowledge in CPR. It is also consistent with other studies that have revealed concerning knowledge gaps and skill deficiencies among nurses 10,11 . The prevalent misconception among nurses regarding the recommended compression frequency in CPR underscores the urgent need for targeted training interventions. Sufficient education on the correct compression frequency is crucial for optimizing the effectiveness of CPR and improving outcomes for cardiac arrest patients in emergency situations. Less than half of the nurses (n = 27) indicated that the correct algorithm for basic resuscitation in adults involves ensuring both their own safety and the safety of the victim, initiating CPR, giving two rescue breaths, and performing defibrillation. This result reflects a lack of knowledge among nurses regarding the algorithm for basic resuscitation in adults, as more than half of the respondents provided incorrect responses. This knowledge gap is significant across all three facilities. The lack of understanding in the algorithm may be attributed to a lack of in-service training for nurses in Basic Life Support (BLS), the associated training costs, and poor retention of BLS knowledge. This finding aligns with the pre-test and 6-month post-test results reported by 11 which indicated poor knowledge of the basic resuscitation algorithm and BLS (CPR) among respondents. Additionally, these studies noted a decrease in CPR retention after 6 months of training 12–15 . They also emphasized that nurses' knowledge was influenced by their motivation, attitude, and willingness to perform BLS or participate in drills. The significant knowledge gap among nurses regarding the algorithm for basic resuscitation in adults underscores the urgent need for ongoing and reinforced training programs. Insufficient education in BLS may impede nurses' ability to respond effectively in emergency situations, highlighting the importance of consistent and accessible training 10,11 to enhance their skills and retain knowledge. The majority of nurses (n = 47) correctly identified the carotid artery as the location to check for the pulse in adults. This knowledge is crucial for promptly initiating chest compressions in trauma patients who experience cardiac arrest. Before starting chest compressions, nurses need to determine if the patient has a pulse by feeling the carotid pulse. This finding is consistent with a study by 16 , where respondents demonstrated the ability to recognize when to initiate CPR. This critical step is essential for determining the survival of cardiac arrest victims. The majority of respondents (n = 53) correctly identified the recommended chest compression to breath ratio in adults as 30 compressions to 2 breaths. This finding differs from the results of a previous survey by 11 , where most respondents in a pre-test were unable to select the correct ratio. Proficiency in this skill is crucial during CPR to ensure adequate ventilation for a person experiencing cardiac arrest. The fact that the majority of respondents correctly identified the chest compression to breath ratio (30:2) indicates improved proficiency in this important CPR skill, which ensures effective ventilation during resuscitation efforts. This enhanced competence is essential for improving the overall quality of life-saving interventions and enhancing patient outcomes in emergency situations. A significant number of respondents (n = 57) agreed that the condition of the victim should be assessed every 5 cycles (30 chest compressions and 2 breaths being one cycle) during basic resuscitation. Ongoing assessment is vital for evaluating the effectiveness of any procedure. Knowing when to assess the condition of the patient being resuscitated is crucial for effective management. Assessing an unconscious patient during CPR informs the responders whether to continue or not, which directly impacts the patient's chances of survival. This finding aligns with a study by 11,16 , which suggested that promptly assessing the condition of an unconscious victim and initiating CPR may improve survival rates and reduce in-hospital mortality. The agreement among a significant number of respondents that the victim's condition should be assessed every 5 cycles (5x 30 chest compressions and 2 breaths) during basic resuscitation underscores the importance of ongoing assessment in evaluating the effectiveness of the procedure. This knowledge is crucial for making informed decisions during CPR, directly influencing the patient's chances of survival. The majority of respondents (n = 47) agreed on the correct sequence for using an Automated External Defibrillator (AED): switching on the AED, applying the electrodes, analyzing the rhythm, ensuring no one touches the victim, and then delivering a shock. However, a few respondents (n = 4) mentioned that the correct sequence was applying the electrodes, analyzing the rhythm, and delivering a shock. The significance of this finding is observed in the TSH, where four respondents chose the incorrect sequence. This discrepancy may be attributed to the unavailability or infrequent use of AEDs, leading to a lack of proficiency in their application. This result corresponds with the findings of 11 , where deficient knowledge in AED use was linked to limited availability and inadequate training. It is also consistent with studies that attribute deficiencies in nurses' knowledge of disaster management to both institutional factors and individual nurse competencies 7,17 . Early defibrillation significantly increases survival rates for cardiac arrest and polytrauma patients. To enhance competence in AED use, efforts should be made to make AEDs readily available and provide regular training. The practical implication emphasizes the need for increased accessibility to AEDs and regular training to enhance nurses' competence in deploying this life-saving technology, particularly considering the significant impact of early defibrillation on survival rates for cardiac arrest and polytrauma patients. Regarding the initial resuscitation of a trauma patient with a suspected head injury, a majority of the respondents (n = 50) agreed that fluids should be restricted as much as possible. This approach is in line with the standard practice of preventing an increase in intracranial pressure. In situations where fluid resuscitation is necessary due to significant blood loss, the recommended ratio is 1:1:1 (plasma: platelets: packed red blood cells), as mentioned in 18 It has also been established that prolonged infusion of crystalloids can have a negative impact on survival rates by causing coagulopathies, as noted in 19 . However, in the context of the CCTH, 27.6% of the respondents (13 nurses) provided incorrect responses, indicating a potential knowledge gap. This is concerning because nurses working in the emergency setting are expected to have a basic understanding and demonstrate proficiency in fluid resuscitation to avoid worsening the patient's condition. This highlights the need for continuous in-service training on the management of critically ill patients. The majority of respondents (n = 49) agreed that Dextrose Normal Saline should be avoided in suspected head injury patients. This is crucial because the appropriate choice of fluid is a glucose-free crystalloid to prevent fluid shift into the brain, which could increase intracranial pressure. If blood products are needed, they should be administered according to the 1:1:1 ratio (plasma: platelets: packed red blood cells), as mentioned in 19 . Overall, the knowledge score obtained ( 6 – 7 ) indicates that respondents from CCTH, TSH, and KPC have moderately adequate knowledge in the initial assessment and resuscitation of patients, including CPR. This finding is consistent with a study by 11 and contradicts the findings of 7,20–22 which reported inadequate knowledge and skills among nurses caring for trauma patients. A binary logistic regression analysis was conducted to examine the relationship between socio-demographic factors and healthcare providers' knowledge of the initial patient assessment and resuscitation. The results revealed an interesting association between gender and knowledge, suggesting potential gender-related disparities in this critical area. Female healthcare providers had significantly higher odds of possessing adequate assessment and resuscitation knowledge compared to their male counterparts. This finding may be attributed to differences in training experiences, communication styles, or access to educational resources between male and female healthcare providers. To address these disparities, tailored training programs that consider gender-specific learning preferences and experiences should be developed. By promoting more equitable distribution of resuscitation knowledge, healthcare providers can be better prepared to handle emergency situations. The length of stay at the healthcare facility was found to be a significant factor influencing healthcare providers' initial assessment and resuscitation knowledge. Respondents