Assessing the Anesthetist Involvement in Trauma Care Management at Trauma Set Ups and Emergency Rooms and Affecting Factors in Addis Ababa Public Hospitals

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Addis Abeba University


Back Ground: Trauma care involves the entire spectrum of care from the first responder through rehabilitation. The original aim of the trauma team is to reduce the second peak of the trimodal distribution of death following trauma, by appropriately managing correctable disturbances to the airway, breathing and circulation, if well implemented, is predicted to reduce preventable deaths by 42%. The initial responsibility is airway management; securing a compromised airway with a definitive airway device may be a priority, usually requiring intubation with rapid sequence induction of anesthesia with manual in-line stabilization of the cervical spine, provision of analgesia and resuscitation both inside and outside the hospital. Anesthetists practice in a variety of settings and one of the most challenging is the trauma set ups and emergency rooms and the setting in which the anesthetists practice may influence the skills needed because of many factors. Objectives: -Assessing the anesthetists involvement in trauma care management at trauma set ups and emergency rooms and affecting factors at Public Hospitals in Addis Ababa. Methods-institutional based cross sectional study was conducted on all eligible Anesthetists working at six randomly selected Public Hospitals in Addis Ababa from Jan 1, to Mar 30, 2017 GC. Data was collected using structured questionnaire and data entry and analysis was done with SPSS version 20. Result- A total of 57 respondents were surveyed with response rate of 100%. Of the respondents (n = 57), 16 (28.1%) of were involved in trauma set ups and ER, 41 (71.9%) were not. Of the 16 respondents involved in trauma set ups and ER 7(43.8%) were involve daily, 6(37.5%) weekly and about 3 (18.8%) reported involved at least once per month. Among the 16 respondents involved 10(62.5%) were participating in airway management, 5(31.3%) were in sedation and 1(6.2%) in peripheral nerve block. Concerning those who were not involved (n=41), 14(34.1%) were due to inadequate resources supply in their setups,8(19.5%) poor teamwork communication and coordination between the staffs,8(19.5%) lack of knowledge , 7(17.1%) shortage of manpower and 4(9.8%) was because of administrative problems. Conclusion and recommendations- The results indicated that 71.9% of the anesthetists remain unable to involve in trauma care management at trauma set ups and emergency rooms. Inadequate resources supply (34.1%); poor teamwork communication and coordination between the staffs, shortage of manpower and to some extent administrative problems were among the most affecting factors for involvement in trauma set ups in this research finding. we suggest to the concerned bodies to fulfill necessary materials to the hospitals and open opportunity for educational development and refresher training for the anesthesia professionals.



Public Hospitals