Improving Anesthesia Safety in Low-Income Regions of the World

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• 作者：Isabeau A. Walker (1)
  Tom Bashford (2)
  J. E. Fitzgerald (3)
  Iain H. Wilson (4)
  
• 关键词：Safety ; Low ; income countries ; Health infrastructure ; Resources ; Training ; Anesthesia equipment ; Quality improvement
• 刊名：Current Anesthesiology Reports
• 出版年：2014
• 出版时间：June 2014
• 年：2014
• 卷：4
• 期：2
• 页码：90-99
• 全文大小：230 KB
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• 作者单位：Isabeau A. Walker (1)
  Tom Bashford (2)
  J. E. Fitzgerald (3)
  Iain H. Wilson (4)
  
  1. Department of Anaesthesia Great Ormond Street Hospital NHS Foundation Trust, UCL Institute of Child Health, Great Ormond Street, London, WC1N 3JH, UK
  2. Department of Anaesthesia, Cambridge University and Cambridge University Hospitals NHS, Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
  3. Lifebox Foundation, 21 Portland Place, London, W1B 1PY, UK
  4. Department of Anaesthesia, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
  
• ISSN：2167-6275

文摘

Safe anesthesia is dependent on a skilled clinician, a functioning anesthesia machine, monitoring equipment, drugs and a healthcare facility with support services and staff. In high-income regions we expect a quality service with excellent levels of safety. In low-income countries, competition for healthcare resources is significant, and surgery has been neglected as a component of public health services. Anesthesia is relatively expensive because of the high cost of imported equipment and drugs, and underinvestment is common. Small numbers of inadequately resourced providers struggle to deliver a service sometimes associated with alarmingly high mortality rates (as much as 1,000 times higher than in the best centers). These factors impact on development of the specialty and recruitment and training, creating a dangerous situation for patients. We review published data on anesthesia services in low-income regions, describe the difficulties, analyze where improvements should be prioritized and make recommendations to improve anesthesia safety in poorer regions of the world.