Cardiopulmonary Resuscitation Capacity in Referral Hospitals in Nigeria: Understanding the Global Health Disparity in Resuscitation Medicine

Zha, Yuanting; Ariyo, M; Olaniran, O; Ariyo, Promise; Lyon, Camila; Kalu, Queeneth; Latif, Asad; Edmond, Byron; Sampson, J.B.

doi:10.1016/j.jnma.2017.09.002

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…Defibrillation has been described as the most effective intervention in ECC [ 40 ], yet there are no Automated External Defibrillators (AEDs) in many public locations, universities and health institutions in Nigeria. A survey of referral hospitals in Nigeria revealed that only 6.7% of them had an AED in places other than the intensive care units (ICUs) [ 41 ]. Moreover, many hospitals lack a cardiac arrest response team [ 41 ] and there is usually no communication with hospitals before bringing in patients in emergency cases [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Awareness and attitude of final year students towards the learning and practice of cardiopulmonary resuscitation at the University of Ibadan in Nigeria

Adewale

Aigbonoga

Akintayo

et al. 2021

African Journal of Emergency Medicine

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Introduction Out-of-hospital cardiac arrest (OHCA) is a major cause of sudden cardiac death which can be prevented by early cardiopulmonary resuscitation (CPR). International bodies recommend that basic life support (BLS) skills be taught in schools in order to increase the rate of bystander CPR and reduce mortality from OHCA. We are not aware of any BLS education program for non-healthcare students in Nigeria. This study was to assess the awareness and attitude to acquiring BLS skills among university students. Methods We conducted a cross-sectional study among final year university undergraduates using a questionnaire that assessed students' sociodemographic characteristics, awareness of CPR, previous experiences, and attitude to basic life support (BLS). Counts and proportions were compared for the demographic characteristics using Chi-squared and Fisher's exact tests. Results Four hundred and seventy-five students from 15 faculties participated in this study, median age was 22.8 years (interquartile range: 21.2–24.5 years). Majority (82.5%) have heard of CPR, 29.7% have undergone CPR training; 77.3% of those who had been trained were confident that they could perform CPR. Previous CPR training was significantly associated with faculty, year of study and age. Eighty-nine (18.7%) students have witnessed someone die from a trauma. Four hundred and fifty (94.7%) respondents would like to get BLS training, 440 (92.6%) think that CPR training should be included in the school curriculum. Conclusion There is good awareness and positive attitude to the acquisition and practice of cardiopulmonary resuscitation among university students in Nigeria. Few students however, have been trained to administer bystander cardiopulmonary resuscitation. Therefore, there is a need to implement university wide BLS education in Nigeria.

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Section: Discussionmentioning

confidence: 99%

Awareness and attitude of final year students towards the learning and practice of cardiopulmonary resuscitation at the University of Ibadan in Nigeria

Adewale

Aigbonoga

Akintayo

et al. 2021

African Journal of Emergency Medicine

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“…In addition to lack of optimal resuscitative measures, quality improvement schemes are also deficient in SSA. A survey of 17 hospitals in SSA found that only 20% of these had a cardiac arrest response team system, only 21% documented CPR events, and only 21% reviewed such events for education and quality improvement [100].…”

Section: Cardiopulmonary Resuscitation (Cpr)mentioning

confidence: 99%

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9-79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely noninvasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights:-Atrial fibrillation/flutter prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA).-Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9-79%) across SSA countries.-Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness.-Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries.

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“…While Solagberu [7], identifi ed the need for resuscitation equipment, Tobi [8] and colleagues in another centre in Nigeria stressed the need for training and certifi cation on BLS/ACLS as well as the establishment of cardiac arrest teams as a means of improving resuscitation outcomes. Zha [9] and colleagues on the other hand in a multi-centre study across Nigeria, corroborated the above fi ndings and in addition stressed a need for quality improvement measures, application of real-time resuscitation documentation with structured meetings for continuous quality evaluation as low-cost, nonresource-intensive measures. These recommendations have the potential to identify areas of dysfunction, opportunities for improvement and problems to be addressed in all aspects of the resuscitation process.…”

Section: Introductionmentioning

confidence: 59%

“…It is a sad reality that SIB's may not be readily available and accessible in every area of the hospital for emergency rescue breathing. 9 Only 22% of respondents attested to the availability of SIBs in their various A&E units. This leaves victims to the willingness or otherwise of healthcare providers to carry out expired air ventilation.…”

Section: Discussionmentioning

confidence: 99%

Witnessed Cardiac Arrest by Nigerian Health Workers; Improving the Outcomes

Ndukwe¹

2018

Glob J Anesth

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Aim: To assess the involvement of health workers in Cross River State, Nigeria with CPR during witnessed sudden cardiac arrest and the resources available to them for intervention. Settings and Design: The study was carried out in Cross River State, Southern Nigeria which has an international boundary with Cameroon in the East. It is a descriptive, Cross sectional study among health workers. Methods and Material: Consenting health workers belonging to the various categories who met the eligibility criteria were selected using the non-probability method. They included; Doctors, Pharmacists, Nurses, Laboratory scientists, Physiotherapists, Optometrists, Radiographers and Anaesthetic Technicians. Those who declined to complete the questionnaire were excluded. Statistical analysis used: Descriptive statistics (frequency proportions, means and standard deviation) was used to summarize variables. The level of signifi cance was set at P<0.05 Results: One hundred and eighty-two (52.8%) out of the 345 respondents surveyed, had witnessed and been involved in CPR for cardiac arrest. Common sites of witness were the ward (79, 43.4%), A & E unit (36, 19.8%), theatre (27, 14.8%), home (23, 12.6%) and ICU (17, 9.4%). Approximately half of respondents (50.5%) were involved in chest compressions for cardiopulmonary resuscitation (CPR), while 45.1%, 36.3%, 31.3%, 28.6% and 22.0% were involved in oxygen therapy, IV fl uid therapy, rescue breathing, IV adrenaline therapy and transportation to hospital, respectively. Only 13.2% performed defi brillation as part of the CPR. Approximately half of respondents (48.9%) had participated in successful CPR. Contribution to successful CPR were attributed to immediate recognition (38.2%), prompt CPR (38.2%), oxygen therapy (30.3%), adrenaline administration (20.2%) and fl uid therapy (19.1%). Conclusion: Health workers will occasionally encounter SCA and participate in resuscitation. To improve resuscitation outcome, the triad of insuffi cient awareness, infrastructure and capacity building must be addressed. There is a critical need to make automated external defi brillators available especially in hospitals.

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Cardiopulmonary Resuscitation Capacity in Referral Hospitals in Nigeria: Understanding the Global Health Disparity in Resuscitation Medicine

Cited by 6 publications

References 17 publications

Awareness and attitude of final year students towards the learning and practice of cardiopulmonary resuscitation at the University of Ibadan in Nigeria

Awareness and attitude of final year students towards the learning and practice of cardiopulmonary resuscitation at the University of Ibadan in Nigeria

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Witnessed Cardiac Arrest by Nigerian Health Workers; Improving the Outcomes

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