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Erschienen in: World Journal of Surgery 11/2010

01.11.2010

Ratification of IATSIC/WHO’s Guidelines for Essential Trauma Care Assessment in the South American Region

verfasst von: Michel B. Aboutanos, Francisco Mora, Edgar Rodas, Juan Salamea, Marcelo Ochoa Parra, Estuardo Salgado, Charlie Mock, Rao Ivatury

Erschienen in: World Journal of Surgery | Ausgabe 11/2010

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Abstract

Background

The purpose of the present study was to evaluate the usefulness of the International Association for Trauma Surgery and Intensive Care (IATSIC)/World Health Organization (WHO)’s Guidelines for Essential Trauma Care (EsTC Guidelines) in providing an internationally applicable and standardized template to assess trauma care capabilities in the South American Region.

Methods

Field assessment was conducted in seven provinces (urban and rural, pop. 2,239,509) and 24 facilities (5 large hospitals (LH); 15 small hospitals (SH); 4 basic hospitals (BH)) in Ecuador using EsTC criteria. A total of 260 individual items in Human Resources (HR– availability, clinical knowledge, skills) and physical resources (PR) were evaluated via inspection, review of local statistics, and administrative and staff interviews. EsTC was evaluated on a scale as follows: 0 (absent); 1(inadequate; < 50%); 2 (partly adequate > 50%); 3 (adequate–100%).

Results

210,045 Emergency Department (ED) visits and 61,365 (29%) ED trauma visits were recorded (incidence rate 2,740/100,000 population). Deficits were noted in prehospital trauma care (inadequate coordination, communication), education and training (ATLS < 30%, TNCC 0%), facility based trauma care (poor physical resources [PR] and human resources [HR]), and quality assurance (1/27 hospitals).

