Anaesthesia and Anaesthesiology

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Browsing Anaesthesia and Anaesthesiology by Subject "Anesthesia,anesthetic practice"

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    Assessment of the pattern and safety of anesthetic practice in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia
    (Addis Ababa Universty, 2017-12) Seifu, Robel (MD); Shimelis, Rediet(MD, Assistant Professor Of Anesthesiology)
    Background: Anesthesia services in many low and middle income countries are extremely poor. Literatures demonstrate a serious, sustained lack of safe anesthesia for surgery. The unacceptably high avoidable mortality rates associated with anesthesia in low income countries are related to airway problem, anesthesia in the presence of hypovolemia, poor technique, lack of training and supervision of non-physician anesthesia care providers and lack of monitoring, drugs and equipment. On the other hand, anesthesia related risk in developed nations is low as result of improvements in training, equipment and drugs and the introduction of mandatory monitoring standards and protocols such as pulse oximetry and capnography. International standards play an important role in guiding the development of anesthesia services. If the safety of anesthetic services is to be improved, wide adoption of these standards by ministries of health and local professional societies is imperative. Methods: A cross-sectional descriptive study design was employed for a 6 weeks’ period of time from October 1st, 2017 to November 14th, 2017 at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. A structured checklist was used to gather data regarding the availability of facilities, equipment and drugs. A structured, self-administered questionnaire was used to gather data regarding patterns and safety of peri-anesthetic care and monitoring. A series of unstructured in-depth interviews were conducted to key-informants to gather data regarding the work force capacity, accessibility of equipment and drugs, and issues that were not addressed by the other data collection tools. Results and Discussion: Anesthesia care at Tikur Anbessa Specialized Hospital was carried out by 44 physician and 47 non physician anesthesia care providers. There was a promising rise in the numbers of anesthesiology residents in recent years. In addition to routine anesthetic care service in the operating rooms, additional anesthesia services were also provided in a gastrointestinal endoscopy suite, MRI suite and pediatric procedure suite. There was a significant resource limitation with regards to airway and other anesthesia equipment and devices used for monitoring. Drugs’ availability was relatively good. The majority of perioperative anesthetic care practices with some exceptions were equivalent to minimum mandatory standards (level 1/basic).