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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Date
2017-06
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Addis Abeba University
Abstract
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.
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Public Hospitals