Conclusions

The IATSIC/WHO EsTC Guidelines provide a simple and useful template to assess trauma care capability in variable facilities and international settings, and they could serve as a valuable tool for trauma system development. Endorsement of EsTC Guidelines by the Panamerican Health Organization and lead trauma societies (the Panamerican Trauma Society) should be considered.
Literatur
1.
Zurück zum Zitat Hofman K, Primack A, Keusch G et al (2005) Addressing the growing burden of trauma and injury in low- and middle-income countries. Am J Public Health 95:13–17CrossRefPubMed Hofman K, Primack A, Keusch G et al (2005) Addressing the growing burden of trauma and injury in low- and middle-income countries. Am J Public Health 95:13–17CrossRefPubMed
2.
Zurück zum Zitat Murray CJ, Lopez AD (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard University Press, Cambridge, MA Murray CJ, Lopez AD (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard University Press, Cambridge, MA
3.
Zurück zum Zitat Murray CJL, Lopez AD (1996) Global health statistics: a compendium of incidence prevalence and mortality estimates for over 200 conditions. Harvard University Press, Cambridge, MA Murray CJL, Lopez AD (1996) Global health statistics: a compendium of incidence prevalence and mortality estimates for over 200 conditions. Harvard University Press, Cambridge, MA
4.
Zurück zum Zitat Pan American Health Organization (2005) Regional Core Health Data and Country Profile Initiative, 2000–2005. www.paho.org. Accessed Nov 10 2005 Pan American Health Organization (2005) Regional Core Health Data and Country Profile Initiative, 2000–2005. www.​paho.​org. Accessed Nov 10 2005
5.
Zurück zum Zitat World Health Organization (2004) The World Health Report 2004: changing history. WHO, Geneva, Switzerland World Health Organization (2004) The World Health Report 2004: changing history. WHO, Geneva, Switzerland
6.
Zurück zum Zitat Perel P, Cases JP, Ortiz Z et al. (2006) Noncommunicable diseases and injuries in Latin America and the Caribbean: time for action. PLoS Med 3:e344 Perel P, Cases JP, Ortiz Z et al. (2006) Noncommunicable diseases and injuries in Latin America and the Caribbean: time for action. PLoS Med 3:e344
7.
Zurück zum Zitat Fraade-Blanar L, Concha-Eastman A, Baker T (2007) Injury in the Americas: the relative burden and challenge. Rev Panam Salud Pub 22:254–259 Fraade-Blanar L, Concha-Eastman A, Baker T (2007) Injury in the Americas: the relative burden and challenge. Rev Panam Salud Pub 22:254–259
8.
Zurück zum Zitat Jamison DT, Mosley H (1991) Disease control priorities in developing countries: health policy responses to epidemiological changes. Am J Public Health 81:15–22CrossRefPubMed Jamison DT, Mosley H (1991) Disease control priorities in developing countries: health policy responses to epidemiological changes. Am J Public Health 81:15–22CrossRefPubMed
9.
10.
Zurück zum Zitat Tercero F, Andersson R, Pena R et al (2006) The epidemiology of moderate and severe injuries in a Nicaraguan community: a household-based survey. Public Health 120:106–114CrossRefPubMed Tercero F, Andersson R, Pena R et al (2006) The epidemiology of moderate and severe injuries in a Nicaraguan community: a household-based survey. Public Health 120:106–114CrossRefPubMed
11.
Zurück zum Zitat Richman M, Shayne P, Heron S et al (2000) Injury control in Honduras: a survey of injury mortality. Ann Emerg Med 36:333–339CrossRefPubMed Richman M, Shayne P, Heron S et al (2000) Injury control in Honduras: a survey of injury mortality. Ann Emerg Med 36:333–339CrossRefPubMed
12.
Zurück zum Zitat Aboutanos MB, Rodas EB, Aboutanos SZ et al (2007) Trauma education and care in the jungle of Ecuador, where there is no advanced trauma life support. J Trauma 62:714–719CrossRefPubMed Aboutanos MB, Rodas EB, Aboutanos SZ et al (2007) Trauma education and care in the jungle of Ecuador, where there is no advanced trauma life support. J Trauma 62:714–719CrossRefPubMed
13.
Zurück zum Zitat Mock C, Kobusingye O, Joshipura M et al (2005) Strengthening trauma and critical care globally. Current Opin Crit Care 11:568–575CrossRef Mock C, Kobusingye O, Joshipura M et al (2005) Strengthening trauma and critical care globally. Current Opin Crit Care 11:568–575CrossRef
14.
Zurück zum Zitat Aboutanos M, Areola-Risa C, Rodas EB (2009) Trauma care system implementation & development in Latin America [Implementación y desarrollo de sistemas de atención en trauma en América Latina]. In: Ferrada R, Rodriguez A et al (eds) Trauma-Sociedad Panamericana de Trauma, 2nd edn. Distribuna Editorial Medica, Cali Colombia, pp 9–28 Aboutanos M, Areola-Risa C, Rodas EB (2009) Trauma care system implementation & development in Latin America [Implementación y desarrollo de sistemas de atención en trauma en América Latina]. In: Ferrada R, Rodriguez A et al (eds) Trauma-Sociedad Panamericana de Trauma, 2nd edn. Distribuna Editorial Medica, Cali Colombia, pp 9–28
