The readiness of emergency and trauma care in low- and middle-income countries: a cross-sectional descriptive study of 42 public hospitals in Albania.

Int J Emerg Med 2016 Dec 7;9(1):26. Epub 2016 Oct 7.

Department of Emergency Medicine, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.

Background: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals.

Methods: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed. Assessment subcategories included the following: (1) specialized training and/or certifications possessed by healthcare providers, (2) interventions performed in the ER, and (3) patient management strategies.

Results: Across the 42 ERs surveyed, less than half (37.1-42.5 %) of physicians and one third of nurses (7.1-26.0 %) working in the ERs received specialized trauma training. About half (47.9-57.1 %) of the ER physicians and one fifth of the nurses (18.3-22.9 %) possessed basic life support certification. This survey demonstrated some significant differences in the emergency medical care provided between primary, secondary, and tertiary hospitals across Albania (the significance level was set at 0.05). Specifically, these differences involved spinal immobilization (p = 0.01), FAST scan (p = 0.04), splinting (p = 0.01), closed reduction of displaced fractures (p = 0.02), and nurses performing cardiopulmonary resuscitation (CPR) (p = 0.01). Between 50.0 and 71.4 % of the facilities cited a combined lack of training and supplies as the reason for not offering interventions such as rapid sequence induction, needle thoracotomy, chest tube insertion, and thrombolysis. Mass casualty triage was utilized among 39.1 % primary hospitals, 41.7 % of secondary, and 28.6 % of tertiary.

Conclusions: The emergency services in Albania are currently staffed with inadequately trained personnel, who lack the equipment and protocols to meet the needs of the population.

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12245-016-0124-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055520PMC
December 2016
25 Reads

Publication Analysis

Top Keywords

specialized training
8
middle-income countries
8
descriptive study
8
hospitals albania
8
patient management
8
low- middle-income
8
cross-sectional descriptive
8
healthcare providers
8
training
5
ers
5
183-229 % possessed
4
medical care
4
survey demonstrated
4
triage utilized
4
nurses 183-229 %
4
physicians nurses
4
utilized 391 %
4
half 479-571 %
4
479-571 % physicians
4
possessed basic
4

References

(Supplied by CrossRef)
Article in J Surg Res
L Dewberry et al.
J Surg Res 2014
Article in Lancet
CJ Murray et al.
Lancet 2013
Article in Trop Med Int Health
U Gopinathan et al.
Trop Med Int Health 2014
Article in Prehosp Disaster Med
RI Donaldson et al.
Prehosp Disaster Med 2012
Article in Int J Emerg Med
AK Nowacki et al.
Int J Emerg Med 2013

C Mock et al.
2004
Article in Am J Prev Med
ME Kruk et al.
Am J Prev Med 2008
Article in J Pediatr
RI Donaldson et al.
J Pediatr 2011
Article in J Surg Res
TE Callese et al.
J Surg Res 2014
Article in CMAJ
GE Guindon et al.
CMAJ 2010
Article in Cochrane Database Syst Rev
S Jayaraman et al.
Cochrane Database Syst Rev 2014

Similar Publications