Show simple item record

dc.contributor.authorKudsk-Iversen, S
dc.contributor.authorTrelles, M
dc.contributor.authorNgowa Bakebaanitsa, E
dc.contributor.authorHagabimana, L
dc.contributor.authorMomen, A
dc.contributor.authorHelmand, R
dc.contributor.authorSaint Victor, C
dc.contributor.authorShah, K
dc.contributor.authorMasu, A
dc.contributor.authorKendell, J
dc.contributor.authorEdgcombe, H
dc.contributor.authorEnglish, M
dc.date.accessioned2020-06-23T19:20:39Z
dc.date.available2020-06-23T19:20:39Z
dc.date.issued2020-03-04
dc.date.submitted2020-04-23
dc.identifier.pmid32139492
dc.identifier.doi10.1136/bmjopen-2019-034891
dc.identifier.urihttp://hdl.handle.net/10144/619652
dc.description.abstractOBJECTIVE: To describe the extent to which different categories of anaesthesia provider are used in humanitarian surgical projects and to explore the volume and nature of their surgical workload. DESIGN: Descriptive analysis using 10 years (2008-2017) of routine case-level data linked with routine programme-level data from surgical projects run exclusively by Médecins Sans Frontières-Operational Centre Brussels (MSF-OCB). SETTING: Projects were in contexts of natural disaster (ND, entire expatriate team deployed by MSF-OCB), active conflict (AC) and stable healthcare gaps (HG). In AC and HG settings, MSF-OCB support pre-existing local facilities. Hospital facilities ranged from basic health centres with surgical capabilities to tertiary referral centres. PARTICIPANTS: The full dataset included 178 814 surgical cases. These were categorised by most senior anaesthetic provider for the project, according to qualification: specialist physician anaesthesiologists, qualified nurse anaesthetists and uncertified anaesthesia providers. PRIMARY OUTCOME MEASURE: Volume and nature of surgical workload of different anaesthesia providers. RESULTS: Full routine data were available for 173 084 cases (96.8%): 2518 in ND, 42 225 in AC, 126 936 in HG. Anaesthesia was predominantly led by physician anaesthesiologists (100% in ND, 66% in AC and HG), then nurse anaesthetists (19% in AC and HG) or uncertified anaesthesia providers (15% in AC and HG). Across all settings and provider groups, patients were mostly healthy young adults (median age range 24-27 years), with predominantly females in HG contexts, and males in AC contexts. Overall intra-operative mortality was 0.2%. CONCLUSION: Our findings contribute to existing knowledge of the nature of anaesthetic provision in humanitarian settings, while demonstrating the value of high-quality, routine data collection at scale in this sector. Further evaluation of perioperative outcomes associated with different models of humanitarian anaesthetic provision is required.en_US
dc.language.isoenen_US
dc.publisherThe BMJen_US
dc.rightsWith thanks to BMJ.en_US
dc.subjectanaesthetics
dc.subjecthuman resource management
dc.subjectorganisation of health services
dc.titleAnaesthesia care providers employed in humanitarian settings by Médecins Sans Frontières: a retrospective observational study of 173 084 surgical cases over 10 yearsen_US
dc.typeArticle
dc.identifier.eissn2044-6055
dc.identifier.journalBMJ Openen_US
dc.source.journaltitleBMJ open
dc.source.volume10
dc.source.issue3
dc.source.beginpagee034891
dc.source.endpage
refterms.dateFOA2020-06-23T19:20:40Z
dc.source.countryEngland


Files in this item

Thumbnail
Name:
Kudsk-Iversen et al 2020 Anesthesia ...
Size:
1.302Mb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record