Department of Anaesthesia, University of Calabar, Calabar, Nigeria.
Department of Community Medicine, University of Calabar, Calabar, Nigeria.
Pan Afr Med J. 2022 Jul 21;42:225. doi: 10.11604/pamj.2022.42.225.35452. eCollection 2022.
Provision of Basic Life Support (BLS) to victims of cardiac arrest and other common causes of sudden death, is a key function of healthcare systems. Such life-saving service, which is lacking in many low- and middle-income countries (LMIC), is highly dependent on consistent availability of BLS devices and essential drugs. These devices are used to secure airway, deliver oxygen, gain intravenous access for infusions, provide cardiac defibrillation and monitor the cardiorespiratory systems. This study was aimed at evaluating the current state of availability of these devices and essential drugs in healthcare facilities in a developing country setting, within the context of urgent need to curb increasing burden of preventable sudden death.
descriptive cross-sectional study design was employed to assess availability of each of the aforementioned subgroups of resuscitation devices and drugs, in each primary and secondary healthcare facility in all eighteen (18) Local Government Areas (LGAs) of Cross River State, in Southern Nigeria. Quantitative data was obtained using structured proforma, which was used to document presence and quantity of physically seen device(s) and drugs in each facility. The proportion of health facilities with presence of the devices and drugs, was compared between the three districts using chi-square test. P-value was set at 0.05.
two hundred and five (205) health care facilities across the eighteen (18) LGAs of Cross River State were assessed. Approximately one-tenth of health facilities had oropharyngeal airway (10.2%) and laryngoscope (9.3%). Only 5.4% and 3.9% had nasopharyngeal and endotracheal tubes, respectively. None of all of these airway devices was found in all health facilities within four LGAs (22.2%). The most commonly available breathing device was self-inflation bag (SIB), which was found in 51.7% of facilities. Seven LGAs (38.9%) had all of their health facilities not having either oxygen delivery devices, oxygen supply or both. Most health facilities had each of the IV access devices and infusion fluids, but only five facilities had automated external defibrillator (AED). Most health facilities had stethoscope (91.2%) and sphygmomanometer (72.2%), but only 15.1% and 9.3% had pulse oximeter and airway nebulizer, respectively. Less than one-fifth (18.5%) of facilities had atropine, and only 3.9% had amiodarone. Except for amiodarone, there was significantly higher proportion of health facilities that had each of the other essential drugs, in northern compared with other districts (p<0.05).
devices and essential drugs required for provision of resuscitation are lacking in most health facilities in Cross River State. This situation significantly limits the health system's capacity to save lives, especially during emergencies. The implications of these state-wide findings, as well as modalities and options for improvement in availability of these essential devices and drugs are discussed in this article.
为心脏骤停和其他常见猝死原因的患者提供基本生命支持（BLS）是医疗保健系统的关键功能。在许多低收入和中等收入国家（LMIC），这种救生服务缺乏，高度依赖 BLS 设备和基本药物的持续可用性。这些设备用于确保气道畅通、输送氧气、建立静脉通路进行输液、提供心脏除颤和监测心肺系统。本研究旨在评估在发展中国家背景下，在迫切需要遏制可预防的猝死负担不断增加的情况下，这些设备和基本药物在医疗保健设施中的现有情况。
采用描述性横断面研究设计，评估尼日利亚南部十字河州所有 18 个地方政府区（LGAs）的每个初级和二级医疗保健设施中上述复苏设备和药物亚组的可用性。使用结构化表格获得定量数据，该表格用于记录每个设施中实际可见设备和药物的数量。使用卡方检验比较三个区之间存在设备和药物的卫生设施比例。P 值设为 0.05。
评估了十字河州 18 个 LGA 中的 205 个医疗保健设施。大约十分之一的卫生设施有口咽气道（10.2%）和喉镜（9.3%）。只有 5.4%和 3.9%分别有鼻咽和气管内管。在四个 LGA（22.2%）中，没有一个卫生设施拥有所有这些气道设备。最常见的呼吸设备是自动充气袋（SIB），51.7%的设施都有。有七个 LGA（38.9%）的所有卫生设施都没有供氧设备、氧气供应或两者都没有。大多数卫生设施都有每种静脉内通路设备和输液，但只有五个设施有自动体外除颤器（AED）。大多数卫生设施都有听诊器（91.2%）和血压计（72.2%），但只有 15.1%和 9.3%有脉搏血氧仪和气道雾化器。不到五分之一（18.5%）的设施有阿托品，只有 3.9%有胺碘酮。除了胺碘酮，北部地区的卫生设施拥有其他每种基本药物的比例明显高于其他地区（p<0.05）。
十字河州大多数卫生设施都缺乏提供复苏所需的设备和基本药物。这种情况极大地限制了卫生系统拯救生命的能力，尤其是在紧急情况下。本文讨论了这些全州范围的发现，以及改善这些基本设备和药物供应的方式和选择。
