| Article Access Statistics | | | Viewed | 364 | | | Printed | 8 | | | Emailed | 0 | | | PDF Downloaded | 90 | | | Comments | [Add] | | |
|
Click on image for details.
|
|
| RESEARCH ARTICLE |
|
| Year : 2017 | Volume
: 21
| Issue : 6 | Page : 343--345 |
A retrospective study of physiological observation-reporting practices and the recognition, response, and outcomes following cardiopulmonary arrest in a low-to-middle-income country
Ambepitiyawaduge Pubudu De Silva1, Jayasingha Arachchilage Sujeewa2, Nirodha De Silva2, Rathnayake Mudiyanselage Danapala Rathnayake2, Lakmal Vithanage2, Ponsuge Chathurani Sigera3, Sithum Munasinghe3, Abi Beane4, Tim Stephens5, Priyantha Lakmini Athapattu6, Kosala Saroj Amarasiri Jayasinghe7, Arjen M Dondorp8, Rashan Haniffa9
1 Network for Improving Critical Care Systems and Training; National Intensive Care Surveillance, Ministry of Health; Intensive Care National Audit and Research Centre, Bangkok, Thailand
2 Monaragala District General Hospital, Monaragala, Sri Lanka
3 Network for Improving Critical Care Systems and Training; National Intensive Care Surveillance, Ministry of Health, Bangkok, Thailand
4 Network for Improving Critical Care Systems and Training, Bangkok, Thailand
5 Network for Improving Critical Care Systems and Training, Bangkok, Thailand; Critical Care Research Team, Royal London Hospital, Whitechapel; The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
6 Office of Director Medical Services, Ministry of Health, Colombo, Sri Lanka
7 Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
8 Mahidol Oxford Tropical Medicine Research Unit, Tungphyathai, Bangkok, Thailand
9 Network for Improving Critical Care Systems and Training; National Intensive Care Surveillance, Ministry of Health, Bangkok, ; Faculty of Medicine, University of Colombo, Colombo; Mahidol Oxford Tropical Medicine Research Unit, Tungphyathai, Bangkok, Thailand
Correspondence Address:
Rashan Haniffa
National Intensive Care Surveillance, Quality Secretariat Building, Castle Street Hospital for Women, Colombo 08
Thailand
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijccm.IJCCM_136_17
Background and Aims: In Sri Lanka, as in most low-to-middle-income countries (LMICs), early warning systems (EWSs) are not in use. Understanding observation-reporting practices and response to deterioration is a necessary step in evaluating the feasibility of EWS implementation in a LMIC setting. This study describes the practices of observation reporting and the recognition and response to presumed cardiopulmonary arrest in a LMIC. Patients and Methods: This retrospective study was carried out at District General Hospital Monaragala, Sri Lanka. One hundred and fifty adult patients who had cardiac arrests and were reported to a nurse responder were included in the study. Results: Availability of six parameters (excluding mentation) was significantly higher at admission (P < 0.05) than at 24 and 48 h prior to cardiac arrest. Patients had a 49.3% immediate return of spontaneous circulation (ROSC) and 35.3% survival to hospital discharge. Nearly 48.6% of patients who had ROSC did not receive postarrest intensive care. Intubation was performed in 46 (62.2%) patients who went on to have ROSC compared with 28 (36.8%) with no ROSC (P < 0.05). Defibrillation, performed in eight (10.8%) patients who had ROSC and eight (10.5%) in whom did not, was statistically insignificant (P = 0.995). Conclusions: Observations commonly used to detect deterioration are poorly reported, and reporting practices would need to be improved prior to EWS implementation. These findings reinforce the need for training in acute care and resuscitation skills for health-care teams in LMIC settings as part of a program of improving recognition and response to acute deterioration.
[FULL TEXT] [PDF]*
|