15.
Zurück zum Zitat Joshipura M, Mock C, Goosen J et al (2004) Essential trauma care: strengthening trauma systems around the world. Injury 35:841–845CrossRefPubMed Joshipura M, Mock C, Goosen J et al (2004) Essential trauma care: strengthening trauma systems around the world. Injury 35:841–845CrossRefPubMed
16.
Zurück zum Zitat Krug EG, Dahlberg LL, Mercy JA et al (eds) (2002) Violence and health. World Health Organization, Geneva Krug EG, Dahlberg LL, Mercy JA et al (eds) (2002) Violence and health. World Health Organization, Geneva
17.
Zurück zum Zitat Peden M, Scurfield R, Sleet D et al (eds) (2004) Road traffic injury prevention. World Health Organization, Geneva Peden M, Scurfield R, Sleet D et al (eds) (2004) Road traffic injury prevention. World Health Organization, Geneva
18.
Zurück zum Zitat Mock C, Lormand JD, Goosen J et al (2004) Guidelines for essential trauma care. World Health Organization, Geneva Mock C, Lormand JD, Goosen J et al (2004) Guidelines for essential trauma care. World Health Organization, Geneva
19.
Zurück zum Zitat Quansah R (2006) Essential trauma care in Ghana: adaptation and implementation on the political tough road. World J Surg 30:934–939CrossRefPubMed Quansah R (2006) Essential trauma care in Ghana: adaptation and implementation on the political tough road. World J Surg 30:934–939CrossRefPubMed
20.
Zurück zum Zitat Joshipura M (2006) Guidelines for essential trauma care: progress in India. World J Surg 30:930–933CrossRefPubMed Joshipura M (2006) Guidelines for essential trauma care: progress in India. World J Surg 30:930–933CrossRefPubMed
21.
Zurück zum Zitat Son NT, Mock C (2006) Improvements in trauma care capabilities in Vietnam through use of the WHO-IATSIC guidelines for essential trauma care. Int J Injury Control Saf Promot 13:125–127CrossRef Son NT, Mock C (2006) Improvements in trauma care capabilities in Vietnam through use of the WHO-IATSIC guidelines for essential trauma care. Int J Injury Control Saf Promot 13:125–127CrossRef
22.
Zurück zum Zitat Arreola-Risa C, Mock C, Vega FR et al (2006) Evaluating trauma care capabilities in Mexico with the World Health Organization’s guidelines for essential trauma care publication. Rev Panam Salud Pub 19:94–103 Arreola-Risa C, Mock C, Vega FR et al (2006) Evaluating trauma care capabilities in Mexico with the World Health Organization’s guidelines for essential trauma care publication. Rev Panam Salud Pub 19:94–103
23.
Zurück zum Zitat Mock C, Nguyen S, Quansah R et al (2006) Evaluation of trauma care capabilities in four countries using the WHO-IATSIC guidelines for essential trauma care. World J Surg 30:946–956CrossRefPubMed Mock C, Nguyen S, Quansah R et al (2006) Evaluation of trauma care capabilities in four countries using the WHO-IATSIC guidelines for essential trauma care. World J Surg 30:946–956CrossRefPubMed
24.
Zurück zum Zitat World Health Organization (2005) Prehospital trauma care systems. World Health Organization, Geneva World Health Organization (2005) Prehospital trauma care systems. World Health Organization, Geneva
25.
Zurück zum Zitat Pan American Health Organization (2007) Health in the Americas, 2007. Volume II-Countries. Pan American Health Organization, Washington, pp 315–321 Pan American Health Organization (2007) Health in the Americas, 2007. Volume II-Countries. Pan American Health Organization, Washington, pp 315–321
26.
Zurück zum Zitat Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2006 Revision and World Urbanization Prospects: The 2007 Revision. http://esa.un.org/unup. Accessed September 03 2009 Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2006 Revision and World Urbanization Prospects: The 2007 Revision. http://​esa.​un.​org/​unup. Accessed September 03 2009
27.
Zurück zum Zitat Proyección de la Población Ecuatoriana, por Años Calendario, Según Regiones y Provincias–Período 2001–2010. Proyecto “Apoyo al Censo de Población y Vivienda y al Fortalecimiento del INEC.” Instituto Nacional de Estadísticas y Censos del Ecuador. INEC–Ecuador’s National Institute for Statistics & Census, 2004 Proyección de la Población Ecuatoriana, por Años Calendario, Según Regiones y Provincias–Período 2001–2010. Proyecto “Apoyo al Censo de Población y Vivienda y al Fortalecimiento del INEC.” Instituto Nacional de Estadísticas y Censos del Ecuador. INEC–Ecuador’s National Institute for Statistics & Census, 2004