with longer tenures, specifically those with 2–3 years, 4–5 years, and over 5 years of experience, demonstrated significantly lower odds of having sufficient knowledge compared to those with 0–1 year of experience. This finding contradicts previous research suggesting that longer time spent in facilities improves CPR knowledge. It is possible that healthcare providers with longer tenures may become complacent or receive less emphasis on continuous training. To address this issue, regular refresher courses and continuous professional development initiatives should be implemented, particularly for experienced healthcare providers. This ensures that their initial assessment and resuscitation knowledge remains up-to-date and effective throughout their careers. On the other hand, the educational level of healthcare workers did not emerge as a significant predictor of knowledge of the initial assessment and resuscitation in this study. While formal education is important, this finding suggests that practical experience and on-the-job training play a more influential role in shaping healthcare providers' knowledge in this area. Therefore, a comprehensive approach to training that combines formal education with practical skill development is crucial. Healthcare institutions should focus on providing hands-on experiences, simulation training, and continuous learning opportunities to enhance resuscitation knowledge, regardless of the healthcare providers' educational qualifications. This approach ensures a well-rounded and adaptable training framework that aligns with the dynamic nature of emergency medical care. Declarations Ethics approval and consent to participate Ethical clearance was obtained from the Ghana Health Service and University of Cape Coast ethics review committees Written consent was obtained from all participants. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analyzed during the current study are not publicly but anonymized data are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests Funding This work received no funding support Authors' contributions Conceptualization, design, data collection and analysis, were done by C.A. and M.M. Preparation of the manuscript was done by C.A., M. M. and I.A.E. The final draft of the manuscript was read and authorised for publication by all authors. Acknowledgements The authors are most grateful to the nurses for their participation. References World Health Organization. WORLD HEALTH STATISTICS - MONITORING HEALTH FOR THE SDGs. World Heal Organ Published online 2016:1121. Blankson PK, Amoako JKA, Asah-Opoku K, Odei-Ansong F, Lartey MY. Epidemiology of injuries presenting to the accident centre of Korle-Bu Teaching Hospital, Ghana. BMC Emerg Med. 2019;19(1):1–6. 10.1186/s12873-019-0252-3 . World Health Organization. WORLD HEALTH STATISTICS. Luxembourg;2015. Garza-Reyes JA, Betsis IE, Kumar V, Radwan Al-Shboul MA. Lean readiness – the case of the European pharmaceutical manufacturing industry. Int J Prod Perform Manag. 2018;67(1):20–44. 10.1108/IJPPM-04-2016-0083 . Kullgren A, Stigson H, Rizzi M, Tingvall C. Fatalities in value chains—an attempt to classify road traffic crashes in accordance with the United Nations General Assembly resolution 74/299. Traffic Saf Res. 2023;5(Special issue). 10.55329/mcmr2018 . Pwavra JBP, Donkor ES, Ani-Amponsah M, Konlan KD. Practice of paediatric triage among nurses in human-resource constrained setting: A cross-sectional study in the Tamale metropolis of Ghana. Int J Afr Nurs Sci. 2023;18(November 2022):100516. 10.1016/j.ijans.2022.100516 . Uzamuhoza F. Nurses’ knowledge, attitude, and practice towards mass casualty preparedness at one referral hospital in Rwanda (Master’s thesis). The University of Rwanda, Rwanda. 2017. Al-Janabi MAM, Al-Ani BAJ. Assessment of Nurses' Knowledge of Cardiopulmonary Resuscitation at Al-Najaf City's Teaching Hospital. J Kufa Nurs Sci. 2014;4(1):1–10. Payal P, Sonu G, Prachi KGA. Management of polytrauma patients in emergency department: An experience of a tertiary care health institution of northern India. World J Emerg Med. 2013;4(1):15. 10.5847/wjem.j.issn.1920-8642.2013.01.003 . Elbaih A, Taha M, Elsakaya M, Elshemally A, Alshorbagy M. Assessment of cardiopulmonary resuscitation knowledge and experiences between emergency department nurses hospital pre and post basic life support training course, Egypt. Ann Med Res. 2019;26(10):2320. 10.5455/annalsmedres.2019.08.473 . Rajeswaran L, Ehlers VJ. Cardiopulmonary resuscitation knowledge and skills of registered nurses in Botswana. Curationis. 2014;37(1):1259. 10.4102/curationis.v37i1.1259 . Farouk N, El A, Original Article Egyptian Journal of Health Care., 2017 EJHC Vol. 8 No. 4 Nesreen Farouk Abd El Moaty, Magda Abd El Aziz, Neamat Allah Gomaa Ahmed. 2017;8(4). Mpotos N, Decaluwe K, Van Belleghem V, et al. Automated testing combined with automated retraining to improve CPR skill level in emergency nurses. Nurse Educ Pract. 2015;15(3):212–7. 10.1016/j.nepr.2014.11.012 . Bukiran A, Erdur B, Ozen M, Bozkurt AL. Retention of nurses’ knowledge after basic life support and advanced cardiac life support training at immediate 6 months, and 12-month post-training interval: A longitudinal study of nurses in Turkey. J Emerg Nurs: 2014;146–52. Saiboon MI, Qamruddin RM, Jaafar JM, Bakar A. A.Effectiveness of teaching automated external defibrillators use using a traditional classroom instruction versus self-instruction video in non-critical care nurses. Saudi Med J. 2016;37(4):429–35. https://doi.org/10.15537/smj.2016.4.14833 . Botes ML. An investigation into specialist practice nurses' knowledge of cardiopulmonary resuscitation guidelines in a tertiary hospital in Gauteng province, South Africa. South Afr J Crit Care. 2020;36(2):68–72. Saidam MN, Eljedi A. Y.Palestinian emergency nurses’ knowledge and role perception about disaster management: a need for immediate actions. Int J Community Med Public Health. 2020;7(3):831–6. http://dx.doi.org/10.18203/2394 6040.ijcmph20200930 . Alzanitan AI, Alzubaidi FK, Alnajjar TA, et al. An Overview on Diagnostic and Management Approach of Road Traffic Accidents in Emergency Department. Entomol Appl Sci Lett. 2021;8(3):74–9. McEvoy MD, Gupta R, Koepke EJ, Feldheiser A, Michard F, Levett D, Koepke E. Perioperative Quality Initiative consensus statement on postoperative blood pressure, risk and outcomes for elective surgery. Br J Anaesth. 2019;122(5):575–86. Makino N, Nakamura K, Ishikawa K, Sugawara M. Difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Open Journal of Nursing, 2019. 9(10), 1073–1087. Dio: 10.4236/ojn.2019.910079 . Mikita P, Trivett JA, Mcmahon M. Emergency nurse knowledge of emergency preparedness: An education gap analysis. Prehosp Disaster Med. 2017;32(1):144–5. 10.1017/S1049023 . Phukubye TA, Mbombi MO, Mothiba TM. Knowledge and practices of triage amongst nurses working in the emergency departments of rural hospitals in Limpopo province. Open Public Health J. 2019;12:439–48. 10.2174/1874944501912010439 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4022396","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":278852626,"identity":"6a8f4b7e-c1a2-4b5d-a493-f82ff69934e3","order_by":0,"name":"CHRISTIANA ASIEDU","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyUlEQVRIie3PoQ6CQBzH8T9zI6HUS9wrHDP6KBYsXsFKJmFxs+Jb+AjH/oHCyAQDzGAxEC1s/pFk4aA5d9/ttl+4z3YHYDL9aAps8IZp02ETyXoe6W/u4snEPeaNaiOU1xxroAF8G48TVoQiS0s8XIu9sGiAf1PjREAIuEyIVA4saICfBhriPmrsEpSiJ90kwgKBVoLBh9AAzjSEVU+RnUrpX+gv/XCEjrhneW9f0YavcmxqGh7XPewrRccRaoYY4vFsYjKZTH/eG/nGSF3iwr5pAAAAAElFTkSuQmCC","orcid":"","institution":"University of Cape Coast","correspondingAuthor":true,"prefix":"","firstName":"CHRISTIANA","middleName":"","lastName":"ASIEDU","suffix":""},{"id":278852627,"identity":"e1a22dfb-1160-4c87-b38f-a880aee66536","order_by":1,"name":"Monica Mensah","email":"","orcid":"","institution":"University of Cape Coast","correspondingAuthor":false,"prefix":"","firstName":"Monica","middleName":"","lastName":"Mensah","suffix":""},{"id":278852628,"identity":"06d91ea6-1c01-4647-b944-612fef3897b5","order_by":2,"name":"Isaac Aidoo Erzuah","email":"","orcid":"","institution":"University of Cape Coast","correspondingAuthor":false,"prefix":"","firstName":"Isaac","middleName":"Aidoo","lastName":"Erzuah","suffix":""}],"badges":[],"createdAt":"2024-03-06 23:51:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4022396/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4022396/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":77527751,"identity":"fc0750db-7808-4d02-9e0a-787c0e8965c8","added_by":"auto","created_at":"2025-03-02 15:01:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1084502,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4022396/v1/de398171-a696-4298-947c-7fc45ca4875e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eKnowledge of Accident and Emergency Regarding Triage, Initial Assessment of Patients and Resuscitation Among Nurses in Central Region of Ghana\u003c/p\u003e","fulltext":[{"header":"Background to the