Assessment of trauma care capacity in Karachi, Pakistan: A step towards an integrated trauma care system in a developing country

Document Type

Article

Department

Anaesthesia

Abstract

Introduction: Trauma has a comparatively higher morbidity and mortality in low-middle income countries such as Pakistan. A major contributing factor of this is the inadequacy of trauma care capacity of hospitals. These shortcomings encompass both the availability of equipment and trained personnel. Our study's objective was to assess trauma care capacity in hospitals across Karachi, Pakistan.
Methods: We assessed the trauma care capabilities of 23 hospitals in Karachi using the WHO Guidelines for Essential Trauma care. Hospitals were selected based on their location, bed capacity, and presence of emergency departments, intensive care units, and operating rooms. Equipment and skills were assessed by on-site surveys and interviews with relevant personnel.
Results: Out of 23 hospitals surveyed, only 13 (57%) had adequate [trauma capacity score (TCS) 67%] resources and skills to provide basic resuscitation measures for initial stabilization.13 (57%) hospitals had an inadequate (TCS <34%) capacity for handling head, neck and spinal injury.15 (65%) hospitals were inadequate or partially adequate (TCS<67) for diagnosis, monitoring and safety. Availability of essential medicines was inadequate in 9 (43%) hospitals.
Conclusion: This study identified specific gaps in the provision of hospital based trauma care in Karachi, which will enable targeted interventions. Appropriate allocation of resources and training of personnel has been shown to improve delivery of care. Our study also identified hospitals which are best equipped to manage traumatic injury; this information will be vital for emergency services when deciding where to transport an injured patient.

Publication (Name of Journal)

Journal of the American College of Surgeons

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