A National Trauma Capacity Assessment of Haiti Public

McCullough, Chelsea (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/tm70mw02t?locale=fr
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Abstract

Background: Trauma systems in high-income countries have been shown to reduce trauma-related morbidity and mortality, however these systems are infrequently implemented in LMICs. Haiti currently lacks a well-resourced and structured trauma system and in turn loses an estimated 800,000 years of healthy life to injuries annually. In the current study, we perform a nation-wide trauma capacity assessment, and using the World Health Organization's Guidelines for Essential Trauma Care as a framework, we attempt to identify achievable steps that can be taken towards improving trauma care in Haiti.

Materials and Methods: This cross-sectional study was performed at 12 facilities nationally using a survey tool assessing the areas of infrastructure, supplies and equipment, personnel and training, and procedural capabilities. Additionally, the total number of trauma cases presenting to each facility was tabulated from emergency room logbooks.

Results: A total of 6 secondary and 6 tertiary facilities were surveyed. Secondary facilities received an average of 35 trauma cases per week, while tertiary facilities received an average of 65 cases per week. Survey results demonstrated a shortage of airway, breathing and circulation equipment and supplies in both facility levels, particularly in emergency rooms. All facilities lacked access to essential surgical personnel and trauma training.

Conclusions: This study makes recommendations for improvements in trauma care in Haiti in the areas of infrastructure & administration, physical resources, and training & human resources. These recommendations represent feasible steps that can be taken towards the construction of a national trauma system in Haiti.

Table of Contents

Chapter 1: Introduction. 1

Chapter 2: Comprehensive Literature Review

2.1 Trauma in Developing Countries. 5

2.2 Trauma Systems in High-Income Countries. 6

2.3 Developing Trauma Systems in Low- and Middle-Income Countries. 9

Chapter 3: Manuscript

3.1 Title Page for Manuscript. 12

3.2 Contribution of the Student. 13

3.3 Abstract. 14

3.4 Introduction. 15

3.5 Methods. 16

3.6 Results. 18

3.7 Discussion. 21

3.8 Manuscript References. 29

3.9 Tables. 32

Chapter 4: Recommendations, Implications and Future Directions. 37

Thesis References. 40

Appendix 1: Survey Tool. 42

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