Study","content":"\u003cp\u003eInstances of traumatic physical injuries are diverse, arising from various causes such as road traffic accidents, contact sports, physical assaults, falls, and burns. Road traffic injuries, in particular, have been identified as a significant global cause of death, with a projected increase in fatalities by 2030\u003csup\u003e1\u003c/sup\u003e. Africa has experienced a consistent rise in road traffic deaths and injuries over the past three decades, with the WHO African Region reporting the highest rate of road traffic injury deaths in 2013. Ghana, in particular, has recorded high numbers of road fatalities and exhibited the highest fatality rate per 100,000 population compared to other countries\u003csup\u003e2,3\u003c/sup\u003e. Efforts have been made to align with the Sustainable Development Goals (SDGs), particularly SDG 3, which aims to reduce road traffic accident deaths and injuries globally. In Ghana, road accidents have resulted in a significant number of fatalities and injuries, with an increase in mortality rates observed over the years. The preparedness of healthcare facilities, particularly emergency departments, is crucial in effectively managing trauma patients. Frontline workers such as emergency department nurses play a vital role in the care of road traffic accident victims, and their preparedness is influenced by their training and periodic in-service training sessions. Facility managers also have a responsibility to ensure that necessary logistics are available to support the care of trauma patients. The burden of road traffic accidents on the healthcare system is evident, with a significant proportion of deaths and injuries attributed to these accidents. Families also face financial and psychological challenges resulting from severe injuries and coping with the consequences of road traffic accidents\u003csup\u003e2\u003c/sup\u003e. Despite comprehensive guidelines provided by the Ministry of Health, many healthcare institutions in Ghana deviate from these guidelines, resulting in inefficiencies in accident and emergency services. Shortcomings in emergency preparedness, insufficient supplies, and a shortage of skilled medical staff have been identified in healthcare facilities, highlighting the urgent need for improved readiness\u003csup\u003e4\u003c/sup\u003e. Proper management of trauma cases caused by road traffic accidents is essential in all health facilities. It is crucial for healthcare facilities to be adequately prepared to handle trauma cases to ensure optimal outcomes and save lives. Efforts aligned with the Sustainable Development Goals, particularly SDG 3, are necessary to reduce road traffic accident-related deaths and injuries\u003csup\u003e5\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study aims to fill the research gap on emergency preparedness, particularly in trauma management, and has the potential to generate interest in improving the readiness of healthcare facilities to manage the challenges posed by road traffic accidents. The findings have the potential to catalyze state interest in fulfilling the responsibility of ensuring healthcare facilities are well-prepared to manage the challenges posed by road traffic accidents\u003csup\u003e2\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResearch Question.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat is the knowledge level of the nurses working in the Accident and Emergency on how to care for trauma victims?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat are the socio-demographic factors influencing the knowledge level of nurses working in the accident and emergency regarding the initial assessment of patients and resuscitation.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"RESEARCH METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eResearch Design\u003c/h2\u003e \u003cp\u003eThe research design employed in this study is a quantitative descriptive cross-sectional design. The quantitative approach is utilized to gather numeric data and analyze it using statistical methods. In this study, the focus is on obtaining information about the knowledge level of nurses, which can be quantified and analyzed to provide objective insights. The descriptive aspect of the design aims to provide a comprehensive overview of the current knowledge level among the target population. By collecting data at a specific point in time, the researchers can capture a snapshot of the knowledge level of the nurses in the A\u0026amp;E department. This allows for an understanding of the prevailing knowledge status within the population at that particular moment. The cross-sectional design enables the researchers to collect data from a sample of participants at a single time point. This approach is practical and efficient, as it does not require following participants over an extended period. It allows for a relatively quick assessment of the knowledge level among the target population, providing valuable information for decision-making and identifying areas for improvement. By employing a quantitative descriptive cross-sectional design, this study aims to provide a quantitative overview of the knowledge of nurses in the A\u0026amp;E department regarding triage, initial patient assessment, and resuscitation. The design allows for the collection of data at a single time point, providing insights into the current knowledge level among the target population. These findings can inform strategies to enhance training, education, and professional development programs for nurses, ultimately improving the quality of care in the A\u0026amp;E department.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003ePopulation\u003c/h2\u003e \u003cp\u003eThe population of interest for this study is composed of nurses who are actively working in the Accident and Emergency (A\u0026amp;E) departments of healthcare facilities located in the Central Region of Ghana. This includes nurses from various healthcare facilities that have dedicated accident and emergency units. By focusing on nurses in the A\u0026amp;E departments, the study aims to gather insights specifically from healthcare professionals who are directly involved in the critical care and initial assessment of patients in emergency situations. These nurses play a crucial role in providing immediate and life-saving interventions, triaging patients, and conducting initial assessments. The inclusion of nurses from healthcare facilities with accident and emergency units ensures that the study captures a diverse range of experiences and knowledge levels. It allows for a comprehensive understanding of the factors influencing the knowledge and practices of nurses in different healthcare settings within the Central Region of Ghana. By targeting this specific population, the study can provide valuable insights into the knowledge gaps, training needs, and areas for improvement among nurses in the A\u0026amp;E departments. The findings can inform healthcare policies, educational programs, and professional development initiatives that aim to enhance the quality of care provided in emergency settings in the Central Region of Ghana.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy Area\u003c/h2\u003e \u003cp\u003eThe study area for this research project was the Central Region of Ghana, specifically focusing on the emergency care services provided by Kasoa, Winneba, and Cape Coast Teaching Hospitals. The Central Region is located in southern Ghana and is known for its historical significance and coastal attractions. It is one of the sixteen administrative regions of Ghana and has a diverse population. Kasoa, Winneba, and Cape Coast Teaching Hospitals are significant healthcare facilities in the region, offering specialized emergency care services to patients. These hospitals play a crucial role in providing medical attention and treatment to individuals who require immediate medical assistance due to accidents, injuries, or severe illnesses. They have dedicated Accident and Emergency (A\u0026amp;E) departments where nurses and other healthcare professionals work together to provide timely and effective care. The Central Region's healthcare infrastructure and facilities make it an appropriate setting for studying the knowledge of nurses in the A\u0026amp;E department regarding triage, initial patient assessment, and resuscitation. By conducting the research in this region, the study aimed to gain insights into the preparedness and competency of nurses in delivering emergency care services in a specific geographical context.