TCYHTH&B s6 5 - 2014 17
DANH GIA KIEN ThCfC SO CUTU BAN DAU KHI B\ BONG CUA NGl/dl DAN VA MQT SO YEU TO LIEN QUAN TAI XA QUANG Bj, CHl/dNG MY, HA NOI NAM 2014
Nguyln Thj Mai Phyang, Trjnh Thj Khanh Trd, Nguydn Thj KIm Ydn, Trdn Thj My Hgnh, Nguydn Thanh Luan Tn/dng D^i hpc Y ti cdng cdng T6M TAT
Nghidn ciru djnh luvng qua phdng vin 200 ngudi din t$i xa Quing Bi, Chuung Mf. Hi Ndi.
Kit qui cho thiy cd 40,5% ngu-di din cd kiin thijc dat vi sa ciru khi bj bdng nhidt, 16% ngifdi dugc hdi cd kiin thirc d^t vi sa cO-u bdng didn, trong khi ty' id cd kiin thuv dgt vi sa ciru bdng hda chit rit ding lo ng^i, chf d$t 8,5%; Dinh gii chung cho thiy chf cd 6% ngwdl din cd kiin thirc dat vi sa ciru khi bj bdng ndi chung. Vide thiiu hut kiin thiic nhw vay Ii mdt thyc trang rit ding lo ng^i vi diy Ii mpt trong nhu'ng tai nan thuung tich thuung g$p nhit cho thiy cin phii cd cic chuung trinh can thipp phu hgp dd ning cao kiin thuu sa ciru ban diu khi bj bdng dinh cho cpng ddng.
ABSTRACT
A quantitative research based on 200 inhabitants interviews was conducted at Quang Bi commune. Chuang My district, Hanoi. The results showed that 40.5%> of participants have the knowledge of first aid for theiwal bums, 16% for electrical burns, and only 8.5% for chemical burns.
Generally, there was only 6% of respondents meeting our standard of bum first aid knowledge.
This- lack of knowledge raises the alarm and requires undertaking appropriate intervention programs at community level.
1 nATvAND^ khoang 1,4 - 2 tridu ngu-di bj bong moi ndm,
^ ^ mdt nda sd trydng hp'p mdt kha ndng lao ddng Bong Id mdt vin de y te cdng cdng todn tam thdi, khoang 70.000 - 108.000 bgnh nhdn cau. Hdng nam trdn the gidi cd khoang bdng phai dieu tn tai bdnh vidn vd khoang 265.000 trydng hp'p td vong do bdng. Da s l 6 500 - 10.000 bdnh nhdn td vong do bdng [5].
cdc trydng ho'p bdng xay ra d nhyng nydc ed 0 Anh, khoang 250.000 ngydi bj bdng mdi thu nhdp thIp vd trung binh, ddc bidt gan mdt ndm, trong dd 175,000 ngydi td cdc vg tai nan nda s l tru'dng hop bdng xay ra d khu vyc khan clp vd 13.000 ngydi phai nhdp vign.
Ddng Nam A [13]. Tinh hinh tai nan bdng d Khoang 1.000 bdnh nhdn cd vet bong nghidm cdc nydc phdt triln dang cd xu hyang giam trong phai tidn hdnh hoi sdc cap cdu, Trong ddn, tuy nhidn d cde nydc chdm phdt triln vd dd, han mdt nya trong s6 ndy id tre em dydi dang phdt trien, tinh hlnh tai ngn bdng vin didn 12 tuli. Cdn d An Do, hon 2 tridu ngydi bj ra phdc tgp vdi s l lyp-ng Idn [3]. 0 Hoa KJ, bdng xay ra mdi ndm (dan s l 500 tridu ngydi).
^ Cf Nepal cd 1.700 ngydi chit vl bdng mdi ndm, Phin bien khoa hpc: GS. TS Le Nam ^ '^ ^^ vong gap 17 lan so vdi Anh [2]. Bdng Id
TCYHTH&B s6 5 - 2014
m6t trong ba nguydn nhan h^ng dSu d^n den to vong a tre em sau tai nan giao thdng du-b-ng bo va duoi nu'dc. Gin 96.000 tre em bj ti> vong do mdi n5m do bong li>a vi ty 1$ tCp vong o" c^c nifffc c6 thu nhSp thap vi trung binh cao gap 11 Ian so v&\ c^c nu'dc c6 thu nhap cao [14],
Chi phi chOa tn danh cho bong cQng l<hd tdn k6m l/dc tinh. chi phi tryc tiep cho cham sdc tre bi bong a Hoa Ky nSm 2000 la hen 211 tridu ddia M^. O Na Uy, chi phi dieu trj bdng tai bdnh vidn trong nSm 2007 Id han 10,5 tridu euro Nam Phi mdi nam t6n khoang 26 tridu ddIa IVly cho di^u tri bong do tai nan b4p dau.
NhCrng chi phi gidn tiep nhy mdt tien lycng, chdm sdc ddi ngay, chan thycng thdn th^ vd tinh th^n, sy chSm sdc cua thdn nhdn v.v...
cOng anh hyd'ng khdng nho d4n kinh t6 - xd hdi [12].
Theo thong kd cua Hdi Bong Hoa Ky nim 2007, vide xy ly, so ciiu, cap ci>u dung tai nai xay ra tai nan vd y te ca sa dd gdp phin Idm giam 87% cdc bl4n chyng sdm nhy s6c bdng, suy hd hSp [10,3] Rawlins JM vd cdng sy khi phdn tich dich te hoc trdn 208 tre bi bdng tai khoa clp CCPU tai Pediatr Emerg Care vdo ndm 2007 da cho biet didn bien vd tidn Iy(?ng vet bong cua trd rat phu thudc vdo viec tre cd dyac sa cip cilu dung cdch hay khdng, nghidn cCru cung dya ra ket ludn rdng vide so cdp cifu khdng tot cd m6i lidn quan chdt vdi miJc dd ndng cua vdt thyang va khuyen nghi vide gido due ve so cap eCru bong phai dyac coi Id bat bude trong vide giam nhe hSu qua cua Chan thyang bong d tre em [11].
O Vidt Nam, so lypng bdnh nhSn bong cd xu hydng gia tdng, chi dyng thy 2 sau tai n?n giao thdng [6] Hdng ndm so nan nhdn bong ydc linh trung binh khoang 791.000 ngydi, trong so dd, tre em chiem khoang 54%, trung binh mdi phydng xa hdng nam cd khoang 75 nan nhdn bdng. Tuy nhidn so nan nhdn bong dyae thu dung didu trj tai eac ca sd y te cdng ISp ty tuyln huydn trd Idn chi chiem gan 50%
s6^ nan nhdn bong trdn thyc te. Sd cdn I^i cd the dyac dieu trj tai cac ca sa ty nhdn, thay
lang, hodc ty dieu trj [3]. Theo thong kd eOa Vidn Bong Qu6c gia, han 70% n?n nhSn bdng deu tap trung d nhO-ng khu vyc ndng thdn vd miln ndi. 80% nan nhdn bdng xudt thdn tCr gia dinh cd thu nhdp thap. 30% edc ca bdng trd ndn tram trpng han khi chuyen tdi cdc bdnh vidn tinh hodc trung yang do gia dinh vd nhdn vidn y te clp ca sd khdng bilt each xy ly kjp thdi, cdch sa ci^u bdnh nhdn bong hodc cdch dilu trj cln thilt trong qud trinh chuyen bdnh nhan tdi bdnh vidn. Dieu trj bong kdo ddi, khdng ohi tin kdm ve chi phi (t£r 16 - 20 tridu ddng) [6] md cdn de i^i cdc hdu qua ndng nl v l sye khde, chiJc ndng, tham my, tdm ly. tdng gdnh ndng v l kinh t l cho ca gia dinh vd xd hdi.
Tuy nhidn, myc dp ndng hay nhp cQng nhy thdnh edng cua dilu trj bdng khdng chi phu thupc vdp hidu qua dieu tri tai edc trung tdm bong md edn phu thudc nhilu vdo cdng tdc cdp cCru ngay sau bdng, vdn chuyen vd elp cdu tai edc CSYT trydc khi chuyen bdnh nhdn din ede trung tdm bong. Cung nhy bat ky chin thyang ndo, clp eiJu ngay sau bong ngodi vide gidi quylt kip thdi edc nguy hilm de dpa den tinh mang do cdc roi lo^in v l hd hip, tuan hoan, cdn ddng vai trd quan trong trong vi§c Idm giam didn tich, dp sdu tin thypng bdng, dy phdng vd han che sy phdt tnen theo hydng xau di eua soe bdng, dy phdng cdc biln ehiing, gdp phin Idm giam ty Id ti vong, nit ngdn thdi gian ndm vipn [1].
Bdy Id mpt vin d l quen thudc dli vdi cdng dong, tuy nhidn d Vidt Nam chya cd nhilu nghidn ci>u ddnh gid tinh hinh thyc t l v l kiln thl>e sa cap ciru bdng cua ngydi dan. Vi vdy, chljng tdi tien hanh nghidn cilu "Binh gii kiin thdc so cip cdu bdng cOa ngudi din vi mot si yiu ti tien quan t^i xa Quing Bi, Chuung My, Hi Ndi nim 2014" nhdm md ta thyc trang v l kiln thyc sa cap ciru bong ciJa ngydi ddn d mdt xa ndng thdn, cd nhttng ddc diem tyang doi dien hinh cho ngoai thdnh Vidt Nam vd tim hilu nhyng ylu to rdo can, ylu t l thudn Ipi tdc dpng din kiln thyc eua ngydi ddn trong sa cap cyu bong.
TCYHTH&B s6 5 - 2014 19
MLIC tidu nghien cu'u
1. Ddnh gid k i l n thyc ve so- edu ban dau khi bj bdng eua ngydi ddn tgi xa Quang Bj, huydn Chyang MJ, thdnh pho Hd Ndi ndm 2014.
2. Xdc djnh mdt s l y l u t l lidn quan den k i l n thdc s o edu ban dau khi bj bdng cua ngydi ddn tai xd Quang Bj, huydn C h y o n g My, thdnh p h i Hd Ndi ndm 2014.
2. D 6 | T U O N G V A PHUXyNG PHAP NGHIEN CU'U 2.1. D6i t u v n g nghidn cij>u
200 ngu-di ddn trdn 18 tuoi song tai tgi xd Quang Bj, C h y a n g Mf, Hd Ndi
2.2. T h i l t kd nghien cu>u
S d dgng p h y o n g phdp nghien edu djnh lyp-ng vdi thiet ke md ta cdt ngang.
2.3. P h y a n g phap chpn mdu Ap dung edng thdc tinh ed m i u sau
n = de.-
Trong dd:
n: sd n g y d i ddn c l n phdng vdn p: Id ty Id y d c tinh n g y d i ddn xa Quang Bi d y p c cung c l p k i l n t h d c ve cdch s a cdu ban d i u khi bj bdng Id p = 0,5
Z. Hp so tin cdy. dng v d i dp tin cdy 95%
thi Z = 1,96
a: Id mdc y nghTa t h i n g kd, lay a = 5%
d sai so cho phdp d = 0,1 (10%) de = 2 hd s6 chon mdu
Thay vdo cdng thdc ta tinh d y p c n = 192. Lam trdn c d mau Id 200 ngydi ddn 2.3.1. Chpn miu
Chon mdu theo p h y a n g phdp chpn mdu
- Xd Quang Bi cd 4 thdn: thdn 1, thdn 2, thdn Lidn Hap, thdn 5.
- Chpn ngdu nhidn 2/4 thdn: thdn 2 vd thdn Lidn Hpp d l phdng v i n
- Mdi thdn phdng v i n 100 hd gia dinh.
2.4. Cdc tidu chl ddnh gia, chdm d i l m K i l n thdc v l s a edu ban dau khi bi bdng nhidt
Cic bwdc cin thyc hidn khi bi bdng do nhidt. (Mil ciu tri Idi diing se duuc 1 diem)
- Ngdm rda b i n g n y d c . - N y d c ngdm rda Id n y d c mdL - Trong khoang thdi gian t d 15 - 30 phdt hodc d i n khi ndo h i t rdt.
- Che phu vet bdng bdng ggc y te/ khdn sgeh/ vai mdn sgch.
- Can de nguydn khi xuat hidn n i t phdng, Diim kiin thOc cOa ddi tuung tham gia nghien ciru vi cich sa ciru khi bi bdng do nhidt dao ddng tie 0 - 5 diim. ^ Cd kiin thirc vi so ciru khi bi bong nhidt khi dat 5/5 diim.
*:• K i l n thdc vd s a cap c d u khi bj bdng do hda chdt
Cdc buuc cin thwc hidn khi bi bdng do hda chit. (Mdi ciu tri Idi dOng sd dwgc 1 diim)
- Ngdm rda bdng n y d c - N y d c ngam rda Id n y d c mdt.
- Thdi gian ngdm rda t d 30 - 60 phiit.
- Bdi c h i t trung hda.
- Che phu vet t h y a n g b i n g gae y t l / khdn s g c h / v a i s a c h .
Diim kidn thirc cOa ddi twgng tham gia nghidn ciru vi cich sa cO'u khi bt bdng do hda chit dao ddng tO'0-5 didm =? Cd kiin thirc vi so CO'U khi bl bdng hda chit d^t 5/5 diim.
20
TCYHTH&B so 5-2014
•:• K i l n thdc ve s a cap cdu khi bj bdng do didn
Cic bwdc cin thuc hidn khi bi bdng do dien. (Mil ciu tra Idi diing sd dwgc 1 didm)
- Vide dau tien can Idm Id ngdt nguon didn/
Cdch ly ngn nhdn ra khdi nguIn dipn.
- K i l m tra mach, nhjp thd cua nan nhdn, - Khi tiep xCie vdi ngn nhdn c l n dung gdy khd/ deo bdng cao su/ cu6n vai khd/ quan ni long/ Di ddp/ g u l e khd hodc ngdt ngudn didn.
- Hd hap nhdn tao hodc dp tim ngoai long ngyc hodc k i t hpp ca hai phyang phdp.
- C h u y i n ngn nhdn d i n CSYT.
Diim kiin thOv cua dii twgng tham gia nghidn ciru vi cich sa ciru khi bi bdng do didr^
dao ddng tir0-5 diim. o Cd kiin thOu vi so ciru khi bi bdng hda chit dat 5/5 diim.
• K i l n thdc so cdu khi bj bdng dat khi du diem dgt ca ba loai bdng trdn
• Thong kd md ta
- Md ta d^e diem chung cua doi typng nghidn edu, s d dung thudt todn tinh t i n s l vd ty Id, gid trj Idn nhat, nhd nhlt...
- Cde ddc diem du-pc md ta bao gom: tuli, gidi tinh, n g h l ngl;itdp, trinh dd hpc van, kiln thdc cua d l i t y p n g tham gia nghidn cdu v l sa c l p edu ban d i u khi bj bong.
• Phdn tich dan b i l n
- B i l n phu thudc Id b i l n "Kien thdc cua ngydi ddn ve SCBD khi bj bong".
- Bien ddc Idp Id cdc bien' tuoi, hpc v i n , giai tinh, n g h l nghidp, kien t h y c . .
- S d dgng k i l m dinh x^ - vdi cde b i l n cd 2 nhdm vdi ede nhdm b i l n : hoe v i n , nghl nghidp, k i l n thdc...
3. K ^ Q U A NGHIEN CLTU
3.1. T h d n g t i n c h u n g v l d d i tvprng nghidn 2.5. P h y a n g phap x d 1]^ s 6 lidu
Nhdp lidu b i n g phan mem Epidata 3.1 vd x d ly s l lidu bdng p h i n m i m SPSS 19.0.
T i n g so cd 200 n g y d i ddn trdn dja bdn xd Quang Bj d y p c tham gia vdo nghidn cdu, thdng tin chung v l d l i t y p n g d y p c t h i hidn qua bang sau:
Bang 1: Thong tin chung v l ddi tup-ng nghien CLFU Die dilm
Gj6i tinh
Ttj6inh6nh^t=18 Cao nh^t=87
Trinh dQhQCvin
Nghe nghilp
Nam Nij 18-40 41-60 Tren 60 Kh6rig cJi hoc/ mil chu Di/ffi trung hoc co so Trung hpc pho thong Trung cap/ day nghe/ dai hpc/ sau dai hpc
Nong dan Cong nhan Can bp vien chuc Lao dong tu do Sinh vidn
Tiin sd (n) 100 100 88 74 38 11 126 45 18 122
4 8 57 9
T y l t ( % | 50 50 44 37 19 5,5 63 22,5
9 61 2 4 28,5 4,5
TCYHTH&B s6 5-2014 21
Tuoi trung binh cua ngydi dan Id 55 tuoi, chu ylu tdp trung d nhdm tuli 30 - 50 tuli (42,5%). 63% ngydi ddn cd trinh dp hpc van Id trung hpc ca sd, chi cd 9% Id trung d p / dgy
nghe/ dgi hpc^ sau dgi hpc vd nghl nghidp chu ydu Id ndng ddn (61%).
3.2. Kidn thi>c cua ngu*di dan ve sa cdu ban ddu khi bj bong
Bang 2: TOng nghe, tirng thyc hi^n s c cu'u bong
Tifng nghe din so ci>u bong Tirng thyc hi$n so cuu
Tin sd (n) ] Ty If (%) 198
166
94,6 83 tham gia nghien cdu dd tdng thyc hidn so edu Hlu hit ngydi ddn dd nghe ndi din tai bdng (83%)
nan bong (94,5%). Rat nhieu nhO-ng ngydi
Bieu dd 1: Cac io^i bdng n g u ^ i dan da nghe ndi
1,5
Bdng nhiet Bdng h6a chit Bdng didn
• T?-1S(%)
Bdng lanh
100% ngydi ddn tham gia phdng vin tra Idi dd tdng nghe ndi din bdng nhidt, 60,5% so ngydi tdng nghe ddn bong hda chat vd 42,5%
ngydi ddn biet din bong didn. So ngydi biet den bdng lanh rlt thIp (1.5%). Mdc du bdng Ignh hidn nay cdng id mdt tai ngn thydng gdp, dde bidt doi vdi cdng nhdn tgi cdc khu edng nghidp.
Phdn tich ridng bidt kiln thyc ve sa cdu tdng loai bdng, chdng tdi thu dypfc kit qua nhy sau:
3.2.1. Kiin f/idc ve sv cap cuv ban dau khi bdng nhlpt
Bang 3: Kiln thi>c v l ngam rda, boi, bang bo/ che phu vlt thuxyng bdng nhi#t
NgSm n>a Kh6ng boi vao viing bong
Bang bo/ che phii tam thoi
TSn so (n) 177 66 30
T y l t ( % ) 88.5
33 15
Ba tidu chi ngdm rda, khdng bdi bit cd chit gi vdo viing bdng vd bdng bd/ che phu tam thdi vet bdng Id 3 thao tdc sa edu ngay Igp tdc vd vd cCing can thiet khi bj bong, nhdng thao tdc ndy dd dypc T l chdc Y t l the gidi
khuyin cdo. Bang 3 cho biet cd tdi 88,5%
ngydi ddn bilt phai ngam rda vet bdng ngay Idp tdc, trong khi vin c6 67% Igi cho rdng phai bdi Idn vung bong dypc sd dung nhy dang thudc, chi cd 15% cho ring cln phai che phu
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TCYHTH&B s6 5-2014
bdng each bdng lai tgm thdi vet bdng d l trdnh ty de vd t i l p xuc vdi chdt ban lam tdng ton thyang vet bdng.
Bang 4: Tr^ng thai nu-o-c ngam n>a khi bj bong nhift
dan b i l t Id phai ngam ngay vdt bdng d l Idm mat nhyng chl c6 8 7 % trong s l dd biet c l n phai chpn logi n y d c mdt thich hpp de ngdm.
Cd tdi 11,9% Igi cho r i n g n y p c da cd tdc dgng tdt han thi ddy Id mpt kien thdc hodn todn sai lam vi khi ngdm vdo n y d c dd cd the gdy nhidm Ignh cho nan nhdn, cdng nguy h i l m khi ngam vdo n y d c I m , Idm tang tinh trang bdng, tuy nhidn vdn cd 1,2% n g y d i ddn tra Idi ngdm v l t bdng vdo n y d c am.
Thdi gian ngdm rda vdo n y d c mat rat
^ quan trong, tdc ddng Idn ddn vet thyang cua Trgng thdi nu-dc ngdm rda Id yeu t l r l t ^ ^ ^ ^ ^ - ^ S ^ ^ g^^ 1^ ^.^^ ^^ ^^ ^^^. g,g^
quan trpng quyet djnh thanh cdng cua qud pgam rda cua n g y d i dan khi bi bdng nhigt: • trinh Idm mdt vet bdng Tuy cd 88,5% ngu-di
Bi4u d l 2: K i i n thiJc v§ tho-i gian ngSm n>a vai nu'd'c s^ch khi bi bong nhi#t Trying thai nyo-c
Nude mat Nuoc del NudeIm
Tin s6 (n) 154 21 2
Ty IS {%) 87 11,9
1,2
60 50 40 30 20 10 0
39,9
Dutrt 15 phi^t 50,3
TfrlS-SOphfit
• Ty is [%) 9,8
Tren 30 phVJt
Mdt dieu dang mdng Id cung cd tdi 50,3%
ngydi d y p c hdi b i l t rdng nen ngdm vdt bdng trong thdi gian t d 15 - 30 phut. Day la mpt k i l n thdc r l t tot phCi hpp vdi k h u y i n cao eua To chdc Y te The gidi ci3ng nhy hu-dng ddn so cdu ma Vidn Bdng Quoc Gia khuyin nghi.
Mdt didu ddng lo ngai r i n g cd den 67%
ngydi dan cho r i n g nen bdi mdt logi chdt vdo
v l t bdng nhyng nhyng chdt hp chpn de bdi qua thyc r l t ddng ban. C d n h i l u ly giai cho nhdng lya chpn nay n h y Id d y a tren kinh nghidm t r u y i n midng, cdc chat d y p c chpn bdi kha da dang t d kem ddnh rang, m d tran va thgm chl Id ca n y d c mdm, nyd'c t y a n g .
Bieu d l 3: C h i t boi vao vting bj bong khi bi bong nhiet
Kem M5 Nircrc Tu L6 hoi DSu cd Xat Nir&c KhSc aSnh tran vitcSy mua muSi tu-ong rang chufii thuSc
• Tfle(%)
T C Y H T H & B s6 5 - 2 0 1 4 23 Chu y l u n g y d i ddn se chon cdch t y mua
t h u l c bdi vdo v l t bdng (31,7%), 16,2% cho r i n g bdi kem ddnh rdng la tot, bdi m d trdn (17,4%), n y d c v l t cdy c h u l i (12%). Ngodi ra, ngyd-i ddn cdn dCing Id hpi, dau cd, n y d c
t y a n g , xdt m u l i . . . d l bdi vdo v l t bdng nhyng ty Id khdng cao Tuy nhidn, bdi cd t h i Idm cho vet t h y o n g t r d ndn trdm trong han nhy v l t t h y a n g bj nhidm trOng vd khien cho nhdn vidn y te khd d i l u trj han khi chuyen d i n bdnh vidn Bang 5: K i l n thu-c v l xu' t n v l t bdng do bdng nhi$t
Khdng chpc vd nit phdng
Xu' tri dung Khi cd vat tilp xuc l(hdng ch§t vdi viing bi bdng Xi> tri dung khi cd v$t tilp xuc chat vdi viing bi bdng
T i n sd (n) 161 166 110
T } l f ( % ) 80,5
83 55
o i l vdi not phdng khi bj bdng, can g i d nguydn, khdng d y p c Idm vd- n i t phong. TJ Id ngydi ddn khdng chpc v d not phdng chiem ty Id cao (80,5%). Cd d i n 8 3 % n g y d i ddn cd cdch x d tri dung khi cd vdt tiep xCic khdng chdt vdi vung bdng b i n g cdch thdo g d cdc vdt g i n vung bong. Nhyng khi d y p c hdi v l cdch x d tri khi cd vdt tiep xuc khdng chdt vdi vung bdng ehi ed 55% n g y d i ddn tra Idi dCing.
3.2.2. Kiin thUrc vi so' cu'u cua nguui din khi bi bong hda chit
Nguy h i l m hon so vdi bdng nhidt, bdng hda chat n l u khdng biet each s a cdu dOng se d l Igi hdu qua r l t nghidm trpng. Tuy nhidn cd d i n 39,5% n g y d i ddn tra Idi khdng b i l t Idm gi khi gdp ngn nhdn bj bdng hda c h i t . Vi vgy, chi cd 60,5% n g y d i ddn tham gia tra Idi cdu hdi v l bdng hda chat. Sau ddy Id bang thong ke edeh ngydi ddn x d tri khi bj bong hda chat:
Bang 6: K i l n thi>c dung v l ngam rda, boi, bang bd/ che phu t^m thai, bio v^ ban thSn khi t i l p xuc v6i viing bong hda c h i t
NgSm rCra Bdi
T i n 5d (n) 62 34
BSng bd/ che phu tam thdi 10 Bao vp ban than i(hi tiep xuc vdi viing bdng 60
Ty P?(%) 31 17 5 30
Khdc vdi bdng nhidt khi t i l n hdnh s a c d u khdng chf t i l n hdnh ngdm r d a , bdng bd/ che phu tgm thdi v l t bdng md cdn phai bdi chat trung hda vdo vung bdng vd bao v d ban thdn khi tiep xdc vdi vCing bdng. Qua bang 6, cd 3 1 % n g y d i dan tien hdnh ngdm rda vet
t h y a n g khi bj bdng hda c h i t , chi cd 5% ngydi ddn tiln hdnh bdng bd/ che phu vet bdng, 30%
n g y d i cho r i n g can bao vd ban thdn khi tiep xuc vdi vQng bong cOa ngn nhan. 17% n g y d i ddn bdi vdo vung bi bdng.
24
TCYHTH&B so 5-2014
Bilu do 4: Tr^ng thdi nu-oc ngam ru-a khi bj bong hda ch4t
100- 80 60 40 20 0
am 91
Nude mH
• T J l i ( % ) 9
Nude Si
Trong ntiiing ngudri tra Idri la ngam vet bong vSo nuac m4t (91%), tuy nhien vin cd bdng vSo nuitic. Ptian Idn nguM dan ngSm vit 9% nguW dan ngSm vet bdng vao ntfdc ii.
Bieu d& 5; Thd'i gian ngim rCpa l<hi bj bdng hda chit
TifSO-eOphllt DlfdriSOphilt Trta60phdt
•T^1S(%]
Mpt trong do yeu to quyet dinh hi#u a/ai lam mat vet thifong chinh la thai gian ngam r!ia. Trong s6 nhOng nguol trS lai ngam vet thu-ang vao nu'd'c mat khi bj bong hoa chat. Cd den 70,5% ngu&i dan ngam nja vet bong trong
nuac trong thai gian iui6\ 30 phut, 2% ngSm tr6n 60 phut. Chl co 27,5% nguM dan trj Idi dung la ngam tiia v4t thuong tir 30-60 phiit.
Sau day la bleu do thong ke cac chjt nguol dan boi vao vCing bj bong:
Bieu do 6: Chat boi v&o vOng bj bong hda chat
-•-•- •
Cliittnjiig Thudc bdi Kfflidtoli Nude vit cay Khac hda ngoai hi«u rSng chuli
thuoc
•Tyl«(%)
TCYHTH&B s6 5-2014
25 Mdc dii cd d i n 17% ngydi ddn tienhdnh bdi vdo vi^ng bdng nhyng ehi cd 8.3%
ngyd-i ddn cd kiln thdc ddng v l bdi chat trung hda vdo vung bdng hda chit. Ngydi
ddn diing thudc bdi mua ngodi hidu thuoc chiim ty Id cao (36,2%), 19,4% ngydi ddn diing kem danh rdng, bdi nydc v l t td cdy chuli chiem 16,7%.
Bang 7: K i l n thi>c v l x d trf dung bong hda c h i t
XLF tri dung khi cd vat tilp xuc khdng chat vdi viing bj bdng Xir tri dung khi cd vat tilp xiic chat vdi viing bj bdng
Tin 5d (n) 106
62
Tyl?l%) 1 53 1 31 1 Gilng nhy bdng nhidt, can loai bo cdc vdt
tiep xuc vdo vCjng bdng neu vdt dd tilp xdc khdng chdt vd khdng logi vd vdt nlu vdt dd dinh chdt vdo vCing bdng. Ty Id ngydi ddn cd kiln thdc dung v l xd tr( khi cd vdt tiep xuc khdng chdt vdi vCing bdng chiem 53%, 31%
ngydi ddn cd cdch xd tri dCing khi cd vdt tilp xuc chdt vdi vCing bj bdng.
3.2.3. Kiin thiec ve so* cap cu'u bong dien Khi tham gia phdng van, cd den 57,5%
ngydi ddn tra Idi khdng bilt Idm gl khi gdp ngn nhdn b\ bdng didn. Vi vgy, chl cd 42,5%
ngydi ddn tham gia tra Idi edu hdl v l sa cdu bdng didn.
Bang 8 : Kiln thiFC chung d^t v l sa clp ci>u bdng di$n Kiln thuc dung
Ngat ngudn di§n/ cdch Iy ngudI dan ra khdi ngudn dien dau tien Kiem tra mach, nhip thd
Chuyin nan nhan din CSYT
Che phu viing bdng khi chuyin nan nhan den CSYT
T i n sd (n) 81 37 64 38
Ty l« (%) 40.5 18,5 32 19
Khdc vdi tiln hdnh sa cdu bdng nhidt vd bdng hda chit. Doi vdi bdng didn vide dau tidn can Idm khi sa cdu ngydi bj bdng dign Id can ngdt nguIn didn/ cdch ly ngn nhdn ra khdi nguon dign, cd den 40,5% ngydi ddn tra idi ddng, phin Idn ngydi ddn diu tra Idi dilng •^
ndy khi tham gia phdng vin. 18,5% ngydi ddn bilt can phai tien hdnh kilm tra mgch, nhip thd.
32% ngu-di ddn tra Idi cln chuyen nan nhdn din CSYT vd 19% ngydi ddn biet can che phu vLing bong khi chuyin ngn nhdn den CSYT.
Sau khi ngydi ddn kilm tra mgch, nhip thd. Neu thiy ngn nhdn ngdng thd, cd 18,5%
ngydi dan biet cln hd hip nhdn tao. Cdch hd
hip nhdn tgo cua ngydi ddn dypc the hidn rd qua bang 9.
Bang 9: K i l n thLFC vh cSch ho h^p n h i n t^o cda ngurai ddn
£p tim ngoai Idng ngi/c Hd hoi thdi ngat Ca 2 dap an trdn Nhd ngudi lam hd nhip nhan tao
T i n sd (n) 5 2 25 5
T* le (%) 2,5
1 12,5
2,5
26 TCYHTH&B s6 5-2014
Cd 12,5% so ngu'di bilt can dp tim ngodi long ngyc vd hd hai thoi nggt, 2,5% ngydi ehi bilt cln dp tim ngodi long ngyc, sd ngydi biet
chi hd hai thoi ngat Id 1%. 2,5% /igydiddn nhd ngydi tra Idi hp khdng bilt cdch Idm hd hip nhdn tao ndn nhd ngydi khdc.
70 60 50 40 30 20 10 0
Bleu d l 7: L^-a chpn c a s a y t§ chuyen tuyln khi c l n 66,5
^ ^ ^ H
^^^M
^^^M
1 ii ^ ^
TYT B#nhvienhuy6n B#nhvi|ntinh Vien Bing Quoc gia
••i:^i§c%)
Khi bj bong, ngn nhan can dupe chuydn den ca sff y t^ gan nhat. C6 den 66,5%
ngitiji dan tra 16'i dung c^n chuyen nan nhan d4n tram y te. S6 ngu'iri dan cho r^ng can chuyin nan nhan den b^nh vi^n tinh thap nhat (2%).
3.3. Ngudn thdng tin
De hilu r5 hon v l kien thi>c cda ngu^i dan, hp biet dupe each sp cCru ban diu qua dau, sau day la bang thflng tin th6ng ka cSc phuang ti$n truyin thang giOp ngu'di dan bilt ve each SP ci>u bong vi cac nguon hp muon dupe tilp can nlu dupe biet ve kiln thi>c so ciJu bong,
Bieu dd 8: Cac phuong t i l n g i u p n g u d i d i n b i l t v d s o cuu bdng
Ngud'i dan bilt dupe thdng tin v l each sp ci>u bong thSng qua ban bii ngudi than/
nhfrng ngupi xung quanh chiem ty l# cao nhat (46%). Day la mW trong nhu'ng ylu to tac dOng ton din kiln thiJc cua nguM dan, vi hp chu yeu bilt qua each dan gian, truyen mi#ng 36%
nguii dan bilt qua dai/ bao/ ti vi chiim. sacW tranh anh/ 16 rai, CBYT la nhifng thdng tin dang tin cay, tuy nhi§n chi cd 7,8% ngudi dan bilt qua sach/ tranh anh/ td rpi; qua CBYT chi chiem 5,2%.
TCYHTH&B so 5 - 2014
27Bilu d l 9: Cac phuvng ti^n ngu'ai dan muln bilt v l ki§n thu'C sa cdu bong
so 40 30 20 10 0
41,9
B4i/bSo/tivi 10,1
Internet 18,6
Sach/ tranh anh/ td rai
• T^18(%) 21,3
CBYT 8,1
Ban b&t ngud'i than/ nhOng ngudi xung quanh
Khi dyp'c hdi v l ngudn thdng tin md ngydi ddn muon tilp cdn thi cd din 41,9% ngydi ddn bilt qua ddi/ bdo/ tivi; 21,3% qua CBYT. S l ngydi ddn muln biet qua bgn bd/ ngydi thdn/
nhdng ngu-di xung quanh thIp nhat (8,1%).
4. BAN LUAN
4.1. Thdng tin chung v l ddi tirp'ng tham gia nghien cdu
Cd tdng s l 200 ngydi tham gia nghidn edu. Tuoi trung binh cua ngydi dan Id 55 tuli, chu yeu tdp trung d nhdm tuli 30-50 tuli (42,5%) Kit qua nghidn cdu cung cho thiy trinh dp hpc van cua doi typng tham gia nghidn cdu chu yeu Id dydi THCS chiem 63%, thlp nhat Id trung d p / dgy nghe/ cao ddng/ dgi hpc/ Sau dai hpc (9%) Phan Idn ngydi ddn tham gia phong vin Id ndng dan (61%); 28,5%
Id lao ddng ty do; 4,5% Id sinh vidn; 2% Id cdng nhdn. Cd thi ly giai day la mdt trong nhdng If do din din kiln thdc chya dgt cua ngydi ddn cao.
4.2. Kiln thd>c cua doi tirang tham gia nghien cdu v l cdch sa ci>u ban diu khi bj bdng
Cd din 94,5% ngydi ddn dd tdng nghe ndi din borig. S l ngydi da thyc hign sa cdu khi bi bdng Idn (83%) thi hidn s l ngydi bj bdng tgi ddy cao vd nhilu ngydi da thyc hidn sa cdu eho ngydi bj bdng. Qua day, chung ta cd the thiy dypc tlm quan trpng cua vide
ngydi ddn nai ddy can cd kiln thdc tot v l sa cdu bdng. Logi bdng md da s6 doi typng nghidn cdu bilt td bdng nhidt chiim 100%, vd giam din theo cdc loai bdng: bdng hda chit (60.5%), bdng didn (42,5%) vd bdng Ignh (1,5%).
38,7% ngydi ddn cd kiln thdc v l ldm mdt vlt bdng khi bi bdng nhidt vd 7,8% khi bj bdng hda chat. So ngydi ddn ngdm rda bing nydc mdt khi bj bdng hda chat thIp han nhilu so vdi bdng nhiet vi 100% ngydi ddn bidt den bdng nhidt vd chl cd 60,5% ngydi ddn bilt den bdng hda chat vd do ngdnh nghl ci3a dli typng tham gia nghidn edu khdng tiep xuc nhieu vdi hda chit ndn s6 ngydi biet ve loai bdng ndy chl cd 60,5%. Ngodi ra, doi typng tham gia nghidn cdu tra Idi sau khi ngdm rda hp tiln hdnh bdi vdo vOng bj bdng cao, chiem 67%.
Nhdng chat ngydi dan bdi vdo vCing bdng;
thuoc dieu trj bong mua tgi hidu thulc, md trdn, kem ddnh rdng, xdt muoi, nydc tyang, nydc edy chuli, Id hdi.. Ly do bdi nhdng chit trdn vdo vung bong cd the ly giai vi kidn thdc ve bdng cua ngypi ddn tiep can qua ban bd/
ngydi than/ nhdng ngydi xung quanh Idn (46%) Vdi nhdng thdng tin khdng chinh xdc, bdi thulc ddn gian. Nhdng cdch Idm tren cung giong vdicdch Idm trong nghidn cdu cua tdc gia Nguydn Nhy Ldm vd Odng Thi BIch Hda [2]. Tuy nhidn, trong nghidn cdu ndy chi cd 23,19% benh nhdn dyp-c lam Ignh be mgt bdng bdng nydc mdt, thIp han so vdi nghien cdu
28 TCYHTH&B so 5-2014
cua nhdm. Ve x d ly vet bdng ngay sau tai ngn, cd 86,92% so t n j d n g hpp khdng x d ly gi, de hd vet bdng, so lidu ndy gan bdng nghidn cdu eua nhdm (85%), Cdc vdt lidu d y p c bdi vdo vet bdng gom dau cd, m d trdn, kem danh rang, la cdy edc logi thdm chi ca bun, vdi bdt, nydc tyong, tro bep, n y d c cdy chudi, pathenol, n y d c m d m . . cQng t y a n g t y nhy cdc c h i t bdi ngydi ddn trd Idi trong nghidn cdu cua nhdm, Cd t h i ly giai, bdi vdo vung bdng Id cdch d i l u tri bdng theo phyang phdp ddn gian, vi t h i cd s y gtong nhau gida cdc doi t y p n g trong cdc nghidn cdu khdc nhau. Cd t h i ly giai, bdi vdo vung bdng Id cdch d i l u trj bdng theo phuang phdp ddn gian, vl the cd s y gtong nhau gida cdc doi typng trong edc nghidn cdu khdc nhau. Tuy nhidn, khdng chl n y d c ta s d dgng cdc c h i t bdi ndy vdo vung bdng md theo nghidn edu cua tdc gia Graham HE [8] vd mdt nghidn cdu khdc d An D d [7] cOng s d dung bidn phdp ndy d l d i l u trj bdng mdc dCi khdng d y p c To chdc YTTG khuyen cdo.
Sau khi t i n g hp'p nhdng edu tra Idi cua doi typng tham gia nghidn edu, k i t qua eua nhdm eho thay s l ngydi ddn b i l t cdch so c d u dCing khi bj bdng hda chat t h I p nhat (8,5%), 40,5%
ngydi ddn cd k i l n thdc ddng ve s a cdu khi bj bdng nhidt, 18% n g y d i ddn cd kien thyc dung v l sa cdu ban d i u khi bj bong didn, ch? cd 6%
ngu'di ddn cd k i l n thu'C dat v l ca 3 logi bdng.
Cd the ly giai vi bdng nhidt Id loai bdng pho b i l n nhlt, hay gdp tgi cdng dong, vl t h i s l ngydi biet cdch s a c d u khi bj bdng nhigt cao han hdn so vdi nhdng logi bdng cdn Igi. Bdng hda chat vd bdng didn xay ra t y a n g d l i nhieu, nd d l Igi nhyng hdu qua c y c kJ nghidm trpng neu khdng b i l t cdch s a cdu ddng. Tuy nhidn, kien thdc cua n g y d i ddn v l bdng hda chat vd bdng didn chya cao. C l n cd nhdng can thidp phu hpp de ndng cao k i l n thdc cua ngydi ddn ve sa cdu bdng, ddc bidt la bdng nhidt vd bdng hda c h i t ,
Trinh dd hpc v i n cua doi t y p n g tham gia nghidn edu da so id d y d i THCS (63%) va n g h l nghidp hidn tgi cua hp Id Idm ndng (61%) do vdy nhdng kien thdc v l cdch sa cdu khi bl
bdng eua hp cQng han c h l . Cf n y d c ngodi, nhdng kT ndng c l n thiet d l s a c d u r l t d y p c quan tdm. 0 Phdp vide ddo tgo nhdng bidn phdp x d 1^', sa c d u , c l p c d u cdc chan thyang t h y d n g ggp trong cudc song trong dd ed c h i n thyang bdng d y p c to c h d c trong cpng ddng ngay t d cap tieu hpc. VI vdy, theo Hdi Bdng Phdp, cd 98% bdnh nhdn bdng d y p c x d tri, sa cdu, c l p cdu dung. Tuy nhidn, d Vigt Nam, chl mpt s6 ngydi cd dieu kidn hay do tinh c h i t cdng vide mdi di hpe idp v l s a c d u ban d i u . nhieu ngydi vdn c h y a nhdn thdc d y p c tam quan trpng cua vide s a c d u ban dau, cde Idp hpc vdn chya pho b i l n den n g y d i ddn
Theo mdt nghidn c d u cGa n y d c ngodi cua tdc gia Wallace HJ Chang [12] cho t h i y phan Idn nhdng n g y d i c h y a t d n g d y p c tham gia khda hoc s a c l p c d u bdng khdng cd k i l n thu'C v l s a c l p edu bong, ehi khoang 15% cd k i l n thdc t i t , tuy nhidn chi cd 9,4% b i l t thyc hdnh Idm mdt vet bdng dung ydu cau. Con s l ndy t h I p han so v d i nghidn edu cua nhdm, theo nghidn edu eua nhdm cd den 38,7%
n g y d i ddn Idm Ignh dung khi bj bdng nhidt vd 7,76% khi bj bdng hda c h i t . Qua nghidn cdu ndy, chdng ta cd t h i giai thich dyp'c ly do vi sao n g y d i ddn tham gia nghidn edu cua nhdm Igi cd t j Id dgt t h I p .
Ngodi ra, nhyng thdng tin md hp b i l t v l sa cdu bdng da so Id thdng qua bgn bd/ ngu'di thdn/ nhdng n g y d i xung quanh (46%), chi cd 7,8% n g y d i ddn b i l t qua ddi/ bdo/ ti vl, qua sdch/ tranh anh/ t d rai, 5,2% qua CBYT.
Nhyng han che v l cung c l p thdng tin dd Idm cho hp khdng du kien t h d c v l cdc so cdu dCing khi bi bdng. Nghidn c d u cua tdc gia Harvey LA vd cdng s y tai New South Wales cho thay cd 82% doi t y p n g dyp'c phdng v i n se Idm mdt v l t bdng bdng n y d c , va 9 % cho b i l t hp se Idm mdt v l t bdng trong 20 phut. R l t It n g y d i tra Idl rdng hp se cdi bd quan do cua bdnh nhdn vd gid I r n n g y d i bj t h y a n g . Cdc n g u I n t i l p cdn vdi kien thdc s a c l p c d u bdng p h i bien n h l t Id mdt c u i n sdch s a cap c d u bong (42%) vd internet (33%) [9]. Tuy nguon tiep cdn cua d l i t y p n g trong nghidn c d u ndy hidn dgi vd ddng
TCYHTH&B so 5-2014 29
tin cdy han so vd-i nghidn cdu cua nhdm, tuy nhidn kit qua cho thay kiln thdc cua ngypi ddn trong nghidn cdu cua nhdm vdn tot han.
Trong nghidn cdu cua Graham HE dypc win hanh ndm 2011 [8] de ddnh gid kiln thdc ve sa cdu ban dau khi bj bong gida cdc bdc cha me dNam Yorkshire, Anh cho thay: 73%
mg se rda vlt bong dydi nydc mdt vd 92%
cha me sd che phi] vlt thyang bing bdng ggc thich hpp, chl ed it han 40% cha me dypc hdi se logi bd quan do vd do trang sdc ndng vd 35% se Idm mdt vet bdng cd du thdi gian ydu cau [7]. Mdc dd vdy. nhdng ty Id trong nghidn edu eua Graham HE cho ta thiy dypc sy quan tdm cua mpi ngydi doi vdi tai nan do bong gdy ra. Tgi cdc nydc phdt triln cdc cap chinh quyIn dd rat quan tdm din vide cung cap kien thdc, k9 ndng v l so cdu ban diu cho ngydi ddn, vi thi kiln thdc cOa hp cao han hdn sao vdi nghidn cdu cua nhdm. Oil vdi nydc ta ve phin ndy vin edn nhilu hgn che.
V) vdy, qua nhdng ket qua trdn chdng ta cd thi thiy hidn b-gng cua vin d l sa cdu bdng dung cdch trong cdng dong. Van de ndy can dypc quan tdm nhieu han eua cdc clp chinh quyIn vd cQng chinh nhOng ngydi ddn trong cpng dong de cd ndng cao kiln thdc bao vd ehlnh minh vd mpi ngydi xung quanh.
4.3. Mpt s6 y l u t l lien quan ddn kiln thdc ci!ia ngu'di ddn v l sa cu'u ban ddu khi bi bong
c* Mli lidn quan gida kien thdc vd gidi tinh Xdt mli lidn quan gida gidi tfnh vd kiln thdc cua ngydi ddn ve bdng nhidt eho thiy khdng cd sy khdc bidt gida gidi tinh vd kiln thdc v l bong nhiet (OR=1,04; 95CI: 0,59-1,83, p>0,05). Tyang ty nhy vdy nam vd nd eOng ed kiln thdc khdng khde bidt nhieu v l bdng hda chat, nhdm nd cd kiln thdc ve sa edu bdng hda chit cao han 1,33 lan so vdi nhdm nam (p>0,05). Tuy nhidn, vdi bdng dign Igi cd sy khdc bidt ddng ke khi nhdm nam ed kiln thdc dgt nhieu han gap 2,31 lln so vdi nhdm gid'i tinh nd (OR=2,31; 95CI 1.09-4,94,
p<0,05). Mdt dieu cung cd the 1]/ gi^i dypc d ddy Id nam thydng Id ngydi sda chda ede thilt bi didn trong gia dlnh nhilu han nu- Tuy nhidn ddy cGng Id mdt lyu y dde bigt quan trpng khi xdy dyng cdc chyang trinh gido due sdc khde vl phu nd vd tre em cQng Id ngydi sd dung nhieu cdc thiet bj didn trong gia dinh vi the cQng can phai bilt vd thyc hdnh tot ede quy tdc an todn.
Kit qua nay khdc so vdi nghidn edu cua tdc gia Wallace HJ Chang vd cdng sy tai Australia Id nd cd kiln thdc tot han nam v l sa cdu ban ddu khi bj bdng.
Moi lidn quan gida tuoi vd kiln thdc cua ngydi ddn
Trong nghidn cdu ndy, moi lidn quan gida vide ngydi ddn dd tdng thyc hidn sa cdu bdng vdi kidn thdc khdng cd sy khdc bigt vdi nhdm ngydi ddn chya tdng thyc hign sa cdu bdng (P>0,05)
Moi lidn quan gida tuoi vd kiln thdc cua ngydi ddn
Khi so sdnh nhdm tuli dypc eho Id gid han (td 50 tuoi trd Idn) vdi nhdm tuoi tre, chdng tdi cung thiy cd sy khdc bidt gida kiln thdc ve bdng nhidt cung nhy bdng hda chat nhyng chya ed •j/ nghTa thing kd (OR=1,25;
95CI: 0,44-3,60; p>0,05) vd (OR=2,19; 95CI.
0,99^.83; p>0,05).
Kit qua ndy gan gilng nghidn edu cua tdc gia Wallace HJ Chang vd cdng sy khi phdt hien thay nhdng ngydi tre cd kiln thdc tdt han nhdng ngydi td 65 tuoi trd Idn.
5. K ^ LUAN
Td kit qua phdn tich 200 doi typng tham gia nghidn cdu eua d l tdi chdng tdi rut ra dypc mdt so kit ludn sau:
• 100% ngydi ddn bilt den bong nhidt;
60.5% ngydi biet bdng hda chit; 42,5% ngydi biet bdng didn, so ngydi biet ddn bdng lanh r l i thlp(1,5%).
30
TCYHTH&B so 5-2014
•> 6% ngydi ddn tham gia nghidn cdu cd kien thdc dgt v l sa cdu ban dau ca 3 loai bdng.
• Kiln thdc sa cdu bong nhiet
• 40,5% ngu'di ddn cd kien thiJc dgt ve so cdu bdng nhigt
- 38,7% ngydi ddn ed kiln thdc dOng ve Idm mdt vlt thu-ang.
15% ngydi ddn biet can bang bd/ che phu tam thdi vet thyang.
- 80,5% ngydi ddn khdng chpc vd nit phong, biet can phai loai bd cac vdt tilp xdc khdng chdt vdi vCing bong cao (83%), 55% biet khdng dypc gd* bd cdc vdt neu nd tilp xuc chdt vdi vung bdng.
• Kiln thdc sa cdu bong hda chat:
8.5% ngydi ddn cd kiln thdc dat v l sa cdu bdng hda chat
- 7.8% ngu'di ddn ed kien thu-c dung ve Idm mdt vlt thyang.
-1.4% ngydi ddn ed kiln thiPc ve bdi dCing chat vdo vCing bdng.
- 5% cd kien thdc v l bdng bd/ che phu tham thdi.
- 30% cd kiln thdc dung ve can bao vd ban thdn khi tiep xuc vdi vung bong.
- 53% xd tri dung khi ed vdt tidp xCic khdng ehltvdi vung bdng. 31% xd tri dung khi cd vdt tiep xOc chdt vdi vCing bdng.
Kiln thdc v l bong didn
18% ngydi ddn cd kien thyc dat v l bdng didn.
- 40,5% ngydi ddn biet can ngdt nguon didn/cdch ly ngn nhdn ra khdi nguIn dign diu tidn
18,5% cd kiln thdc ve kiem tra mgch, nhjp thd vd cln biet hd hap nhan tgo neu ngn nhan ngdng thd.
-19% cd kien thdc dung ve che phi) vung bdng khi vin chuyen nan nhdn den ca sd y te
•:• 66,5% ngydi ddn cd kien thdc ddng v l lya chpn ca sd y t l chuyen tuyln khi cln.
Kiln thdc sa edu khi bj bdng cua ngydi ddn bilt nhilu nhat thdng qua ban bd/ ngydi thdn/ nhdng ngydi xung quanh (46%). Sau dd din ddi/ bdo/ tivi chiim 36%.
5. KHUYEN NGHj
Mdc dCi tai nan do bdng hidn nay rlt phi biln vd dd d l Igi nhilu hdu qua ndng n l trong cpng ding, tuy nhidn vin de ndy v§n chya dypc cdc cap chinh quyen quan tdm nhilu.
Sau ddy Id mpt so khuyin nghj cua nhdm nhlm ndng cao kiln thdc cua ngydi ddn v l sa cdu ban dau khi bj bdng:
Cln ed nhu'ng chyang trinh can thidp nhlm ndng cao kiln thdc sa clp cdu tai ngn thyang tich vd ddc bidt Id bdng cho edng ding, ddc bidt Id nhdng ngydi chdm sdc tre vd cho tuyen y t l ca sd Id trgm y t l .
Cde khuyen cao ve sa cap cdu bdng cln dypc truyin thdng rdng rdi hai, ndng cao •j thyc d l phdng tai nan bdng nhyng cflng gidp ngydi ddn chu ddng ndng cao kien thdc sa cdu khi bj bdng, han ehl nhdng kinh nghidm, quan nidm sai lam trong sa cap cdu.
Can b l sung huln luydn sa elp cdu bdng vdo cdc chyang trinh ddo tao gido due phdng chdy chda chdy hidn dang dypc thyc hidn.
long ghdp vdo cac buoi hpp thdn hay hogt dpng ngogi khda cua cdc em hpc smh.
TAI LIEU THAM KHAO
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!. Nguyln Nhu- Lam, D?ng Thj Bich Hod (2006), 'BAnU gia thi/c trang so clp ci>u nan nhan bong tgi cac ca sff y te", T$p chi y hoc Thim hoa va bdng (1).tr. 18-24.
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(http://www.who int/mediacentre/factsheets/rs365/en0 Margie Peden, Kayode Oyegbite (2008) "World report on child injury prevention" World Health Organization.
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