Ratification of IATSIC/WHO's guidelines for essential trauma care assessment in the South American region.
BACKGROUND
The purpose of the present study was to evaluate the usefulness of the International Association for Trauma Surgery and Intensive Care (IATSIC)/World Health Organization (WHO)'s Guidelines for Essential Trauma Care (EsTC Guidelines) in providing an internationally applicable and standardized template to assess trauma care capabilities in the South American Region.


METHODS
Field assessment was conducted in seven provinces (urban and rural, pop. 2,239,509) and 24 facilities (5 large hospitals (LH); 15 small hospitals (SH); 4 basic hospitals (BH)) in Ecuador using EsTC criteria. A total of 260 individual items in Human Resources (HR- availability, clinical knowledge, skills) and physical resources (PR) were evaluated via inspection, review of local statistics, and administrative and staff interviews. EsTC was evaluated on a scale as follows: 0 (absent); 1(inadequate; < 50%); 2 (partly adequate > 50%); 3 (adequate-100%).


RESULTS
210,045 Emergency Department (ED) visits and 61,365 (29%) ED trauma visits were recorded (incidence rate 2,740/100,000 population). Deficits were noted in prehospital trauma care (inadequate coordination, communication), education and training (ATLS < 30%, TNCC 0%), facility based trauma care (poor physical resources [PR] and human resources [HR]), and quality assurance (1/27 hospitals).


CONCLUSIONS
The IATSIC/WHO EsTC Guidelines provide a simple and useful template to assess trauma care capability in variable facilities and international settings, and they could serve as a valuable tool for trauma system development. Endorsement of EsTC Guidelines by the Panamerican Health Organization and lead trauma societies (the Panamerican Trauma Society) should be considered.
Aboutanos
Michel B
MB
Department of Surgery, International Trauma System Development Program, Virginia Commonwealth Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA. mbaboutanos@vcu.edu
Mora
Francisco
F
Rodas
Edgar
E
Salamea
Juan
J
Parra
Marcelo Ochoa
MO
Salgado
Estuardo
E
Mock
Charlie
C
Ivatury
Rao
R
D004484:Ecuador / Q000453:epidemiology; D017408:Guidelines as Topic; D006287:Health Planning Guidelines; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D014944:World Health Organization; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy*