scholarly journals Current Trauma Care System in Saudi Arabia: Literature Review and a Proposed Action Plan

2021 ◽  
pp. 1-11
Author(s):  
Abdallah Mohammad Alferdaus ◽  
Abdulaziz Shaher
Keyword(s):  
Saudi Arabia ◽  
Literature Review ◽  
Trauma Care ◽  
Action Plan ◽  
Trauma System ◽  
World Health ◽  
Trauma Centers ◽  
Research Activities ◽  
Essential Components ◽  
Care System

<b><i>Introduction:</i></b> Trauma is one of the leading causes of morbidity and mortality in Saudi Arabia (SA) and worldwide and remains the leading cause of mortality in younger people. We conducted a literature review to assess the current trauma system in SA and formulated an action plan that might help guide leaders and colleagues in implementing a mature trauma system across the country. <b><i>Methods:</i></b> We searched PubMed, ScienceDirect, publications from the World Health Organization (WHO), and American College of Surgeons (ACS) and formal reports from the ministries and authorities in SA. <b><i>Results:</i></b> After aligning the trauma care system in SA to the WHO trauma system maturity index (TSMI) and ACS criteria for a mature system, the SA system was found to have many deficiencies in essential components such as national trauma registry or active trauma research activities. Injury prevention and prehospital care are progressing and may be graded as TSMI level III, indicating room for improvement. Regarding the definitive care at hospitals and centers, only 2 centers at Riyadh met the criteria for level I trauma centers. Other regions in SA do not have major trauma centers yet. Overall, the components of the SA trauma care system were graded from levels I to III on the basis of the WHO TSMI and ACS criteria for a mature trauma system. <b><i>Conclusion:</i></b> In SA, injury remains the primary cause of death in children and other younger people. Efforts to reduce the prevalence and burden of trauma in SA are progressing. Completion of a nationwide trauma system would be a major step toward achieving that goal. We have proposed an action plan to achieve that goal.

Current trauma care system in Saudi Arabia: A scoping literature review

2020 ◽  
Vol 144 ◽  
pp. 105653 ◽  
Author(s):  
Rayan Jafnan Alharbi ◽  
Virginia Lewis ◽  
Ian Mosley ◽  
Charne Miller
Keyword(s):  
Saudi Arabia ◽  
Literature Review ◽  
Trauma Care ◽  
Scoping Literature Review ◽  
Care System

scholarly journals The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

2021 ◽  
Author(s):  
Suzan Dijkink ◽  
Erik W. van Zwet ◽  
Pieta Krijnen ◽  
Luke P. H. Leenen ◽  
Frank W. Bloemers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Trauma System ◽  
Future Research ◽  
Severely Injured ◽  
Trauma Centers ◽  
Severely Injured Patients ◽  
The Right ◽  
Injured Patients ◽  
The Impact

Abstract Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

scholarly journals Access barriers to visual health

2018 ◽  
Vol 16 (1) ◽  
pp. 95-109 ◽  
Author(s):  
María Alejandra Rodríguez-Echeverría ◽  
Angélica María Páez-Castro
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Health Care System ◽  
World Health ◽  
Local Health Authority ◽  
Barriers To Access ◽  
The World ◽  
Health Organization ◽  
Visual Health ◽  
Care System

A number of factors and conditions hinder and restrict access to the health care system and its different services; these barriers to access put at risk the health of people by affecting adequate processes. Objective: To carry out a literature review on barriers to access to the health care system and visual health services in Colombia and around the world. Methodology: A literature review was carried out based on a search of the Medline, ScienceDirect, and Pubmed databases, as well as indexed public health journals and the websites of the Local Health Authority, the World Health Organization, the Pan American Health Organization, the UNESCO, and the Brien Holden Vision Institute. Results: The main barriers related to demand, both in general services and in visual health, are the lack of perception on the need for service and lack of economic resources; at the offer level, the existing policies constitute a real obstacle. Conclusions: Awareness-raising in the population, together with the implementation of health policies that grant equal access to health care services, are fundamental to prevent people from being affected, to a large extent, by barriers related to demand or offer, regardless of their location or level of income.

scholarly journals Individual and healthcare system factors influencing antenatal care attendance in Saudi Arabia

2019 ◽  
Author(s):  
Wdad Alanazy ◽  
Amy Brown
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Antenatal Care ◽  
Health Care System ◽  
Maternal Education ◽  
World Health ◽  
Missed Appointments ◽  
Risk Pregnancy ◽  
System Factors ◽  
Care System

Abstract Background The World Health Organisation recommends women have at least 4 antenatal care visits (ANC) during a low risk pregnancy. However, in Saudi Arabia, many mothers miss these appointments placing their health and that of their baby at risk. Limited research exploring why this is happening usually focuses on low maternal education or personal barriers such as lack of transport. The aim of the current research was therefore to understand what factors at the individual and healthcare systems level were associated with missing antenatal care in Saudi Arabia.Methods Two hundred and forty two pregnant women in their third trimester completed a questionnaire examining their care attendance alongside barriers to attending care. These included maternal demographic background, health literacy, personal barriers, health care system factors and staff communication).Results Over half of women had missed at least one appointment and a third had delayed their care. Mothers who had missed appointments blamed health care system factors such as poor clinic facilities and waiting times. Attending care was not associated with maternal education or literacy. However perceptions of staff communication, consistency and care were lower amongst those who had missed at least one appointment.Conclusions Although in previous research health professionals believe it is maternal education that leads to poor attendance, in our sample at least, it is in fact perceptions of staff communication that affect attendance. Making changes at the health care level e.g. through adapting clinic times and investing in staff training may increase antenatal care attendance in Saudi Arabia.

Analysis of Hospital Ability to Provide Trauma Services: A Comparison between Teaching and Community Hospitals

1991 ◽  
Vol 6 (4) ◽  
pp. 455-458 ◽  
Author(s):  
Keith W. Neely ◽  
Robert L. Norton ◽  
Ed Bartkus ◽  
John A. Schiver
Keyword(s):  
Trauma Care ◽  
Trauma Center ◽  
Trauma System ◽  
Teaching Hospitals ◽  
Trauma Centers ◽  
Ct Scanner ◽  
Community Hospitals ◽  
Availability Analysis ◽  
Level Ii ◽  
American College Of Surgeons

AbstractHypothesis:Teaching hospitals (TH) can maintain the American College of Surgeons Committee on Trauma (ACSCOT) criteria for Level II trauma care more consistently than can community hospitals (CH).Methods:A retrospective analysis of 2,091 trauma system patients was done to determine if TH in an urban area are better able to meet the criteria for Level II trauma care than are CH. During the study period, a voluntary trauma plan existed among five hospitals; two TH and three CH. A hospital could accept patients that met trauma system entry criteria as long as, at that moment, it could provide the resources specified by ACSCOT. Hospitals were required to report their current resources accurately. A centralized communications center maintained a computerized, inter-hospital link which continuously monitored the availability of all participating hospitals. Trauma system protocols required paramedics to transport system patients to the closest available trauma hospital that had all the required resources available. Nine of the required ACSCOT Level II trauma center criteria were monitored for each institution emergency department (ED); trauma surgeon (TS); operating room (OR); angiogaphy (ANG); anesthesiologist (ANE); intensive care unit (ICU); on-call surgeon (OCS); neurosurgeon (NS); and CT scanner (CT) available at the time of each trauma system entry.Results:With the exception of OR, TH generally maintained the required staff and services more successfully than did CH. Further, less day to night variation in the available resources occurred at the TH. Specifically, ANE, ICU, TS, NS and CT were available more often both day and night, at TH than CH. However, OR was less available at TH than CH during both day and night (p<.01).Conclusions:In this community, TH provided a greater availability of trauma services than did CH. This study supports the designation of TH as trauma centers. A similar availability analysis can be performed in other communities to help guide trauma center designation.

Emergency management of trauma in India: Expectations and reality

2007 ◽  
Vol 2 (1) ◽  
pp. 13-19 ◽  
Author(s):  
B. R. Sharma, MBBS, MD
Keyword(s):  
Emergency Management ◽  
Trauma Care ◽  
Population Control ◽  
Trauma System ◽  
Mass Casualty ◽  
Trauma Centers ◽  
National Agency ◽  
Stage Of Development ◽  
Care Systems ◽  
And Child Health

Emergency management of trauma in the developing world is at a nascent stage of development. Industrialized cities, rural towns, and villages coexist, with an almost complete lack of organized trauma care. There is no leading national agency to coordinate the various components of a trauma system, and no mechanism for accreditation of trauma centers and professionals exists. Accelerated urbanization and industrialization over the last three to four decades has led to an alarming increase in the rate of accidental injuries, crime, and violence, and ever-increasing terrorist activities over the last two decades have ushered in man-made mass-casualty disasters. However, communicable diseases, maternal and child health, and population control continue to be government priorities, far ahead of trauma care, in countries like India. New initiatives under the National Health Policy 2002 were expected to result in improvements in the systems, but grossly inadequate funding allocation made any significant impact on the outcome impossible. Strengthening in several areas is severely needed to achieve a reasonable level of efficiency, despite significant efforts on the part of the private sector to develop trauma care systems.

A Decade Evaluation of a State Trauma System: Has Access to Inpatient Trauma Care at Designated Trauma Centers Improved?

