OBJECTIVE: To evaluate whether a 30-minute decision-to-delivery interval is a realistic target for emergency caesarean section. DESIGN: An audit of all emergency caesarean sections over five separate periods. SETTING: A district general hospital. PARTICIPANTS: Five groups of women (343 women) with an indication for emergency caesarean section. METHODS: Following an initial survey, a structured time sheet was introduced, followed by four other surveys to complete the audit cycle. MAIN OUTCOME MEASURE: The proportion of caesarean sections where the decision-to-delivery interval was achieved within 30 minutes. The reasons for delay. RESULTS: In the first survey of 73 emergency caesarean sections, the time to deliver the infant exceeded 30 minutes in 47 women (64%). The main sources of delay were transferring the women to the operating theatre and starting the anaesthetic. After the introduction of a structured time sheet, there was an improvement with each survey, but the target of 30 minutes was reached in only 71% of caesarean sections in the final survey. CONCLUSIONS: The introduction of a time sheet can improve the decision-to-delivery interval for emergency caesarean section; however, a universal standard of 100% in 30 minutes is unrealistic.
OBJECTIVE: To evaluate whether a 30-minute decision-to-delivery interval is a realistic target for emergency caesarean section. DESIGN: An audit of all emergency caesarean sections over five separate periods. SETTING: A district general hospital. PARTICIPANTS: Five groups of women (343 women) with an indication for emergency caesarean section. METHODS: Following an initial survey, a structured time sheet was introduced, followed by four other surveys to complete the audit cycle. MAIN OUTCOME MEASURE: The proportion of caesarean sections where the decision-to-delivery interval was achieved within 30 minutes. The reasons for delay. RESULTS: In the first survey of 73 emergency caesarean sections, the time to deliver the infant exceeded 30 minutes in 47 women (64%). The main sources of delay were transferring the women to the operating theatre and starting the anaesthetic. After the introduction of a structured time sheet, there was an improvement with each survey, but the target of 30 minutes was reached in only 71% of caesarean sections in the final survey. CONCLUSIONS: The introduction of a time sheet can improve the decision-to-delivery interval for emergency caesarean section; however, a universal standard of 100% in 30 minutes is unrealistic.
Authors: K K Roy; Jinee Baruah; Sunesh Kumar; A K Deorari; J B Sharma; Debjyoti Karmakar Journal: Indian J Pediatr Date: 2009-02-04 Impact factor: 1.967