Levels of public awareness regarding cervical spine injury and the suitable first aid response among adults in Saudi Arabia

Mohammed L. Al-Otaibi; Khalid H. Almutairi; Khalid M. Al-Otaibi; Abdulelah N. Alghaeb; Saeed H. Al-Hadi

doi:10.15537/smj.2021.42.5.20200760

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Table 1

- Sociodemographic characteristics of the study participants (Saudi Arabia).

Characteristics	n	(%)
Age, years
<20	790	(16.1)
21-30	2088	(42.5)
31-40	783	(15.9)
41-50	828	(16.8)
50₊	425	(8.6)
Gender
Male	2865	(58.3)
Female	2049	(41.7)
Educational level
Secondary or below	1251	(25.5)
University student	1603	(32.6)
University/above	2060	(41.9)
Monthly income, SAR
<5000	2466	(50.2)
5000-10000	1155	(23.5)
>10000	1293	(26.3)
Marital status
Single	2483	(50.5)
Married	2280	(46.4)
Divorced/widowed	151	(3.1)
Trained as first responder
Yes	941	(19.1)
No	3973	(80.9)

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Table 2

- Public awareness of the correct response to cervical spine trauma among Saudi Arabia residents.

Response	n	(%
Cervical injury risk factors
RTA	3695	(75.2)
Sports	99	(2.0)
Inflammation	208	(4.2)
Tumor	123	(2.5)
Long use of devices	10	(0.2)
Incorrect sitting posture	6	(0.1)
Fall	5	(0.1)
Do not know	768	(15.6)
Is it possible for a cervical spine injury to be accompanied by damage to the spinal cord?
Yes	3900	(79.4)
No	84	(1.7)
Do not know	930	(18.9)
Can injuries to the cervical spine lead to life-long disability?
Yes	3502	(71.3)
No	222	(4.5)
Do not know	1190	(24.2)
Complications of cervical injury
Motor disability	2559	(52.1)
Sensory disability	1918	(39.0)
Affected breathing	1414	(28.8)
Urine incontinence	1191	(24.2)
Stool incontinence	1132	(23.0)
Smell & taste problems	386	(7.9)
Do not know	2249	(45.8)
May a patient with cervical spine injury require medical and physical management for their whole life?
Yes	2707	(55.1)
No	624	(12.7)
Do not know	1583	(32.2)
The first management for cervical spine injury patient
Minimizing movement during transport	1838	(37.4)
Changing patient position	84	(1.7)
Call emergency services	2304	(46.9)
Do not know	688	(14.0)
Early prediction of cervical spine injury will help in preventing complications
Yes	3818	(77.7)
No	179	(3.6)
Do not know	917	(18.7)
Proper management at accident cite may prevent permanent spinal cord damage
Yes	3292	(68.4)
No	371	(7.7)
Do not know	1153	(23.9)
To safely stabilize a patient requires which of the following
Keeping the patient same position if the place is safe until emergency services arrive	3582	(72.9)
Correct deformity pulls arms neck and Legs	398	(8.1)
Set patient up	41	(0.8)
Do not know	893	(18.2)
How would you respond should the patient require resuscitation?
Call emergency services, start resuscitation, ensuring spine immobilization	4243	(86.3)
Transport patient to nearest hospital in my vehicle	83	(1.7)
Do nothing	91	(1.8)
Do not know	497	(10.1)
Which of the following signs may be indicative of a cervical cord injury?
Unable to move hand	1618	(32.9)
Pain in arms	770	(15.7)
Numbness	1195	(24.3)
Neck deformity	629	(12.8)
All of the above	2989	(60.8)
Do not know	68	(1.4)
Which of the following diseases may increase the risk of cervical spine injury?
Down’s syndrome	745	(15.2)
Rheumatoid arthritis	3660	(74.5)
Diabetes milieus	818	(16.6)
Obesity	2060	(41.9)
Overall awareness level
Poor	3349	(68.2)
Good	1565	(31.8)

RTA: road traffic accidents

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Table 3

- Self-reported first responses to witnessed cervical spine injury among Saudi Arabia residents.

Responses	n	(%)
I will help people involved in a car accident or fall
Yes	3614	(73.5)
No	1300	(26.5)
A proper response can help the victim
Yes	4197	(85.4)
No	113	(2.3)
Do not know	604	(12.3)
Cervical spine injury can affect patient quality of life until death
Yes	3501	(71.2)
No	274	(5.6)
Do not know	1139	(23.2)
I would take spinal movement precaution in an unconscious trauma patient
Yes	4047	(82.4)
No	867	(17.6)
I will try not to move the patient and call emergency services
Yes	4573	(93.1)
No	122	(2.5)
Do not know	219	(4.5)
I will call emergency services before beginning first aid intervention
Yes	4171	(84.9)
No	743	(15.1)
I will take extreme care at all times to maintain the alignment of the head, neck and spine
Yes	4717	(96.0)
No	197	(4.0)
If the patient is responsive and I suspect cervical spine injury I will do the following
Reassure them and tell them to remain still	4119	(83.8)
Check their neck mobility	249	(5.1)
Try to change their position	54	(1.1)
Do not know	492	(10.0)

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Table 4

- Levels of public awareness regarding cervical spine trauma, stratified by survey participant demographic characteristics

Awareness level
Variables	Poor		Good		P-value
Age, years
<20	663	(72.9)	127	(16.1)	0.001*
21-31	1593	(76.3)	495	(23.7)
31-40	576	(73.6)	207	(26.4)
41-50	340	(41.1)	488	(58.9)
50+	177	(41.6)	248	(58.4)
Gender
Male	1624	(59.7)	1241	(43.3)	0.001*
Female	1725	(84.2)	324	(15.8)	0.001*
Educational level
Secondary or below	860	(68.7)	391	(31.3)	0.002*
University student	1273	(79.4)	330	(20.6)
University/above	1216	(59.0)	844	(41.0)
Monthly income, Saudi Riyals
<5000	1970	(79.9)	496	(20.1)	0.001*
5000-10000	747	(64.7)	408	(35.3)
>10000	632	(48.9)	661	(51.1)
Marital status
Single	1918	(77.2)	565	(22.8)	0.058*
Married	1339	(58.3)	941	(41.3)
Divorced/widowed	92	(60.9)	59	(39.1)
Trained as first responder
Yes	27	(2.9)	914	(97.1)	0.001
No	3322	(83.6)	651	(16.4)	0.001

Values are presented as number and percentage (%). Comparisons were performed with the Pearson x² test. *P-value of <0.05 was considered indicative of a statistically significant difference.