evaluation of head and spinal cord injury care in ecuador using the iatsic/Who essential Guidelines for trauma c are

Abstract:

Background: Neurological trauma represents a major cause of global death and disability, with low and middle income countries representing the greatest burden of disease. The goal of this study was to assess the capability of Ecuadorian hospitals to manage head and spinal cord injury utilizing the International Association for Trauma Surgery and Intensive Care (IATSIC)/World Health Organization (WHO) Guidelines for Essential Trauma Care (EsTC). Materials and methods: Site visits were performed at 24 hospitals in 7 provinces of southeastern Ecuador. The 23 human and physical resources required for management of head injury (HI) and spinal injury (SI) were evaluated using EsTC criteria. Resource capabilities were graded as 3 (adequate,> 90%), 2 (partially adequate,> 50%), 1 (inadequate,< 50%), or 0 (absent). Results: Five tertiary (TH) and 12 general (GH) public hospitals were included in the final assessment. Initial assessment of neurological injuries was at least partially adequate for HI (100% TH/GH) and partially adequate for SI (100% TH, 83.3% GH). Maintenance of normotension and oxygenation to prevent secondary neurological injury was partially adequate in TH (100% HI/SI) and inadequate in GH (only 58.3% were partially adequate for HI and 67.7% for SI). Surgical capabilities for treatment of neurological injuries were partially adequate with wide variability in TH. Familiarity or compliance with AANS guidelines and international classification systems for HI and SI were absent at all facilities. CT and MRI capabilities were universally inadequate. Conclusion: Based on WHO/IATSIC EsTC guidelines, significant improvement in …

Año de publicación:

2012

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