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSampling Procedure\u003c/h2\u003e \u003cp\u003eThe sampling procedure for this study involved a census approach, where all eligible nurses operating in the Accident and Emergency (A\u0026amp;E) departments of the selected hospitals were included in the study. The total number of nurses in these departments was 82. The decision to use a census approach was made due to the relatively small size of the nursing population in the A\u0026amp;E departments. By including all eligible participants, this approach ensured that there was no sampling error and that the study captured the perspectives and experiences of every nurse working in these departments. The use of a census approach eliminated the need for sampling techniques that could introduce potential biases or errors in participant selection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData Collection Instrument\u003c/h2\u003e \u003cp\u003eTo gather data on the knowledge of nurses regarding triage, initial patient assessment, and resuscitation, a structured questionnaire was utilized. The questionnaire incorporated a combination of closed-ended and open-ended questions to capture quantitative data. It was developed based on pertinent literature and established guidelines that outline best practices in emergency care. The questionnaire consisted of two sections, labeled as Section A and Section B. Section A focused on gathering information specifically related to nurses' knowledge concerning triage, initial patient assessment, and resuscitation. On the other hand, Section B aimed to explore socio-demographic factors that might influence the level of knowledge among nurses working in the accident and emergency department regarding the initial assessment of patients and resuscitation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Collection Procedure\u003c/h2\u003e \u003cp\u003eThe data collection process included distributing questionnaires to the nurses working in the Accident and Emergency (A\u0026amp;E) departments. To obtain permission to collect background information, an introductory letter was obtained and presented to the three selected healthcare facilities. Ethical clearance was sought from the Cape Coast Teaching Hospital (CCTH) and the Ethics Review Committee (ERC) of the Ghana Health Service (GHS) to conduct the data collection at Winneba Trauma and Specialist Hospital, Kasoa Polyclinic, and CCTH. The questionnaires were designed to be self-administered by the participants, but the researchers also provided assistance and facilitation as needed, depending on the preference and convenience of the participants.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData Processing and Analysis\u003c/h2\u003e \u003cp\u003eThe collected data is carefully reviewed and checked for any errors, inconsistencies, or missing values. Any necessary corrections or adjustments were made to ensure the accuracy and integrity of the data. The data collected were coded and entered into SPSS version 26 for analysis. This process involves assigning numerical codes or labels to different response options to facilitate quantitative analysis. Descriptive and inferential statistics were used to analysis the data. Frequency tables and percentages were generated to describe the distribution of responses on knowledge. Regression analysis was done to assess the socio-demographic factors influencing the knowledge level of nurses working in the accident and emergency regarding the initial assessment of patients and resuscitation. The logistic regression model enabled the researchers to identify factors or variables that are associated with the outcome of interest and quantify their impact.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003e The study underwent a thorough ethical approval process, starting with obtaining ethical clearance from the Ghana Health Service (GHS), Central Regional Health Directorate (CR/G-263/608), and the Cape Coast Teaching Hospital ethical review committee. Additionally, approval was obtained from the GHS Ethics Review Committee (GHS-ERC: 020/02/23) in order to conduct the study. The researcher strictly adhered to all necessary ethical standards and conducted the study within the established guidelines set forth by the review boards. Informed consent was obtained from each participant, ensuring their voluntary participation, as well as guaranteeing confidentiality and anonymity. Participants were provided with detailed information regarding the purpose of the study, their rights to withdraw at any time, and the utilization of their data solely for research purposes. All identifiable information was treated with utmost confidentiality, and the data was reported in aggregate form to maintain anonymity.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge on triaging, initial assessment of patients and resuscitation including cardiopulmonary resuscitation\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the findings on the knowledge levels of triaging, initial patient assessment, and resuscitation, specifically cardiopulmonary resuscitation (CPR). All 65 nurses (100%) in the study agreed with the defined concept of triage. A significant majority of 87.7% (n\u0026thinsp;=\u0026thinsp;57) acknowledged the triage color codes as red, orange, yellow, green, and black. Regarding the versions of the triage scale, 100% (n\u0026thinsp;=\u0026thinsp;65) of the nurses recognized the existence of three versions for adults, children, and infants, and 96.9% (n\u0026thinsp;=\u0026thinsp;63) identified the two components of the triage scale as the triage early warning score and the discriminator list. Concerning the triage early warning score (TEWS), 92.3% (n\u0026thinsp;=\u0026thinsp;60) of the nurses agreed that the total score is derived from observing the basic vital signs of the patient. In terms of basic resuscitation operations following the 2020 American Heart Association guidelines, 47.7% (n\u0026thinsp;=\u0026thinsp;31) of the nurses indicated that the algorithm includes clearing the airway, checking breathing, and assessing the pulse. When encountering an unconscious person on the road, 73.8% (n\u0026thinsp;=\u0026thinsp;48) of the nurses expressed their priority as ensuring both their safety and that of the unconscious person. Regarding the correct hand placement for chest compression in an adult, 49.2% (n\u0026thinsp;=\u0026thinsp;32) identified the center of the chest. Additionally, 64.6% (n\u0026thinsp;=\u0026thinsp;42) recognized the recommended compression rate as 120 compressions per minute. Concerning the algorithm for basic resuscitation in an adult, 49.25% (n\u0026thinsp;=\u0026thinsp;32) highlighted ensuring safety, calling an ambulance, checking for a pulse, and initiating CPR. When checking the pulse on an adult, 72.3% (n\u0026thinsp;=\u0026thinsp;47) of the nurses correctly identified the carotid artery. Regarding the chest compression-to-breath ratio in adults, 81.5% (n\u0026thinsp;=\u0026thinsp;53) agreed on 30 compressions followed by 2 rescue breaths, and 87.7% (n\u0026thinsp;=\u0026thinsp;57) acknowledged the need to assess the victim's condition every 5 cycles (30 chest compressions and 2 rescue breaths) during basic resuscitation. Regarding the use of an AED defibrillator, 72.3% (n\u0026thinsp;=\u0026thinsp;47) of the nurses agreed with the correct steps: switching on the AED, applying the electrodes, analyzing the rhythm, ensuring no one touches the victim, and delivering a discharge. Moreover, 76.9% (n\u0026thinsp;=\u0026thinsp;50) of the nurses affirmed that fluid restriction is crucial in the initial resuscitation of a trauma patient with a suspected head injury. Similarly, 75.4% (n\u0026thinsp;=\u0026thinsp;49) agreed on avoiding Dextrose Normal Saline in suspected head injury patients.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge on triaging, initial assessment of patients and resuscitation including cardiopulmonary resuscitation\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eName of facility\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eCCTH\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTSH\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eKASOA\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriage means \u0026ldquo;to sort out\u0026rdquo; the sick or injured people according to the severity of their sickness or injury in order to ensure that medical and nursing staff and facilities are used most efficiently; assessment of injury intensity and the immediacy or urgency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e83(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUsing the SATS protocol, the triage colour codes include red, orange, yellow, green and black.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e43(91.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9(90.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e57(87.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e4(8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7(10.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThere are three versions of the triage scale namely adults, children and infants.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e47(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e65(100.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe two parts of the triage scale are the Triage Early Warning Score (TEWS) and the Discriminator list.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e46(97.