Prioritizing injury care: A review of trauma capacity in low and middle-income countries

Evan Wong, Shailvi Gupta, Dan L. Deckelbaum, Tarek Razek, Adam L. Kushner

Research output: Contribution to journalArticle

Abstract

Background: Trauma is a large contributor to the global burden of disease, particularly in low and middle-income countries (LMICs). This study aimed to summarize the literature assessing surgical capacity in LMICs to provide a current assessment of trauma capacity, which will help guide future efforts. Materials and methods: The MEDLINE database was queried via PubMed to identify studies assessing baseline surgical capacity in individual LMICs. Data were collected from each study by extracting the relevant information from the full-published text or tables. Trauma capacity was evaluated using 12 surrogate criteria of trauma care, including laparotomy, cricothyroidotomy and chest tube insertion capabilities, and accessibility to a blood bank. Results: Seventeen studies were reviewed, documenting data from 531 hospitals in seventeen countries. None of the countries had access to all twelve trauma criteria in all their hospitals. Endotracheal intubation and cricothyrotomy or tracheostomy were available at 48% (107/222) and 41% (163/418) of facilities, respectively. Bag mask valves were available at 61% (234/383) of the institutions. Although 87% (193/221) of facilities responded that they were able to provide initial resuscitation, only 48% (169/349) of them had access to a blood bank and 70% (191/271) had access to intravenous fluids. A third or less of district hospitals had access to basic resuscitation (33%; 8/24), endotracheal tubes (32%; 31/97), blood banks (31%; 32/102), and cricothyrotomies and/or tracheostomies (32%; 30/95). Conclusions: Deficiencies in trauma capacity in LMICs remain widespread. This study provides specific avenues for improved evaluations of trauma capacity and for strengthening trauma systems in LMICs.

Original languageEnglish (US)
Pages (from-to)217-222
Number of pages6
JournalJournal of Surgical Research
Volume193
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Wounds and Injuries
Blood Banks
Tracheostomy
Resuscitation
Chest Tubes
Intratracheal Intubation
District Hospitals
Masks
PubMed
MEDLINE
Laparotomy
Databases

Keywords

  • Capacity
  • Injury
  • Low income
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Prioritizing injury care : A review of trauma capacity in low and middle-income countries. / Wong, Evan; Gupta, Shailvi; Deckelbaum, Dan L.; Razek, Tarek; Kushner, Adam L.

In: Journal of Surgical Research, Vol. 193, No. 1, 01.01.2015, p. 217-222.

Research output: Contribution to journalArticle

Wong, Evan ; Gupta, Shailvi ; Deckelbaum, Dan L. ; Razek, Tarek ; Kushner, Adam L. / Prioritizing injury care : A review of trauma capacity in low and middle-income countries. In: Journal of Surgical Research. 2015 ; Vol. 193, No. 1. pp. 217-222.
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