Road traffic injuries (RTI) are the leading cause of death worldwide in children over 5 and adults aged 18–29. Nonfatal RTIs result in 20–50 million annual injuries. In Bangladesh, a new mechanism of RTI has emerged over the past decade known as a ‘scarf injury.’ Scarf injuries occur when scarves, part of traditional female dress, are caught in the driveshaft of an autorickshaw. The mechanism of injury results in novel, strangulation-like cervical spine trauma. This study aimed to understand the immediate emergency response, acute care pathway, and subsequent functional and health outcomes for survivors of scarf injuries. Key informant interviews were conducted with female scarf injury survivors (n = 12), caregivers (n = 6), and health care workers (n = 15). Themes and subthemes were identified via inductive content analysis, then applied to the three-delay model to examine specific breakdowns in pre-hospital care and provide a basis for future interventions. Over half of the scarf injury patients were between the ages of 10 and 15. All but two were tetraplegic. Participants emphasized less than optimal patient outcomes were due to unawareness of scarf injuries and spinal cord injuries among the general public and health professionals; unsafe and inefficient bystander first aid and transportation; and high cost of acute health care. Females in Bangladesh are at significant risk of sustaining serious and life-threatening trauma through scarf injuries in autorickshaws, further worsened through inadequate care along the trauma care pathway. Interventions designed to increase awareness and knowledge of basic SCI care at the community and provider level would likely improve health and functional outcomes.

中文翻译：

---

围巾损伤：从孟加拉国道路交通损伤的独特机制对应急响应和急性护理途径的定性研究

道路交通伤害 (RTI) 是全球 5 岁以上儿童和 18-29 岁成年人死亡的主要原因。非致命性 RTI 每年导致 20-5000 万人受伤。在孟加拉国，过去十年出现了一种新的 RTI 机制，称为“围巾损伤”。当围巾是传统女性服饰的一部分，被卡在自动人力车的传动轴上时，就会发生围巾受伤。损伤机制导致新的、类似勒颈的颈椎创伤。本研究旨在了解围巾损伤幸存者的即时应急响应、急性护理途径以及随后的功能和健康结果。对女性围巾损伤幸存者 (n = 12)、护理人员 (n = 6) 和卫生保健工作者 (n = 15) 进行了关键知情人访谈。通过归纳内容分析确定主题和子主题，然后应用于三延迟模型，以检查院前护理的具体故障，并为未来的干预措施提供基础。超过一半的围巾损伤患者年龄在 10 至 15 岁之间。除两人外，其他人都四肢瘫痪。参与者强调，由于公众和卫生专业人员不了解围巾损伤和脊髓损伤，患者的治疗效果不佳；不安全和低效的旁观者急救和运输；以及高昂的急性保健费用。孟加拉国的女性因在自动人力车上的围巾受伤而遭受严重和危及生命的创伤的风险很大，并且由于创伤护理途径中的护理不足而进一步恶化。