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9(90.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63(96.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0()\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe total score for the triage early warning score (TEWS) is generated by observing the basic vital signs of the patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e42(89.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60(92.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI do not agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3(6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3(4.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe 2020 American Heart Association (AHA) guidelines concerning basic resuscitation operations recommend the following algorithm of procedure.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompress the chest, clear the airway, check the breathing.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3(6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7(70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11(16.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClear the airway, check the breathing, check the pulse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e26(55.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(250)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31(47.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCheck the breathing, clear the airway, check the pulse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e18(38.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23(35.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYou find your friend in the middle of the road- he is unconscious, does not react, and does not breathe properly. What do you do first?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI will clear his airways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e5(10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9(13.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI will make sure we are both safe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e36(76.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7(70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48(73.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBegin to give him chest compressions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e6(12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8(12.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat is the correct place for the compression of the chest in an adult?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe left side of the chest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e10(21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15(23.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe right side of the chest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe centre of the chest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e25(53.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e32(49.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe xiphoid process\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e12(25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17(26.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe correct frequency of chest compressions during CPR for adults and children is\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt least 100 compressions per minute.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11(16.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 100 compressions per minute.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e5(10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8(12.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e80 compressions per minute\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4(6.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e120 compressions per minute\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e38(80.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42(64.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhich of the following is the algorithm for basic resuscitation in an adult?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMake sure both you and the victim are safe, give two rescue breaths, perform defibrillation, and begin CPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4(6.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMake sure both you and the victim is safe, call an ambulance, check for a pulse, begin CPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e19(40.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9(90.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e32(49.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCheck for a pulse, give two rescue breaths, make sure both you and the victim is safe, perform defibrillation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMake sure both you and victim are safe, begin CPR, give two rescue breaths, perform defibrillation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e24(51.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27(41.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWe check for a pulse in an adult on the \u0026hellip;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCarotid artery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e32(68.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(87.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8(80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47(72.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachial artery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e6(12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8(12.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemoral artery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e7(14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7(10.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTemporal artery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3(4.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe ratio of chest compressions to breaths during CPR in adults is\u0026hellip;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15:2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e4(8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6(9.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15:1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30:1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4(6.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30:2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e41(87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e53(81.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuring the basic resuscitation procedure, the condition of the victim should be assessed:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery minute\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e4(8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6(9.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery 5 cycles (30 compressions and 2 recue breaths)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e42(89.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10(100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e57(87.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen the victim starts to breathe incorrectly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBefore the attachment of the AED electrodes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhich of the following is the correct sequence of the use of AED defibrillator?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSwitch on the AED, apply the electrodes, discharge, and analyse the rhythm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e4(8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6(9.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSwitch on the AED, apply the electrodes, analyse the rhythm, make sure no one touches the victim, and discharge.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e39(83.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6(60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47(72.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eApply the electrodes, check the pulse, discharge, and analyse the rhythm.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4(6.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCheck the pulse, apply the electrodes, analyse the rhythm, and discharge.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3(6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8(12.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn initial resuscitation of a trauma patient with a suspected Head injury, fluids should be restricted as much as possible\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e34(72.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9(90.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50(76.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFalse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e13(27.