Authors: Charles Mock Son Nguyen Robert Quansah Carlos ArreolaRisa Ramesh Viradia Manjul Joshipura
Publish Date: 2006/05/15
Volume: 30, Issue: 6, Pages: 946-956
Abstract
We sought to identify affordable and sustainable methods to strengthen trauma care capabilities globally especially in developing countries using the Guidelines for Essential Trauma Care These guidelines were created by the World Health Organization WHO and the International Society of Surgery and provide recommendations on elements of trauma care that should be in place at the range of health facilities globallyThe guidelines were used as a basis for needs assessments in 4 countries selected to represent the world’s range of geographic and economic conditions Mexico middle income Latin America Vietnam low income east Asia India low income south Asia and Ghana low income Africa One hundred sites were assessed including rural clinics n = 51 small hospitals n = 34 and large hospitals n = 15 Site visits utilized direct inspection and interviews with administrative and clinical staffResources were partly adequate or adequate at most large hospitals but there were gaps that could be improved especially in lowincome settings such as shortages of airway equipment chest tubes and traumarelated medications and prolonged periods where critical equipment eg Xray laboratory were unavailable while awaiting repairs Rural clinics everywhere had difficulties with basic supplies for resuscitation even though some received significant trauma volumes In all settings there was a dearth of administrative functions to assure quality trauma care including trauma registries traumarelated quality improvement programs and regular inservice trainingThis study identified several lowcost ways in which to strengthen trauma care globally It also has demonstrated the usefulness of the Guidelines for Essential Trauma Care in providing an internationally applicable standardized template by which to assess trauma care capabilities
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