2017 ◽  
Vol 83 (7) ◽  
pp. 769-777 ◽  
Author(s):  
◽  
Dennis W. Ashley ◽  
Etienne E. Pracht ◽  
Regina S. Medeiros ◽  
Elizabeth V. Atkins ◽  
...  
Keyword(s):  
Trauma Care ◽  
Injury Severity ◽  
Trauma System ◽  
Age Groups ◽  
Trauma Centers ◽  
Access To Treatment ◽  
Score Method ◽  
Severity Levels ◽  
Injured Patients ◽  
Discharge Database

Recently, the trauma center component of the Georgia trauma system was evaluated demonstrating a 10 per cent probability of increased survival for severely injured patients treated at designated trauma centers (DTCs) versus nontrauma centers. The purpose of this study was to determine the effectiveness of a state trauma system to provide access to inpatient trauma care at DTCs for its residents. We reviewed 371,786 patients from the state's discharge database and identified 255,657 treated at either a DTC or a nontrauma center between 2003 and 2012. Injury severity was assigned using the International Classification Injury Severity Score method. Injury was categorized as mild, moderate, or severe. Patients were also categorized by age and injury type. Access improved over time in all severity levels, age groups, and injury types. Although elderly had the largest improvement in access, still only 70 per cent were treated at a DTC. During the study period, increases were noted for all age groups, injury severity levels, and types of injury. A closer examination of the injured elderly population is needed to determine the cause of lower utilization by this age group. Overall, the state's trauma system continues to mature by providing patients with increased access to treatment at DTCs.

scholarly journals National Trauma System Establishment Based on Implementation of Regional Trauma Centers Improves Outcomes of Trauma Care; A Follow-up Observational Study in South Korea

2021 ◽  
Author(s):  
Kyoungwon Jung ◽  
Junsik Kwon ◽  
Yo Huh ◽  
Jonghwan Moon ◽  
Kyungjin Hwang ◽  
...  
Keyword(s):  
Trauma Care ◽  
Death Rate ◽  
Injury Severity ◽  
Trauma System ◽  
Trauma Centers ◽  
Middle Income ◽  
Death Rates ◽  
Middle Income Countries ◽  
National Trauma ◽  
Trauma Death

Abstract Background: Although Korea is a high-income country, its trauma system is comparable to low- and middle-income countries with high preventable trauma death rates (> 30%). Since 2012, Korea has established a national trauma system based on the implementation of regional trauma centers and improvement of the transfer system; this study aimed to evaluate its effectiveness.Methods: We compared the national preventable trauma death rates, transfer patterns, and outcomes between 2015 and 2017. The review of preventable trauma deaths was conducted by multiple panels and a severity-adjusted logistic regression model was created to identify factors influencing the preventable trauma death rate. We also compared the number of trauma patients transferred to emergency medical institutions and mortality in models adjusted with injury severity scores.Results: The preventable trauma death rate decreased from 2015 to 2017 (30.5% vs. 19.9%, p < 0.001). In the severity-adjusted model, the preventable trauma death risk had a lower odds ratio (0.68, 95% confidence interval: 0.53–0.87, p = 0.002) in 2017 than in 2015. Regional trauma centers received 1.6 times more severe cases in 2017 (according to the International Classification of Diseases Injury Severity Score [ICISS]; 23.1% vs. 36.5%). In the extended ICISS model, the overall trauma mortality decreased significantly from 2.1% (1008/47806) to 1.9% (1062/55057) (p = 0.041).Conclusions: Establishment of the national trauma system was associated with significant improvements in performance and outcomes of trauma care. This was mainly because of the implementation of regional trauma centers and because more severe patients were transferred to regional trauma centers. This study might be a good model for low- and middle-income countries, which lack a trauma system.

scholarly journals Management of severe trauma worldwide: implementation of trauma systems in emerging countries: China, Russia and South Africa

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jing Zhou ◽  
Tianbing Wang ◽  
Igor Belenkiy ◽  
Timothy Craig Hardcastle ◽  
Jean-Jacques Rouby ◽  
...  
Keyword(s):  
South Africa ◽  
Trauma Care ◽  
Hospital Care ◽  
Life Support ◽  
Trauma Registry ◽  
Trauma System ◽  
Emerging Countries ◽  
Trauma Centers ◽  
Trauma Systems ◽  
National Trauma

AbstractAs emerging countries, China, Russia, and South Africa are establishing and/or improving their trauma systems. China has recently established a trauma system named “the Chinese Regional Trauma Care System” and covered over 200 million populations. It includes paramedic-staffed pre-hospital care, in-hospital care in certified trauma centers, trauma registry, quality assurance, continuous improvement and ongoing coverage of the entire Chinese territory. The Russian trauma system was formed in the first decade of the twenty-first century. Pre-hospital care is region-based, with a regional coordination center that determines which team will go to the scene and the nearest hospital where the victim should be transported. Physician-staffed ambulances are organized according to three levels of trauma severity corresponding to three levels of trauma centers where in-hospital care is managed by a trauma team. No national trauma registry exists in Russia. Improvements to the Russian trauma system have been scheduled. There is no unified trauma system in South Africa, and trauma care is organized by public and private emergency medical service in each province. During the pre-hospital care, paramedics provide basic or advanced life support services and transport the patients to the nearest hospital because of the limited number of trauma centers. In-hospital care is inclusive with a limited number of accredited trauma centers. In-hospital care is managed by emergency medicine with multidisciplinary care by the various specialties. There is no national trauma registry in South Africa. The South African trauma system is facing multiple challenges. An increase in financial support, training for primary emergency trauma care, and coordination of private sector, need to be planned.

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