Pediatric Anesthesia in Developing Countries

Bösenberg, Adrian; Murat, I.

doi:10.1016/b978-141603134-5.50055-x

Cited by 12 publications

(20 citation statements)

References 60 publications

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“…Language barriers frustrate communication during the short encounters between patients and medical volunteers (Bosenberg 2007;Sneag et al 2007). Good translation is essential to obtaining an accurate history and providing appropriate care (Won et al 2006).…”

Section: Cultural and Language Barriersmentioning

confidence: 99%

“…Moreover, equipment considered disposable in the developed world is often washed and reused in operating rooms in the developing world (Christman 2000;Patterson 2007). Steady electrical power supplies are not guaranteed; thus, medical volunteers must be prepared to operate under flashlights and without the ability electronically to monitor patients under general anesthesia (Bosenberg 2007;Cappello et al 1995). Even after successful surgery, patients are faced with significant obstacles to recovery.…”

Section: Limited Medical Resourcesmentioning

confidence: 99%

“…They lack ventilators, electrocardiogram machines, and cardiac monitors (Abrams 1998;Clem and Green 1996;Eddleston et al 2006). Without ventilator support and close postoperative monitoring, the risks of morbidity and mortality are higher than in the developed world (Bosenberg 2007).…”

Section: Limited Medical Resourcesmentioning

confidence: 99%

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The Context of Ethical Problems in Medical Volunteer Work

Wall

2011

HEC Forum

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Ethical problems are common in clinical medicine, so medical volunteers who practice clinical medicine in developing countries should expect to encounter them just as they would in their practice in the developed world. However, as this article argues, medical volunteers in developing countries should not expect to encounter the same ethical problems as those that dominate Western biomedicine or to address ethical problems in the same way as they do in their practice in developed countries. For example, poor health and advanced disease increase the risks and decrease the potential benefits of some interventions. Consequently, when medical volunteers intervene too readily, without considering the nutritional and general health status of patients, the results can be devastating. Medical volunteers cannot assume that the outcomes of interventions in developing countries will be comparable to the outcomes of the same interventions in developed countries. Rather, they must realistically consider the complex medical conditions of patients when determining whether or not to intervene. Similarly, medical volunteers may face the question of whether to provide a pharmaceutical or perform an intervention that is below the acceptable standard of care versus the alternative of doing nothing. This article critically explores the contextual features of medical volunteer work in developing countries that differentiate it from medical practice in developed countries, arguing that this context contributes to the creation of unique ethical problems and affects the way in which these problems should be analyzed and resolved.

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Section: Cultural and Language Barriersmentioning

confidence: 99%

Section: Limited Medical Resourcesmentioning

confidence: 99%

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The Context of Ethical Problems in Medical Volunteer Work

Wall

2011

HEC Forum

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“…Unfortunately, many low and middle-income countries (LMICs) have not yet benefited from either a culture of patient safety or an investment in standards [3]. Years of poverty and competition for scarce resources have resulted in a long-term lack of infrastructure, equipment, and clinical capacity [5][6][7][8][9][10][11][12][13]. The infrastructure gap between high-income and low-income countries unfortunately translates into a patient safety gap, and anaesthesia and surgical outcomes reveal the tragic reality [13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Many hospitals providing emergency and essential surgery in LMICs provide anaesthesia without much of what is considered essential in HIC's. The patients receiving care in these settings have few options, and the anaesthesia providers are tasked with providing the best possible care under the circumstances [7,13,[36][37][38].…”

Section: Introductionmentioning

confidence: 99%

The Bare Minimum: The Reality of Global Anaesthesia and Patient Safety

et al. 2015

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Influential international organizations have historically published anaesthesia guidelines, but for the most part, without impacting substantial documentable changes or outcomes in low-income environments. This analysis, and subsequent recommendations, reviews the effectiveness of existing strategies for international guidelines, and proposes practical, step-wise implementation of patient safety approaches for LMICs.

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The Safer Anaesthesia from Education (SAFE)^® paediatric anaesthesia course: educational impact in five countries in East and Central Africa

et al. 2019

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Summary There is an urgent need to improve access to safe surgical and anaesthetic care for children living in many low‐ and middle‐income countries. Providing quality training for healthcare workers is a key component of achieving this. The 3‐day Safer Anaesthesia from Education (SAFE)® paediatric anaesthesia course was developed to address the specific skills and knowledge required in this field. We undertook a project to expand this course across five East and Central African countries (Ethiopia, Kenya, Malawi, Uganda and Zambia) and train local faculty. This study reports the outcomes from course evaluation data, exploring the impact on knowledge, skills and behaviour change in participants. Eleven courses were conducted in a 15‐month period, with 381 participants attending. Fifty‐nine new faculty members were trained. Knowledge scores (0–50 scale) increased significantly from mean (SD) 37.5 (4.7) pre‐course to 43.2 (3.5) post‐course (p < 0.0001). Skills scores (0–10 scale) increased significantly from 5.7 (2.0) pre‐course to 8.0 (1.5) post‐course (p < 0.0001). One hundred and twenty‐six participants in Malawi, Uganda and Zambia were visited in their workplace 3–6 months later. Knowledge and skills were maintained at follow‐up, with scores of 41.5 (5.0) and 8.3 (1.4), respectively (p < 0.0001 compared with pre‐course scores). Content analysis from interviews with these participants highlighted positive behaviour changes in the areas of preparation, peri‐operative care, resuscitation, management of the sick child, communication and teaching. This study indicates that the SAFE paediatric anaesthesia course is an effective way to deliver training, and could be used to help strengthen emergency and essential surgical care for children as a component of universal health coverage.

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Pediatric Anesthesia in Developing Countries

Cited by 12 publications

References 60 publications

The Context of Ethical Problems in Medical Volunteer Work

The Context of Ethical Problems in Medical Volunteer Work

The Bare Minimum: The Reality of Global Anaesthesia and Patient Safety

The Safer Anaesthesia from Education (SAFE)^® paediatric anaesthesia course: educational impact in five countries in East and Central Africa

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Pediatric Anesthesia in Developing Countries

Cited by 12 publications

References 60 publications

The Context of Ethical Problems in Medical Volunteer Work

The Context of Ethical Problems in Medical Volunteer Work

The Bare Minimum: The Reality of Global Anaesthesia and Patient Safety

The Safer Anaesthesia from Education (SAFE)® paediatric anaesthesia course: educational impact in five countries in East and Central Africa

Contact Info

Product

Resources

About

The Safer Anaesthesia from Education (SAFE)^® paediatric anaesthesia course: educational impact in five countries in East and Central Africa