Clinical Characteristics,Treatment Pattern Andoutcome of Burkitt’slymphoma Patients Athaematology unit of Tikur Anbessa Specialized Hospital
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Date
2024-04-19
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Addis Ababa University
Abstract
Background: Any sickness and injury characterized by the failure of important organs and a high risk of life-threatening conditions that necessitate prompt action beginning on the scene to preserve life and minimize morbidity is considered a critical illness. It is becoming more common, and the need for acute care is rising, facing a time-sensitive challenge to the healthcare system. In both prehospital and in-hospital settings, airway resuscitation is the cornerstone for the early care of critically ill patients. In addition to prehospital airway management, interfacility communication and continuity care during ambulance transferring are always demanding substantial tasks for all EMS workers from on the scene to treatment centers, anywhere in the globe. Still, Hypoxic agitation, hypoxic disability, peri intubation arrest, death on arrival, and dead body at arrival are poor clinical outcomes resulting from patients arriving with hypoxia at the ED too late as adversely affect. However, this prehospital insufficient care is being rushed to the ED. Real-time care and pre-arrival contact should be implemented to provide escalation of care according to evolving updated clinical practice for better patient outcomes.
Objective: This study was intended to assess critically sick and injured patients' actual oxygenation state, prehospital communication, and mode of transportation upon arrival at the emergency department and to explain any gaps in prehospital treatment or in the ED. Methodology: TASH and ZMH ED hosted a prospective cross-sectional study design for two consecutive months, from August to October over 2 months. A total of 202 samples were recruited using a convenient sampling method. The data has been cleaned and analyzed using the SPSS version 27. Descriptive and chi-square tests were used. Result: Significant hypoxia (86.1%) and poor prehospital communication (16.8%) were seen in the results. Ambulance usage was also 46%. The chi-square test showed that the relation between mode of arrival and airway status was not statistically significant. Overall findings revealed that oxygen therapy was not based on respiratory support requirements during interfacility transferring; Ambulance transportation was not organized with resuscitation equipment and experts to optimize compromised airway; lack of clear communication on patients' clinical status between the prehospital system and the treating staff. Conclusion and recommendation: The study identified that there was suboptimal prehospital airway management in all modes of arrival. In addition to this, pre-arrival contact was loose between the treating team and the prehospital system to facilitate preparations for the receiving hospital. Based on the study findings, the recommendation would be to have a well-organized and equipped EMS to have optimal airway status at ED arrival by delivering sufficient prehospital care. EMS system should be the point of first medical contact to have better clinical outcomes for time-sensitive critical illness and injury. Ambulance mode of transferring should be given along with advanced resuscitation to address continuity of care during transportation and decrease time to intervention. A critically ill patient from any referring hospital or catchment health center should have been notified to the on-call treating team by the liaison officer beforehand.
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CLINICAL CHARACTERISTICS TREATMENT PATTERN,