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15(23.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhich of these fluids is not to be given to a suspected head injury patient?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDextrose Normal Saline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e38(80.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6(60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49(75.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal Saline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e7(14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10(15.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRingers Lactate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4(6.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eSource: Field data\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eAssociation between knowledge on the initial assessment of patients and resuscitation and demographic factors\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e displays the outcomes of the binary logistic regression analysis, which examined the relationship between knowledge of initial patient assessment and resuscitation and various demographic factors. The goodness-of-fit test, using Hosmer and Lemeshow's chi-square test, yielded a non-significant result (p\u0026thinsp;=\u0026thinsp;0.839) with a value of 2.753 and 6 degrees of freedom. This suggests that the logistic regression model fits the data well. The Nagelkerke R Square, indicating the proportion of explained variance by the model, was 0.539, representing a moderate level of predictive accuracy. These results indicate that the logistic regression model adequately fits the data, and the included variables significantly contribute to the prediction of knowledge on the initial assessment of patients and resuscitation among the participants in the study. In terms of demographic factors, female healthcare providers exhibited significantly higher odds of possessing adequate resuscitation knowledge (AOR\u0026thinsp;=\u0026thinsp;23.631, p\u0026thinsp;=\u0026thinsp;0.000; 95% CI: 2.88\u0026ndash;193.68). Regarding length of stay at the facility, respondents with 2\u0026ndash;3 years (AOR\u0026thinsp;=\u0026thinsp;0.137, p\u0026thinsp;=\u0026thinsp;0.034; 95% CI: 0.022\u0026ndash;0.859), 4\u0026ndash;5 years (AOR\u0026thinsp;=\u0026thinsp;0.045, p\u0026thinsp;=\u0026thinsp;0.013, 95% CI: 0.004\u0026ndash;0.526), and over 5 years (AOR\u0026thinsp;=\u0026thinsp;0.022, p\u0026thinsp;=\u0026thinsp;0.005; 95% CI: 0.002\u0026ndash;0.317) demonstrated significantly lower odds of having sufficient knowledge on the initial patient assessment and resuscitation compared to those with 0\u0026ndash;1 year. However, the education level of healthcare workers was not a significant predictor of knowledge of the initial patient assessment and resuscitation in the regression analysis.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBinary logistic regression of the association between knowledge on the initial assessment of patients and resuscitation and demographic factors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e95% Confidence Interval\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.681\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.631***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e193.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of stay at facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-1.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.137*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.859\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-3.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.045*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.526\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-3.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.809\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.022**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.317\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCertificate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDegree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-1.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMasters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-19.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHosmer and Lemeshow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003e2.753 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u0026thinsp;=\u0026thinsp;0.839\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNagelkerke R Square\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003e0.539\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003e***\u003c/b\u003e p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001; ** p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.01; * p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge on triage, initial assessment of patient and resuscitation including CPR\u003c/h2\u003e \u003cp\u003eAll 65 participants unanimously agreed on the definition of triage, indicating a shared understanding of the concept. However, only 57 nurses (87.7%) recognized the triage color codes as red, orange, yellow, green, and black, which demonstrates a significant understanding of the SATS protocol. All nurses (n\u0026thinsp;=\u0026thinsp;65) acknowledged the existence of three versions of the triage scale for adults, children, and infants. However, only 63 nurses (96.9%) agreed that the triage scale consists of two parts, namely the triage early warning score and the discriminator list. Furthermore, 60 nurses (92.3%) agreed that the total score for the triage early warning score is derived from observing the basic vital signs of a patient. Overall, the majority of respondents demonstrated proficiency in triage, as indicated by the cumulative score for CCTH, KPC, and TSH, suggesting that participants had sufficient knowledge (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) in triage. These findings align with previous studies by\u003csup\u003e6,7\u003c/sup\u003e, which also found that nurses generally possess knowledge in triage. However, these findings contrast with the results of\u003csup\u003e8\u003c/sup\u003e, which concluded that nurses had inadequate knowledge in triage. The difference in results may be attributed to the introduction of the NURSMID protocol, which enhances knowledge and the effective use of the triage tool in many emergency departments (EDs) in Ghana.\u003c/p\u003e \u003cp\u003eThe study revealed a diverse range of educational qualifications among the nurses, ranging from diplomas to master's degrees, indicating varied academic backgrounds within the emergency department. While the majority of nurses hold diplomas, the presence of degree holders and those with advanced qualifications suggests a mix of educational experiences. This diversity in educational background may have contributed to their ability to appropriately triage patients since triage workshops often involve in-service training and practical sessions that benefit from a certain level of formal education for understanding and implementation. The diverse mix of nurses with varied skills and perspectives can contribute to a well-rounded team, which is essential in patient management, particularly during critical situations such as road traffic accidents. This finding is positive, as proper triaging of patients enables timely management of polytrauma patients\u003csup\u003e8,9\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e Less than half of the nurses (n\u0026thinsp;=\u0026thinsp;31) demonstrated knowledge of the 2020 American Heart Association (AHA) guidelines, specifically the algorithm for clearing the airway, checking breathing, and checking the pulse. The responses indicated that a significant number of emergency department nurses were not familiar with the current AHA recommendations. This finding is consistent with a previous study by\u003csup\u003e9\u003c/sup\u003e, which found that a considerable proportion of respondents lacked knowledge of AHA guidelines. The lack of comprehensive staff training, often due to financial constraints in some facilities, as well as limited personal funds for participating in courses, may contribute to this knowledge gap. Currently, a single course on Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) can cost between 2,500 to 3,500 Ghana Cedis. The limited awareness of the 2020 AHA guidelines among emergency department nurses, combined with financial limitations for training courses, can impede the effective implementation of updated life support protocols and compromise patient care in critical situations. This knowledge gap emphasizes the importance of financial support and organizational investment in ongoing training for emergency department nurses to ensure they stay updated with the latest life support guidelines. Addressing these constraints is crucial for improving patient outcomes and maintaining a high standard of care in emergency settings.