Bontha V Babu1, Karthik Vishwanathan2, Aruna Ramesh3, Amit Gupta4, Sandeep Tiwari5, Babu U Palatty6, Yogita Sharma7. 1. Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India. Electronic address: babubontha@gmail.com. 2. Department of Orthopaedics, Pramukhswami Medical College, Karamsad, Anand, India. 3. Department of Emergency Medicine, M.S. Ramaiah Medical College, Bengaluru, India. 4. Division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India. 5. Department of General Surgery, King George's Medical University, Lucknow, India. 6. Department of Emergency Medicine, Jubilee Mission Medical College and Research Institute, Thrissur, India. 7. Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India.
Abstract
BACKGROUND: India is in the process of strengthening the trauma care system, and assessment of the current situation using standard guidelines has immense use. This study reports the status of trauma care facilities in India, with a broad framework of guidelines for essential trauma care by the World Health Organization. MATERIALS AND METHODS: This study is part of a multicentric intervention study to standardize structured trauma care services in five Indian cities. Thirty trauma care facilities (five level I, 10 level II, and 15 level III facilities) were included. Data on the availability of equipment and manpower were collected. Availability of knowledge + skills and equipment + supplies was assessed based on the guidelines for essential trauma care by World Health Organization. RESULTS: There is almost 100% availability of services and equipment in level I hospitals, but availability varied between 50% and 100% at level II facilities. Very fewer number of services are available at level III facilities. Inadequacy of equipment is reported in level II and III facilities. Only level I facilities have required human resources. Availability of resources in terms of knowledge and equipment of different skills indicated that overall optimal level is observed in level I hospitals. Level II facilities are more deficient in nursing and paramedic staff, and level III facilities reported deficiencies in all categories. CONCLUSIONS: A significant imbalance between recommended resources and the resources that are available in the trauma care facilities was noted. Hence, the study warrants urgent strengthening of trauma care facilities, particularly of level II and III facilities.
BACKGROUND: India is in the process of strengthening the trauma care system, and assessment of the current situation using standard guidelines has immense use. This study reports the status of trauma care facilities in India, with a broad framework of guidelines for essential trauma care by the World Health Organization. MATERIALS AND METHODS: This study is part of a multicentric intervention study to standardize structured trauma care services in five Indian cities. Thirty trauma care facilities (five level I, 10 level II, and 15 level III facilities) were included. Data on the availability of equipment and manpower were collected. Availability of knowledge + skills and equipment + supplies was assessed based on the guidelines for essential trauma care by World Health Organization. RESULTS: There is almost 100% availability of services and equipment in level I hospitals, but availability varied between 50% and 100% at level II facilities. Very fewer number of services are available at level III facilities. Inadequacy of equipment is reported in level II and III facilities. Only level I facilities have required human resources. Availability of resources in terms of knowledge and equipment of different skills indicated that overall optimal level is observed in level I hospitals. Level II facilities are more deficient in nursing and paramedic staff, and level III facilities reported deficiencies in all categories. CONCLUSIONS: A significant imbalance between recommended resources and the resources that are available in the trauma care facilities was noted. Hence, the study warrants urgent strengthening of trauma care facilities, particularly of level II and III facilities.
Authors: Mohammad Salman Khalil; Asad Latif; Muhammad Nabeel Ashraf; Muhammad Mehmood Alam Atiq; Hasnain Zafar; Adil Haider; Lubna Samad Journal: World J Surg Date: 2021-07-12 Impact factor: 3.352