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Wladis, Andreas
Publications (2 of 2) Show all publications
Lampi, M., Junker, J., Tabu, J. S., Berggren, P., Jonson, C.-O. & Wladis, A. (2018). Potential benefits of triage for the trauma patient in a Kenyan emergency department. BMC Emergency Medicine, 18, Article ID 49.
Open this publication in new window or tab >>Potential benefits of triage for the trauma patient in a Kenyan emergency department
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2018 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 18, article id 49Article in journal (Refereed) Published
Abstract [en]

Background

Improved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country.

Methods

A prospective descriptive study was conducted. Adult trauma patients admitted to the emergency department during an 8-month period at Moi Teaching and Referral Hospital in Eldoret, Kenya, were included. Mode of arrival and vital parameters were registered. Variables included in the analysis were Injury Severity Score, time before physician’s assessment, length of hospital stay, and mortality. The patients were retrospectively categorized according to the Rapid Emergency Triage and Treatment System (RETTS) from patient records.

Results

A total of 571 patients were analyzed, with a mean Injury Severity Score of 12.2 (SD 7.7) with a mean length of stay of 11.6 (SD 18.3) days. The mortality rate was 1.8%. The results obtained in this study illustrate that trauma patients admitted to the emergency department at Eldoret are not assessed in a timely fashion, and the time frame recommendations postulated by RETTS are not adhered to. Assessment of patients according to the triage algorithm used revealed a significantly higher average Injury Severity Score in the red category than in the other color categories.

Conclusion

The results from this study clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. This is further demonstrated by the retrospective triage classification of patients, which identified patients with high ISS as in urgent need of care. Since no significant difference in to time to assessment regardless of injury severity was observed, the need for a well-functioning triage system is apparent.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Triage, Trauma, Emergency department
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-153305 (URN)10.1186/s12873-018-0200-7 (DOI)000452637100002 ()30497397 (PubMedID)2-s2.0-85057551142 (Scopus ID)
Note

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2020-01-20Bibliographically approved
Haverkamp, F. J. C., Veen, H., Hoencamp, R., Muhrbeck, M., von Schreeb, J., Wladis, A. & Tan, E. C. T. (2018). Prepared for Mission? A Survey of Medical Personnel Training Needs Within the International Committee of the Red Cross. World Journal of Surgery, 42(11), 3493-3500
Open this publication in new window or tab >>Prepared for Mission? A Survey of Medical Personnel Training Needs Within the International Committee of the Red Cross
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2018 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 42, no 11, p. 3493-3500Article in journal (Refereed) Published
Abstract [en]

Background Humanitarian organizations such as the International Committee of the Red Cross (ICRC) provide worldwide protection and medical assistance for victims of disaster and conflict. It is important to gain insight into the training needs of the medical professionals who are deployed to these resource scarce areas to optimally prepare them. This is the first study of its kind to assess the self-perceived preparedness, deployment experiences, and learning needs concerning medical readiness for deployment of ICRC medical personnel. Methods All enlisted ICRC medical employees were invited to participate in a digital questionnaire conducted during March 2017. The survey contained questions about respondents personal background, pre-deployment training, deployment experiences, self-perceived preparedness, and the personal impact of deployment. Results The response rate (consisting of nurses, surgeons, and anesthesiologists) was 54% (153/284). Respondents rated their self-perceived preparedness for adult trauma with a median score of 4.0 on a scale of 1 (very unprepared) to 5 (more than sufficient); and for pediatric trauma with a median score of 3.0. Higher rates of self-perceived preparedness were found in respondents who had previously been deployed with other organizations, or who had attended at least one master class, e.g., the ICRC War Surgery Seminar (p amp;lt; 0.05). Additional training was requested most frequently for pediatrics (65/150), fracture surgery (46/150), and burns treatment (45/150). Conclusion ICRC medical personnel felt sufficiently prepared for deployment. Key points for future ICRC pre-deployment training are to focus on pediatrics, fracture surgery, and burns treatment, and to ensure greater participation in master classes.

Place, publisher, year, edition, pages
SPRINGER, 2018
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-152369 (URN)10.1007/s00268-018-4651-5 (DOI)000446776000004 ()29721638 (PubMedID)
Note

Funding Agencies|World Health Organization [001]

Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2019-05-01
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