\u003c/p\u003e \u003cp\u003eA majority of nurses (n\u0026thinsp;=\u0026thinsp;48) expressed that their priority would be to ensure both their own safety and the safety of an unconscious person before initiating CPR. However, 17 nurses lacked knowledge about when to start CPR, which can be dangerous and potentially decrease the survival rate of cardiac arrest patients. In terms of the correct hand placement for chest compressions in adults, 32 nurses correctly identified the center of the chest, while the remaining 33 nurses chose incorrect sites for compression. This suggests that more than half of the emergency department nurses lack knowledge about the appropriate hand placement during chest compressions. Proper hand placement is crucial for the effectiveness of CPR, and an incorrect approach can significantly impact the survival rate of cardiac arrest patients. This finding aligns with previous studies that emphasize the importance of continuous training and periodic refresher courses in CPR\u003csup\u003e10,11\u003c/sup\u003e. The significant number of emergency department nurses with inconsistent knowledge about the initiation and correct technique of CPR highlights the need for targeted training programs. Improved education on CPR protocols is essential to enhance nurses' preparedness and competence, ultimately leading to better outcomes for cardiac arrest patients in emergency settings.\u003c/p\u003e \u003cp\u003eOnly 11 respondents correctly indicated that the recommended compression frequency during CPR for adults and children should be at least 100 compressions per minute, while the majority of nurses (42) believed it should be 120 compressions per minute. This finding is noteworthy across all three facilities, as a large portion of respondents selected the incorrect response. Nurses with inadequate knowledge of chest compressions may produce suboptimal results, leading to lower survival rates for cardiac arrest patients. The American Heart Association (AHA) recommends that, during CPR, compressions should be firm and fast but at least 100 compressions per minute to allow for complete chest recoil and ensure sufficient blood flow to vital organs like the brain. Chest compressions that are too rapid can undermine this objective. This result aligns with findings from pre-test surveys conducted by\u003csup\u003e11\u0026thinsp;\u0026minus;\u0026thinsp;10\u003c/sup\u003e where the majority of respondents provided incorrect responses regarding the frequency of chest compressions in CPR, indicating a lack of knowledge in CPR. It is also consistent with other studies that have revealed concerning knowledge gaps and skill deficiencies among nurses\u003csup\u003e10,11\u003c/sup\u003e. The prevalent misconception among nurses regarding the recommended compression frequency in CPR underscores the urgent need for targeted training interventions. Sufficient education on the correct compression frequency is crucial for optimizing the effectiveness of CPR and improving outcomes for cardiac arrest patients in emergency situations.\u003c/p\u003e \u003cp\u003eLess than half of the nurses (n\u0026thinsp;=\u0026thinsp;27) indicated that the correct algorithm for basic resuscitation in adults involves ensuring both their own safety and the safety of the victim, initiating CPR, giving two rescue breaths, and performing defibrillation. This result reflects a lack of knowledge among nurses regarding the algorithm for basic resuscitation in adults, as more than half of the respondents provided incorrect responses. This knowledge gap is significant across all three facilities. The lack of understanding in the algorithm may be attributed to a lack of in-service training for nurses in Basic Life Support (BLS), the associated training costs, and poor retention of BLS knowledge. This finding aligns with the pre-test and 6-month post-test results reported by\u003csup\u003e11\u003c/sup\u003e which indicated poor knowledge of the basic resuscitation algorithm and BLS (CPR) among respondents. Additionally, these studies noted a decrease in CPR retention after 6 months of training\u003csup\u003e12\u0026ndash;15\u003c/sup\u003e. They also emphasized that nurses' knowledge was influenced by their motivation, attitude, and willingness to perform BLS or participate in drills. The significant knowledge gap among nurses regarding the algorithm for basic resuscitation in adults underscores the urgent need for ongoing and reinforced training programs. Insufficient education in BLS may impede nurses' ability to respond effectively in emergency situations, highlighting the importance of consistent and accessible training\u003csup\u003e10,11\u003c/sup\u003e to enhance their skills and retain knowledge. The majority of nurses (n\u0026thinsp;=\u0026thinsp;47) correctly identified the carotid artery as the location to check for the pulse in adults. This knowledge is crucial for promptly initiating chest compressions in trauma patients who experience cardiac arrest. Before starting chest compressions, nurses need to determine if the patient has a pulse by feeling the carotid pulse. This finding is consistent with a study by\u003csup\u003e16\u003c/sup\u003e, where respondents demonstrated the ability to recognize when to initiate CPR. This critical step is essential for determining the survival of cardiac arrest victims.\u003c/p\u003e \u003cp\u003eThe majority of respondents (n\u0026thinsp;=\u0026thinsp;53) correctly identified the recommended chest compression to breath ratio in adults as 30 compressions to 2 breaths. This finding differs from the results of a previous survey by\u003csup\u003e11\u003c/sup\u003e, where most respondents in a pre-test were unable to select the correct ratio. Proficiency in this skill is crucial during CPR to ensure adequate ventilation for a person experiencing cardiac arrest. The fact that the majority of respondents correctly identified the chest compression to breath ratio (30:2) indicates improved proficiency in this important CPR skill, which ensures effective ventilation during resuscitation efforts. This enhanced competence is essential for improving the overall quality of life-saving interventions and enhancing patient outcomes in emergency situations.\u003c/p\u003e \u003cp\u003eA significant number of respondents (n\u0026thinsp;=\u0026thinsp;57) agreed that the condition of the victim should be assessed every 5 cycles (30 chest compressions and 2 breaths being one cycle) during basic resuscitation. Ongoing assessment is vital for evaluating the effectiveness of any procedure. Knowing when to assess the condition of the patient being resuscitated is crucial for effective management. Assessing an unconscious patient during CPR informs the responders whether to continue or not, which directly impacts the patient's chances of survival. This finding aligns with a study by\u003csup\u003e11,16\u003c/sup\u003e, which suggested that promptly assessing the condition of an unconscious victim and initiating CPR may improve survival rates and reduce in-hospital mortality. The agreement among a significant number of respondents that the victim's condition should be assessed every 5 cycles (5x 30 chest compressions and 2 breaths) during basic resuscitation underscores the importance of ongoing assessment in evaluating the effectiveness of the procedure. This knowledge is crucial for making informed decisions during CPR, directly influencing the patient's chances of survival. The majority of respondents (n\u0026thinsp;=\u0026thinsp;47) agreed on the correct sequence for using an Automated External Defibrillator (AED): switching on the AED, applying the electrodes, analyzing the rhythm, ensuring no one touches the victim, and then delivering a shock. However, a few respondents (n\u0026thinsp;=\u0026thinsp;4) mentioned that the correct sequence was applying the electrodes, analyzing the rhythm, and delivering a shock. The significance of this finding is observed in the TSH, where four respondents chose the incorrect sequence. This discrepancy may be attributed to the unavailability or infrequent use of AEDs, leading to a lack of proficiency in their application. This result corresponds with the findings of \u003csup\u003e11\u003c/sup\u003e, where deficient knowledge in AED use was linked to limited availability and inadequate training. It is also consistent with studies that attribute deficiencies in nurses' knowledge of disaster management to both institutional factors and individual nurse competencies \u003csup\u003e7,17\u003c/sup\u003e. Early defibrillation significantly increases survival rates for cardiac arrest and polytrauma patients. To enhance competence in AED use, efforts should be made to make AEDs readily available and provide regular training. The practical implication emphasizes the need for increased accessibility to AEDs and regular training to enhance nurses' competence in deploying this life-saving technology, particularly considering the significant impact of early defibrillation on survival rates for cardiac arrest and polytrauma patients. Regarding the initial resuscitation of a trauma patient with a suspected head injury, a majority of the respondents (n\u0026thinsp;=\u0026thinsp;50) agreed that fluids should be restricted as much as possible. This approach is in line with the standard practice of preventing an increase in intracranial pressure. In situations where fluid resuscitation is necessary due to significant blood loss, the recommended ratio is 1:1:1 (plasma: platelets: packed red blood cells), as mentioned in \u003csup\u003e18\u003c/sup\u003e It has also been established that prolonged infusion of crystalloids can have a negative impact on survival rates by causing coagulopathies, as noted in \u003csup\u003e19\u003c/sup\u003e. However, in the context of the CCTH, 27.6% of the respondents (13 nurses) provided incorrect responses, indicating a potential knowledge gap. This is concerning because nurses working in the emergency setting are expected to have a basic understanding and demonstrate proficiency in fluid resuscitation to avoid worsening the patient's condition. This highlights the need for continuous in-service training on the management of critically ill patients.