No abstract

Introduction Provision of Basic Life Support (BLS) to victims of cardiac arrest and other common causes of sudden death, is a key function of healthcare systems. Such life-saving service, which is lacking in many low- and middle-income countries (LMIC), is highly dependent on consistent availability of BLS devices and essential drugs. These devices are used to secure airway, deliver oxygen, gain intravenous access for infusions, provide cardiac defibrillation and monitor the cardiorespiratory systems. This study was aimed at evaluating the current state of availability of these devices and essential drugs in healthcare facilities in a developing country setting, within the context of urgent need to curb increasing burden of preventable sudden death. Methods descriptive cross-sectional study design was employed to assess availability of each of the aforementioned subgroups of resuscitation devices and drugs, in each primary and secondary healthcare facility in all eighteen (18) Local Government Areas (LGAs) of Cross River State, in Southern Nigeria. Quantitative data was obtained using structured proforma, which was used to document presence and quantity of physically seen device(s) and drugs in each facility. The proportion of health facilities with presence of the devices and drugs, was compared between the three districts using chi-square test. P-value was set at 0.05. Results two hundred and five (205) health care facilities across the eighteen (18) LGAs of Cross River State were assessed. Approximately one-tenth of health facilities had oropharyngeal airway (10.2%) and laryngoscope (9.3%). Only 5.4% and 3.9% had nasopharyngeal and endotracheal tubes, respectively. None of all of these airway devices was found in all health facilities within four LGAs (22.2%). The most commonly available breathing device was self-inflation bag (SIB), which was found in 51.7% of facilities. Seven LGAs (38.9%) had all of their health facilities not having either oxygen delivery devices, oxygen supply or both. Most health facilities had each of the IV access devices and infusion fluids, but only five facilities had automated external defibrillator (AED). Most health facilities had stethoscope (91.2%) and sphygmomanometer (72.2%), but only 15.1% and 9.3% had pulse oximeter and airway nebulizer, respectively. Less than one-fifth (18.5%) of facilities had atropine, and only 3.9% had amiodarone. Except for amiodarone, there was significantly higher proportion of health facilities that had each of the other essential drugs, in northern compared with other districts (p<0.05). Conclusion devices and essential drugs required for provision of resuscitation are lacking in most health facilities in Cross River State. This situation significantly limits the health system’s capacity to save lives, especially during emergencies. The implications of these state-wide findings, as well as modalities and options for improvement in availability ...

Objectives: Anesthesia is a technology driven specialty, technological advancement in anesthesia and monitoring equipment has made sophisticated surgery possible. Safe anesthesia is possible when machines are in good condition. The chain of survival as used by the International Liaison Committee on Resuscitation refers to a series of actions that, properly executed, reduce the mortality associated with cardiac arrest. A similar chain can be applicable to anesthetic equipment for optimal patient care. Early acquisition of appropriate equipment, appropriate training of end users, prompt preventive maintenance, timely repair, and replacement at the end of the equipment lifespan. In 2002, the Federal Government of Nigeria (FGN) commissioned a project to refurbish eight teaching hospitals which was later upgraded to 14. This paper assessed the functional status of 10 frequently used equipment in anesthesia and intensive care units among the beneficiaries. Material and Methods: A structured questionnaire was sent to heads of anesthesia departments in the 14 beneficiary hospitals of the FGN/VAMED intervention. They reported on the status of 10 equipment commonly used by anesthetists in the operating rooms and intensive care units. Results: All hospitals had the equipment installed in the past 7–14 years with end user training on all the equipment, biomedical engineers were available in the immediate post-installation period. There has been no routine scheduled preventive maintenance of the equipment. Faulty equipment are being used in all the hospitals, 54.6% of the installed equipment are spoilt and no longer in use. The weakest link in the equipment chain of survival is the absence of preventive maintenance. Conclusion: Routine scheduled preventive maintenance and the constant availability of trained and skillful biomedical engineers will no doubt increase the lifespan of anesthetic equipment.