The highest number of admissions into the ICU was for severe TBI following MVA. Developing a viable trauma team and separately equipped neurosurgical ICU with adequately trained and motivated staff will help improve the outcome of patients.

BackgroundAdverse healthcare events are major public health problem with the heaviest burden in the low and middle-income countries. Patient safety awareness among healthcare professionals is known to impact this outcome; thus we set out to appraise the patient safety awareness among surgeons in Enugu, Nigeria.MethodsA multi-institutional cross-sectional survey was carried out among surgeons in Enugu, Nigeria and data obtained were analyzed using the statistical package for scientific solutions (SPSS) version 20 software.ResultsA total of 309 surgeons were surveyed. Majority of the surgeons (51.9%) had poor perception of patient safety issues. One hundred and twenty respondents (38.8%) have awareness of any institutional protocol for preventing wrong-site surgery while only 35 respondents (11.3%) regularly practiced an institutional protocol for preventing wrong-site surgery. The professional status of the surgeons and years in service showed significant association with perception of patient safety issues.ConclusionThe patient safety awareness and practice among the surgeons in Enugu, Nigeria is apparently low and this was found to be influenced by the professional status and years in service of the surgeon.

Background: The exact incidence of vascular injuries in Nigeria as a country especially southeast zone of Nigeria is unknown on account of under reporting and uncoordinated management of victims. Aim: To determine the pattern and outcome of common civilian vascular injuries managed in a teaching hospital in the southeast zone of Nigeria. Method: This is a retrospective study from January, 2007 to December, 2013. All case records of common civilian vascular injuries presenting at the accident center and those referred to the clinics as well as operation register and data banks of managing surgeons, were retrieved and analysed. Results: The age range of 12-75 years was recorded for the 26 patients. In this spectrum, age range of 21-30 years (19.2%) was the highest while the age range, 61-70 years (0%) was the lowest. One female (3.9%) and twenty five males (96.1%) were recorded, giving a female to male ratio of 1:25. In the upper extremity, brachial artery 6 (23.1%) was the most involved vessel while in the lower extremity, the most involved was the femoral artery 9 (34.6%). The patterns of presentation were isolated bleeding 10 (38%), arterivenous fistula 1 (3.5%) and pseudoaneurysm 8 (30%). 23 (88%) had good outcome. Conclusion: The incidence is about 4 cases per year. 23 (88%) had good outcome. The shortcoming of lattending physicians was because they were not conversant with hard and soft signs of vascular injuries with attendant limb loss and death of one of the victims. This short coming can be averted by training and retraining of doctors.

Tramadol is effective in control of shivering during spinal anaesthesia in obstetric patients. Tramadol 0.5 mg/kg controlled shivering better than 0.25 mg/kg. Therefore, 0.5 mg/kg of tramadol can be used to manage shivering following caesarean section under spinal anaesthesia.

Background Tracheal tubes are routinely used during anaesthesia and in the intensive care unit. Subjective monitoring of cuff pressures have been reported to produce consistently inappropriate cuffs pressures, with attendant morbidity. But this practice of unsafe care remains widespread. With the proliferation of intensive care units in Nigeria and increasing access to surgery, morbidity relating to improper tracheal cuff pressure may assume a greater toll. We aimed to evaluate current knowledge and practice of tracheal cuff pressure monitoring among anaesthesia and critical care providers in Nigeria. Methods This was a multicenter cross-sectional study conducted from March 18 to April 30, 2021. The first part (A) was conducted at 4 tertiary referral hospitals in Nigeria by means of a self-administered questionnaire on the various cadre of anaesthesia and critical care providers. The second part (B) was a nation-wide telephone survey of anaesthesia faculty fellows affiliated to 13 tertiary hospitals in Nigeria, selected by stratified random sampling. Results Only 3.1% (6/196) of the care providers admitted having ever used a tracheal cuff manometer, while 31.1% knew the recommended tracheal cuff pressure. The nationwide telephone survey of anaesthesia faculty fellows revealed that tracheal cuff manometer is neither available, nor has it ever been used in any of the 13 tertiary hospitals surveyed. The ‘Pilot balloon palpation method’ and ‘fixed volume of air from a syringe’ were the most commonly utilized method of cuff pressure estimation by the care providers, at 64.3% and 28.1% respectively in part A survey (84.6% and 15.4% respectively, in the part B survey). Conclusion The use of tracheal cuff manometer is very limited among the care providers surveyed in this study. Knowledge regarding tracheal cuff management among the providers is adjudged to be fair, despite the poor practice and unsafe care.