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Published:
Jun 4, 2004Keywords:
Anaesthesia emergency surgery daytime emergency theatre health insurance
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An audit of emergency anaesthesia and surgery
Abstract
Background: Emergency surgical patients pose problems in initial resuscitation, anaesthetic and surgical management and postoperative care. Lack of basic amenities, scarce financial resources and poor organization of available health resources are factors that negatively influence the quality of surgical care rendered in developing countries. This paper presents findings of an audit of emergency surgical and anaesthetic services provided at the main theatre of the Ahmadu Bello University Teaching Hospital, Kaduna (ABUTHK) in year 2001. Our focus was to survey emergency surgical and anaesthetic services over a twelve-month period in order to evaluate the pattern of presentation and adequacy of management of surgical emergencies.
Method: Data collected for all emergencies booked at the ABUTHK main theatre included grade of anaesthetists and operating surgeons, the age, sex and ASA class of patients. Also, the time of booking surgery, actual time of surgery, type of anaesthesia given, immediate outcome of surgery, cases booked but not done and the reasons, were all examined. Analysis of the data relied on simple statistical tables and charts.
Results: Three hundred and forty eight patients were booked for emergency surgery within the study period while 331 emergency surgeries were actually performed. The surgery cancellation rate was 4.8%. Young adult females with obstetric emergencies formed the bulk of the patients requiring emergency surgery. 57.7% of emergency surgeries were performed outside normal working hours. Surgical residents handled 66.13% of the emergencies while anaesthetic residents and nurse anaesthetists provided anaesthesia for 96.3% of patients. General anaesthesia was most often given. Emergencies were sometimes delayed or not done due to lack of theatre space, electricity, water, sterile gowns, anaesthetic drugs, investigation results and patients' inability to pay.
Conclusion: Provision of a separate daytime emergency theatre, constant electricity and water and a functional health insurance scheme would solve most of the problems encountered.
Key Words: Anaesthesia, emergency surgery, daytime emergency theatre, health insurance
Nigerian Journal of Surgical Research Vol.5(1&2) 2003: 140-147
Method: Data collected for all emergencies booked at the ABUTHK main theatre included grade of anaesthetists and operating surgeons, the age, sex and ASA class of patients. Also, the time of booking surgery, actual time of surgery, type of anaesthesia given, immediate outcome of surgery, cases booked but not done and the reasons, were all examined. Analysis of the data relied on simple statistical tables and charts.
Results: Three hundred and forty eight patients were booked for emergency surgery within the study period while 331 emergency surgeries were actually performed. The surgery cancellation rate was 4.8%. Young adult females with obstetric emergencies formed the bulk of the patients requiring emergency surgery. 57.7% of emergency surgeries were performed outside normal working hours. Surgical residents handled 66.13% of the emergencies while anaesthetic residents and nurse anaesthetists provided anaesthesia for 96.3% of patients. General anaesthesia was most often given. Emergencies were sometimes delayed or not done due to lack of theatre space, electricity, water, sterile gowns, anaesthetic drugs, investigation results and patients' inability to pay.
Conclusion: Provision of a separate daytime emergency theatre, constant electricity and water and a functional health insurance scheme would solve most of the problems encountered.
Key Words: Anaesthesia, emergency surgery, daytime emergency theatre, health insurance
Nigerian Journal of Surgical Research Vol.5(1&2) 2003: 140-147