\u003c/p\u003e \u003cp\u003eThe majority of respondents (n\u0026thinsp;=\u0026thinsp;49) agreed that Dextrose Normal Saline should be avoided in suspected head injury patients. This is crucial because the appropriate choice of fluid is a glucose-free crystalloid to prevent fluid shift into the brain, which could increase intracranial pressure. If blood products are needed, they should be administered according to the 1:1:1 ratio (plasma: platelets: packed red blood cells), as mentioned in\u003csup\u003e19\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOverall, the knowledge score obtained (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) indicates that respondents from CCTH, TSH, and KPC have moderately adequate knowledge in the initial assessment and resuscitation of patients, including CPR. This finding is consistent with a study by\u003csup\u003e11\u003c/sup\u003e and contradicts the findings of \u003csup\u003e7,20\u0026ndash;22\u003c/sup\u003e which reported inadequate knowledge and skills among nurses caring for trauma patients. A binary logistic regression analysis was conducted to examine the relationship between socio-demographic factors and healthcare providers' knowledge of the initial patient assessment and resuscitation. The results revealed an interesting association between gender and knowledge, suggesting potential gender-related disparities in this critical area. Female healthcare providers had significantly higher odds of possessing adequate assessment and resuscitation knowledge compared to their male counterparts. This finding may be attributed to differences in training experiences, communication styles, or access to educational resources between male and female healthcare providers. To address these disparities, tailored training programs that consider gender-specific learning preferences and experiences should be developed. By promoting more equitable distribution of resuscitation knowledge, healthcare providers can be better prepared to handle emergency situations. The length of stay at the healthcare facility was found to be a significant factor influencing healthcare providers' initial assessment and resuscitation knowledge. Respondents with longer tenures, specifically those with 2\u0026ndash;3 years, 4\u0026ndash;5 years, and over 5 years of experience, demonstrated significantly lower odds of having sufficient knowledge compared to those with 0\u0026ndash;1 year of experience. This finding contradicts previous research suggesting that longer time spent in facilities improves CPR knowledge. It is possible that healthcare providers with longer tenures may become complacent or receive less emphasis on continuous training. To address this issue, regular refresher courses and continuous professional development initiatives should be implemented, particularly for experienced healthcare providers. This ensures that their initial assessment and resuscitation knowledge remains up-to-date and effective throughout their careers.\u003c/p\u003e \u003cp\u003eOn the other hand, the educational level of healthcare workers did not emerge as a significant predictor of knowledge of the initial assessment and resuscitation in this study. While formal education is important, this finding suggests that practical experience and on-the-job training play a more influential role in shaping healthcare providers' knowledge in this area. Therefore, a comprehensive approach to training that combines formal education with practical skill development is crucial. Healthcare institutions should focus on providing hands-on experiences, simulation training, and continuous learning opportunities to enhance resuscitation knowledge, regardless of the healthcare providers' educational qualifications. This approach ensures a well-rounded and adaptable training framework that aligns with the dynamic nature of emergency medical care.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e Ethical clearance was obtained from the Ghana Health Service and University of Cape Coast ethics review committees Written consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly but anonymized data are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work received no funding support\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization, design, data collection and analysis, were done by C.A. and M.M. Preparation of the manuscript was done by C.A., M. M. and I.A.E. The final draft of the manuscript was read and authorised for publication by all authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are most grateful to the nurses for their participation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. WORLD HEALTH STATISTICS - MONITORING HEALTH FOR THE SDGs. World Heal Organ Published online 2016:1121.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBlankson PK, Amoako JKA, Asah-Opoku K, Odei-Ansong F, Lartey MY. Epidemiology of injuries presenting to the accident centre of Korle-Bu Teaching Hospital, Ghana. 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Open Public Health J. 2019;12:439\u0026ndash;48. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2174/1874944501912010439\u003c/span\u003e\u003cspan address=\"10.2174/1874944501912010439\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"emergency preparedness, emergency departments, knowledge, nurses, road traffic accidents, trauma management, triaging","lastPublishedDoi":"10.21203/rs.3.rs-4022396/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4022396/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eRoad traffic accidents represent a global health challenge, with approximately 1.3\u0026nbsp;million fatalities annually, and a staggering 93% of these incidents occurring in low- and middle-income countries.\u003c/p\u003e\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThis research focuses on evaluating the level of emergency preparedness in trauma management in the Central Region of Ghana, considering the high prevalence of road traffic accidents in low- and middle-income countries.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe study utilized a quantitative research design, specifically a cross-sectional survey, to collect data from three public health facilities in the Central Region. All 65 nurses working in the emergency departments of these hospitals were included in the study using a census approach. A structured questionnaire consisting of checklists, true/false items, and multiple-choice questions (MCQs) was used for data collection. The data was analyzed using descriptive statistics and binary logistic regression.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe results revealed that nurses in the Accident and Emergency department had moderate knowledge in the initial assessment and resuscitation of patients, including CPR. However, the study also identified gaps in CPR knowledge among nurses working in the emergency department.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe findings highlight the need for further study and training in triaging for nurses, as well as regular refresher courses and hands-on training opportunities to enhance their skills.\u003c/p\u003e","manuscriptTitle":"Knowledge of Accident and Emergency Regarding Triage, Initial Assessment of Patients and Resuscitation Among Nurses in Central Region of Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-14 11:57:16","doi":"10.21203/rs.3.rs-4022396/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d4b71723-b673-4cfe-a56b-ead998b4d9e1","owner":[],"postedDate":"March 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-03-02T14:53:26+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-14 11:57:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4022396","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4022396","identity":"rs-4022396","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}