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Advancing Delivery of Emergency Care in Honduras: Creating a Reanimation Room

Published online by Cambridge University Press:  13 July 2023

Killiam Argote-Araméndiz
Affiliation:
BIDMC Fellowship in Disaster Medicine, Boston, USA International Committee of the Red Cross, Geneva, Switzerland
Angel Bárcenas
Affiliation:
Hospital Escuela, Tegucigalpa, Honduras
Hector Apolinar-Menéndez
Affiliation:
International Committee of the Red Cross, Geneva, Switzerland
Elsa Ciliezar-López
Affiliation:
International Committee of the Red Cross, Geneva, Switzerland
Fernando Castro
Affiliation:
Hospital Escuela, Tegucigalpa, Honduras
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Abstract

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Introduction:

Early recognition and treatment of critical clinical conditions have decreased morbidity and mortality in critically wounded and sick patients. Worldwide, Emergency Rooms (ER) are overcrowded, and the complexity and number of patients keep increasing. This phenomenon challenges health professionals when applying time-sensitive interventions generating unfavorable outcomes. Considering that the ER is the first point of contact for patients of Hospital Escuela, a 1306-bed, academic, tertiary care hospital in Honduras, we describe the creation of a Resuscitation Room (RR) to improve patient care in the ER.

Method:

Data from patients, including dates, source of admission, diagnosis, and outcomes, were recorded daily in a database from June 1, 2022, until October 31, 2022. Then the analysis and interpretation were made using Microsoft Excel.

Results:

In the five-month period, 1,118 patients were admitted to the RR, with 58% males, a 52-year-old mean, and October as the busiest month (33%). Most patients consulted between 0600 and 1800 hours (70%). The primary admission cause was a medical condition (71%), and shock (41%) was the most common type of emergency followed by trauma (25%). After stabilization, 86% of patients remained in observation areas of the ER, only 5% went to the operating theater, and 1% to the intensive care unit. The mortality rate was 5%, 48% trauma related.

Conclusion:

A RR meeting the minimal standards for space, trained staff, medical equipment, and consumable resources has been shown to be beneficial in improving interdisciplinary work in the ER. This RR has enabled life-threatening conditions to be recognized and treated rapidly while also promoting information gathering on critically wounded and sick patients and their outcomes. The need to standardize the clinical care to such patients has also been identified. Further efforts to protocolize the response are needed to improve patient care.

Type
Lightning and Oral Presentations
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine