Introduction of the Cardiff Trauma Pack in Road Traffic Accidents in Namibia for use by First-Responders: An early phase study

Road traffic injuries are world's eighth leading killer of human beings and thus a major Public Health issue. They are the biggest killer in the world of young people aged 15 and 29 years, and globally account for 1.2 million deaths/year, with at least 1 million people disabled and a minimum of 10 million people suffering injury, annually. The loss of life, the loss of earning potential (because of age-range involved) and poverty implications for families, and the burden of care for our global society is tremendous.

The United Nations aims to stabilise and then reduce forecast level of road traffic fatalities around the world. The Cardiff Trauma Pack Research and Development Team have developed a solution which directly responds to the United Nation's 'decade of action for road safety, 2011-2020'. We have developed a Trauma Pack to minimise loss of life and disability in major trauma and accidents, by providing the essential elements of necessary care for the 'golden hour' by Namibian First-Responders. The Trauma Pack is designed and manufactured in accordance with the World Health Organisation's 4 A's: accessibility, availability, affordability, appropriateness.
Our innovative Cardiff Trauma Pack interventions include:
1. The Tear and Wear concept, saving on weight and space;
2. An anatomically correct and intuitive to place neck collar;
3. An interchangeable leg and arm brace, also Tear and Wear, saving weight and space;
4. Being intuitive and logical: ABCDE, also available when required in CABCDE;
5. Affordable: construction from easily available and cheap materials (even in developing world, specifically trialed in Zambia);
6. Light weight (adaptable shape and content).

Consequently, we propose a small scale early phase study in a sub-Saharan African Country, with a major Road Traffic Accident problem. This will happen in Namibia, as Professor Judith Hall the Primary Investigator has a long term, effective, output and outcome driven project in Namibia, The Phoenix Project. She is working closely with the University of Namibia (School of Public Health), Namibian University of Science and Technology (Paramedic School) and the Ministry of Health and Social Services. She also has excellent contacts in the Namibian Traffic Police through the University of Namibia.

An early phase study is required, prior to proceeding to a major full study (a population level introduction of the Cardiff Trauma Pack into Namibia), because our group has recently achieved design lock for the Cardiff Trauma Pack, and we must now:
1. Identify First-Responders in Namibia during the initial networking building exercise (eg police, paramedics, drivers, senior villagers and chiefs)
2. Develop educational materials to train in the use of the Cardiff Trauma Pack, materials which are:
a. At an appropriate educational level for use by Namibian First-Responders in Road Traffic Accidents;
b. Ethnographically appropriate;
c. Linguistically appropriate, or that appropriate illustrations/cartoons are available to support use.
3. Assess usability of the pack by first responders in the geographical Namibian context;
4. Assess pack content is correct for the Namibian context and its First-Responders;
5. Assess best Cardiff Trauma Pack community/responder placement to ensure optimum accessibility in the major study;
6. Assess that the pack performs successfully in the field.

We will achieve this using a major training exercise of First-Responders in either Rehoboth or Oshakati in Namibia using 50 Cardiff Trauma Packs. After which, with appropriate ethical approval, we will utilise 200 packs in Road Traffic Accidents to assess their ease of use, suitability of contents, appropriateness to the specific First-Responders and the Road Traffic Casualties. Once this is achieved, we will use this information to plan the major population-level study for the introduction of the Cardiff Trauma Pack into Namibia.

Road traffic injury is the world's eighth leading killer causing 1.2 million deaths annually. We have produced an ultra-low-cost Trauma Pack for developing world use, by non-specialists in the first or 'golden' hour after trauma, when lives are saved.
Our solution is also lightweight, compact, and tackles transportability, standardisation and usability. It enables organised delivery of first response by users with limited knowledge or skill. The pack meets or exceeds the performance of existing products and reduces purchase cost by over 80%, through materials selection and product design.
The Trauma Pack provides intuitive, life-saving equipment and easily understood instructions, using the global standard C/ABCDE care sequence. It addresses the transportation of unstable victims, ensuring non-expert users stabilise before transportation.
A co-creative approach with International Red Cross and Royal Centre for Defence Medicine means the pack was developed with a clear understanding of contexts, end users, function and usability.
Symbiosis IP Ltd identified that parts of the pack, or the whole, maybe protectable through patent application and design rights.
Namibia has one of the worst Road Traffic Accidents problems in the world. Prof Hall has a major successful collaboration in Namibia which will be mobilised for the study. An early-phase study of Trauma Pack utilisation in Namibia will develop educational material to train First-Responders in its use, with educationally, ethnographically and linguistically appropriate materials. A subsequent 6 month study of 200 pack uses will assess for the major study :
a. usability of the pack in the Namibian context;
b. correct pack content for Namibia and its First-Responders;
c. best Trauma Pack community/responder placement to ensure optimum accessibility ;
d. that the pack performs successfully in the field.
These results will enable the design of a major population intervention study of the Trauma Pack