28.
Zurück zum Zitat Anuario de estadísticas de transporte (2006–2007) Instituto Nacional de Estadísticas y Censos del Ecuador. INEC—Ecuador’s National Institute for Statistics & Census Anuario de estadísticas de transporte (2006–2007) Instituto Nacional de Estadísticas y Censos del Ecuador. INEC—Ecuador’s National Institute for Statistics & Census
29.
Zurück zum Zitat Proyectos de infraestructura para el transporte, construcción, reconstrucción, mantenemineto y mejoramiento—Augosto 2009. Ministerio de Transporte y Obras Publicas. Ecuador ‘s Ministry of Transporte and Public Works Proyectos de infraestructura para el transporte, construcción, reconstrucción, mantenemineto y mejoramiento—Augosto 2009. Ministerio de Transporte y Obras Publicas. Ecuador ‘s Ministry of Transporte and Public Works
30.
Zurück zum Zitat American College of Surgeons (2007) Advanced Trauma Life Support (ATLS) Student Manual, 7th edn. American College of Surgeons, Chicago American College of Surgeons (2007) Advanced Trauma Life Support (ATLS) Student Manual, 7th edn. American College of Surgeons, Chicago
31.
Zurück zum Zitat Emergency Nurse Association (2008) Trauma Nursing Core Course (TNCC) Provider Manual, 6th edn. Emergency Nurse Association, Des Plaines Emergency Nurse Association (2008) Trauma Nursing Core Course (TNCC) Provider Manual, 6th edn. Emergency Nurse Association, Des Plaines
32.
Zurück zum Zitat Aboutanos M, Mora F, Duong M et al. (2007) Telemedicine applications and rural system development in Latin America: Ecuador’s experience. J Health Technol Appl. Accessed on line Nov 15, 2009 Aboutanos M, Mora F, Duong M et al. (2007) Telemedicine applications and rural system development in Latin America: Ecuador’s experience. J Health Technol Appl. Accessed on line Nov 15, 2009
33.
Zurück zum Zitat Arreola-Risa C, Mock C, Padilla D et al (1995) Trauma care systems in urban Latin America: the priorities should be prehospital and emergency room management. J Trauma 39:457–462CrossRefPubMed Arreola-Risa C, Mock C, Padilla D et al (1995) Trauma care systems in urban Latin America: the priorities should be prehospital and emergency room management. J Trauma 39:457–462CrossRefPubMed
34.
Zurück zum Zitat Marson A, Thomson J (2001) The influence of prehospital trauma care on traffic accident mortality. J Trauma 50:917–921CrossRefPubMed Marson A, Thomson J (2001) The influence of prehospital trauma care on traffic accident mortality. J Trauma 50:917–921CrossRefPubMed
35.
Zurück zum Zitat Arreola-Risa C, Mock C, Herrera-Escamilla AJ et al (2004) Cost-effectiveness and benefit of alternatives to improve training for prehospital trauma care in Mexico. Prehospital Disaster Med 19:318–325PubMed Arreola-Risa C, Mock C, Herrera-Escamilla AJ et al (2004) Cost-effectiveness and benefit of alternatives to improve training for prehospital trauma care in Mexico. Prehospital Disaster Med 19:318–325PubMed
36.
Zurück zum Zitat Ali J, Cohen R, Adam R et al (1997) Effect of the Prehospital Trauma Life Support Program (PHTLS) on prehospital trauma care. J Trauma 42:786–790CrossRefPubMed Ali J, Cohen R, Adam R et al (1997) Effect of the Prehospital Trauma Life Support Program (PHTLS) on prehospital trauma care. J Trauma 42:786–790CrossRefPubMed
37.
Zurück zum Zitat Mock C, Abantanga F, Goosen J et al (2009) Strengthening care of injured children globally. Bull WHO 87:382–389PubMed Mock C, Abantanga F, Goosen J et al (2009) Strengthening care of injured children globally. Bull WHO 87:382–389PubMed
38.
Zurück zum Zitat MacKenzie EJ, Rivara FP, Jurkovich GJ et al. (2006) A national evaluation of the effect of trauma-center care on mortality. N Engl J Med 26(354):366–378 MacKenzie EJ, Rivara FP, Jurkovich GJ et al. (2006) A national evaluation of the effect of trauma-center care on mortality. N Engl J Med 26(354):366–378
39.
Zurück zum Zitat Mann N, Mullins R, Mackenzie E et al (1999) A systematic review of published evidence regarding trauma system effectiveness. J Trauma 47:S23–S25 Mann N, Mullins R, Mackenzie E et al (1999) A systematic review of published evidence regarding trauma system effectiveness. J Trauma 47:S23–S25
Metadaten
Titel
Ratification of IATSIC/WHO’s Guidelines for Essential Trauma Care Assessment in the South American Region
verfasst von
Michel B. Aboutanos
Francisco Mora
Edgar Rodas
Juan Salamea
Marcelo Ochoa Parra
Estuardo Salgado
Charlie Mock
Rao Ivatury
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 11/2010
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-010-0716-9

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