Faculty of Medicine, University of Medical Sciences and Technology (UMST), Khartoum, Sudan.
Department of Surgery, Orthopedics and Trauma, University of Medical Sciences and Technology (UMST), Khartoum, Sudan.
Injury. 2024 May;55(5):111268. doi: 10.1016/j.injury.2023.111268. Epub 2023 Dec 13.
Early recognition and initial treatment of trauma patients prevents deterioration and buys time for making a definitive diagnosis. The "Airway, Breathing, Circulation, Disability and Exposure" (ABCDE) approach should be used whenever an injury is suspected. It provides quick identification and management of life-threatening problems. Still, there is limited knowledge regarding adherence to the ABCDE approach. This research aims to assess the adherence of the trauma team members to the ABCDE approach in the management of major trauma patients and the factors affecting it.
The study is a cross-sectional hospital-based study conducted in the trauma and resuscitation rooms of major governmental hospitals in Khartoum in the period from Jan.30, 2022, to Mar.29, 2022. It was done among the medical staff dealing with major trauma cases. Data were collected by observation using a modified standardized checklist for assessing the ABCDE approach and via a self-administered questionnaire for identifying the factors affecting adherence. Total coverage of all major trauma cases resuscitation (n = 50) was done. Also, a sample size of 158 medical staff was covered for the questionnaire. The data was analyzed in Statistical Package for the Social Science (SPSS) V.23.
The mean percentage of adherence to the ABCDE approach was 37.9 % (SD 15.44). When the ABCDE sequence was not followed, the ACB was the commonest sequence. Also, adherence had no significant relation with any patient or staff-related factor. The main present obstacles to adherence to the ABCDE approach were overcrowding in the room and unprepared facilities. While the major present facilitator was the clinical experience.
The adherence rate was low, but initiation of the ABCDE approach was rapid. The factors participating in low adherence rates were usually facility or population-based factors. We recommend further studies, further training and embedment of guidelines, and the provision of larger trauma rooms with adequate supplies.
早期识别和初步治疗创伤患者可防止病情恶化，并为明确诊断争取时间。每当怀疑有损伤时，都应采用“气道、呼吸、循环、残疾和暴露”（ABCDE）方法。它可快速识别和处理危及生命的问题。然而，人们对 ABCDE 方法的依从性知之甚少。本研究旨在评估创伤团队成员在处理重大创伤患者时对 ABCDE 方法的依从性及其影响因素。
这是一项在 2022 年 1 月 30 日至 3 月 29 日期间在喀土穆的主要政府医院的创伤和复苏室进行的基于医院的横断面研究。研究对象为处理重大创伤病例的医务人员。使用改良的标准化检查表评估 ABCDE 方法，通过自我管理问卷评估影响依从性的因素，通过观察收集数据。对所有重大创伤病例的复苏进行了全面覆盖（n=50）。还对 158 名医务人员进行了问卷调查，以覆盖样本量。数据分析使用社会科学统计软件包（SPSS）V.23。
ABCDE 方法的依从率平均为 37.9%（SD 15.44）。当不遵循 ABCDE 顺序时，最常见的顺序是 ACB。此外，依从性与任何患者或员工相关因素均无显著关系。遵循 ABCDE 方法的主要障碍是房间拥挤和设施准备不足。而主要的促进因素是临床经验。
依从率较低，但 ABCDE 方法的启动速度很快。导致低依从率的因素通常是设施或人口因素。我们建议进行进一步的研究、进一步的培训和实施指南，并提供更大的创伤室，配备充足的供应品。
