EVALUATION OF KNOWLEDGE OF EMERGENCY PHYSICIANS REGARDING ASSESSMENT AND INITIAL MANAGEMENT OF HAND INJURIES

Introduction: We encounter acute traumatic injuries of the hand and wrist very often in the emergency department, ranging from simple soft tissue laceration to life threatening injuries.So for the optimum treatment of any serious hand injury depends upon early recognition and appropriate referral. This can only be achieved with a thorough understanding about the evaluation and management of hand injuries by the Emergency physicians. Aims and Objectives: To assess the knowledge on initial management of common hand injuries presenting to emergency department. To understand the importance of evaluation and management of hand injuries and for prompt referral and further expert management (surgical). Limitations of the Study: The study populations are being tested upon a confined set of questionnaire and it may not cover the entire range of questions. Physicians will be selected randomly, which may not represent ideal demographic scenario of physicians in our country. As some of the questionnaires are being distributed by e-mails, there is a high possibility of low response. Methodology: Over a 12-month period of all doctors working in the department of emergency and trauma care, working in the private and govt. sectors of the state of West Bengal, were asked to solve the questionnaire based on clinical scenarios of hand injuries which included evaluation of the same and the primary management .The clinical experience of these doctors varied from post graduate trainees to senior consultants in the field of emergency and trauma care. All replies were assessed by one individual. Results and Discussion: In our study we found that 25(16.7%) emergency physicians were ≤30 years old, 61(40.7%) emergency physicians were 31-40 years old and 64(42.7%) emergency physicians were 41-50 years old.43 (28.7%) emergency physicians were Female and 107(71.3%) emergency physicians were Male. Questions on the Haemorrhage Control, Fight Bites, Burns, Nerve Examination, Fractures, Tendon Injury, Radiology and local anaesthesia were answered correctly by most of the emergency physicians, but there was significant knowledge deficit in the questions based on Amputation , Nail bed injury and High pressure injection injury. Overall ,our study shows that there is significant knowledge deficit amongst the emergency physicians ,out of the twenty questions on various hand injuries presenting to ED,10(6.7%) emergency physicians had 100% correct answers, 35(23.3%) emergency physicians had 50% correct answers and 105(70.0%) emergency physicians had below 50% correct answers.Hence this study showed significant knowledge deficit in assessment and management of hand injuries amongst Emergency Physicians.