Abstract
Advanced Trauma Life Support (ATLS) protocols aim to provide good trauma care by enhancing the skills of medical personnel all over the world and while this is well established in developed countries it does not appear to be so in developing countries. This study aims to assess the knowledge and proficiency in initial trauma management skills among health caregivers in some general/cottage hospitals in north central Nigeria. Questionnaires were developed to assess the knowledge and skills of care givers in airway management, respiratory distress and shock. The questionnaires were administered on caregivers involved in trauma care in some general/cottage hospitals that offer secondary care in a state in north-central Nigeria. There were 34 health workers who responded, 10 (29.41%) were doctors and 24(70.54%) were nurses. Their years of experience were from 2 to 35 years (median 14years). Ten (29.41%) had at least one training in ATLS in the past while 24(70.59%) had none. In assessing their management skills, 97.06% reported they were able to assess the airway, 88.24% could do chin lift, 73.53% jaw thrust while 91.18% were able to insert oral airway. Thirty-one (91.18%) were able to recognize respiratory distress, 88.24 were able to administer oxygen using facemask and 64.71% using nasal prong. Thirty (88.24%) could assess a patient for shock, 82.35% could splint fractures for haemorrhage control. Twenty-seven (79.41%) reported knowing parameters to monitor during resuscitation. We concluded that knowledge of airway management was high but proficiency and confidence in performing these skills were low.
Highlights
Africa bears a heavy burden from trauma with more deaths occurring each year from injury than deaths linked to HIV/AIDS, tuberculosis and malaria combined.[1]
Eight (80%) of those who had training in Advanced Trauma Life Support (ATLS) were doctors while 2(20%) were nurses In assessing their airway management skills,33(97.06%) said they were able to carry out airway assessment,30(88.24%) were able to perform chin lift,25(73.53%) were able to perform jaw thrust, 31(91.18%) were able to insert an oral airway and 23(67.66%) a nasal airway
Even though the evidence shows that a significant percentage of trauma deaths occur in the pre-hospital setting[7,8] and that many deaths could be prevented by proper measures, 9,10 prehospital trauma care is mostly non-existent in Nigeria
Summary
Africa bears a heavy burden from trauma with more deaths occurring each year from injury than deaths linked to HIV/AIDS, tuberculosis and malaria combined.[1]. Advanced trauma life support (ATLS) has revolutionalized in-hospital management of major trauma patients and is accepted as a standard in many countries worldwide.[5] The ATLS protocol has been found to enhance the knowledge and skills of healthcare personnel and while this is well established in developed countries, it is not so in many developing countries like Nigeria. Our study is designed to assess the knowledge and proficiency in the skills of resuscitating trauma patients among healthcare personnel in some general and cottage hospitals that provide secondary healthcare in Plateau state, North-central Nigeria
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