Sultan Al-Shaqsi

Emergency medical services versus private transport of trauma patients in the Sultanate of Oman: a retrospective audit at the Sultan Qaboos University Hospital

Aims This study aims to assess the differences in the outcome of road traffic trauma patients between those transported by emergency medical services (EMS) and those privately transported to the Sultan Qaboos University Hospital in the Sultanate of Oman in 2011. Methods This is a retrospective study of road traffic trauma patients admitted to the Sultan Qaboos University Hospital between January to December 2011. Data for all cases were retrieved from the emergency department database. The general linear multivariate regression analysis model was performed to test the differences in outcome. The analysis controlled for age, gender, ethnicity, weekend injury, time of injury, triage status, Injury Severity Score, existence of head injury, need for intensive care unit admission and need for surgical management. Results There were 821 trauma cases in 2011. 66.7% were transported by EMS. Male patients represented 65.7% of the cases. There was no significant difference in the characteristics of EMS and non-EMS trauma patients. In terms of inhospital mortality, the relative ratio of inhospital mortality between EMS and non-EMS groups was 0.64 (0.36–1.13), and p value 0.13. There is no significant difference in all other secondary outcomes tested. Conclusions EMS transported trauma patients had a statistically non-significant 36% reduction in mortality compared with privately transported patients admitted to the Sultan Qaboos University Hospital in 2011. Further, research that incorporates prehospital factors such as crash to arrival of EMS services and transport time to definitive healthcare facility should be conducted to evaluate the effectiveness of such a system in trauma care. Since non-EMS transport is likely to continue, public first aid training is critical to reduce mortality and morbidity of road traffic trauma in Oman.

Current challenges in the provision of ambulance services in New Zealand

Emergency Medical Services (EMS) in New Zealand has been serving the society since the first ambulance in 1892. Since then it has developed rapidly following national health system reforms and changes in lifestyle that increase demands and expectations from local communities. Today, the system provides high-quality pre-hospital emergency care. This article will briefly introduce some of the issues facing EMS that will impact the future of this crucial system in New Zealand. These issues include demands because of an aging population funding, double crewing, and volunteerism, registration, and unified standards.

Cutaneous Scar Prevention and Management : Overview of current therapies

Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management.

Self‐reported preparedness of New Zealand acute care providers to mass emergencies before the Canterbury Earthquakes: A national survey

Disasters occur more frequently. Acute care providers are the first to respond to mass emergencies from the healthcare sector. The preparedness of acute care providers in New Zealand to respond to mass emergencies has not been previously studied.

The State of Healthcare Disaster Plans in New Zealand and the Sultanate of Oman: An International Comparative Analysis

Aim. The aim of this study was to carry out an audit of healthcare plans in New Zealand and Oman. Methods. The study utilizes a deductive content analysis method. Written plans from New Zealand District Health Boards (DHBs) and the Omani secondary and tertiary hospitals were analyzed. A checklist was used to score the plans against twelve elements which are command and control, hazard analysis, surge capability, communication, standard operating procedures (SOPs), life-line backups, public and media, training, welfare, coordination, and recovery. Results. There were 14 plans from New Zealand and 7 plans from Oman analysed. The overall coverage of New Zealand plans was 67.5% compared to 53.3% in Oman. Plans from both countries scored similarly in “command and control,” “hazard analysis,” “surge,” and “communication” elements. Omani plans scored lower than those of New Zealand in “media and the publicv” “training,” “coordination,” and “recovery.” Both countries scored very low in addressing the welfare of responders. Conclusion. This study highlighted the value of health emergency plans in New Zealand as reflected by the high score of DHBs’ coordination. Therefore, a similar approach in Oman will enhance emergency preparedness. Responders’ welfare is an issue that needs to be addressed by emergency preparedness plans in both countries.

The Painful Sacrifice: The Epidemiology of Hand Injuries During the Holy Festivals in the Sultanate of Oman—A 10-Year Case-Control Study

Background: The human hand is an important functional and sensory organ. Its complex anatomy reflects its important functional capabilities. Many Muslim countries observe the holy festivals with a traditional sacrifice of an animal in order to share the meat (basic commodity) with beloved ones. During such festivals hand injuries have been reported to increase. This study aimed to compare cases and controls of hand injuries treated at the national trauma center in the Sultanate of Oman during a 10-year time period. Methods: This is a case-control retrospective review for 10 years in the Sultanate of Oman. The cases were all hand injuries registered and assessed at Khoula Hospital in the Sultanate of Oman during the 3 days of both holy festivals from January 2004 to December 2013. Controls were hand injuries registered and assessed at Khoula Hospital in the Sultanate of Oman during nonfestival days. Data were extracted and collected from the Emergency Department database. A descriptive and comparative analysis was done. Results: There were 1091 cases reviewed in this study. Knife laceration was 2.4 more common during holy festivals than any other time. Extensor tendon injuries were 2.7 more common during holy festivals than nonfestival times. Thumb and index fingers constituted around 40% of the total injuries. Of all patients reviewed, 85% were treated and discharged home without admission. Conclusion: Holy festivals in the sultanate of Oman are risky times for hand injuries. Knife lacerations are more common during such times than any other times. Emergency and plastic services should be aware of the pattern of hand injuries during such times in order to prepare and plan services accordingly.

Epidemiology of injuries caused by civil unrest in Yemen. A case series of the first wave of patients treated at the National Trauma Center of the Sultanate of Oman

INTRODUCTION: Civil unrest leads to a significant healthcare impact. The unsettled Yemeni political scene has been present for a long time. This civil conflict has led to loss of innocent lives and long-lasting physical and emotional morbidity. To date, there has been no description of the initial impact of the Yemeni civil conflict on healthcare services. OBJECTIVE: To describe the demographics and the pattern of injuries, management and follow-up for the first wave of civil war victims repatriated to the Sultanate of Oman in March 2015. METHOD: A retrospective review of all civil victims repatriated from Yemen to the Sultanate of Oman after the March 2015 bombings. The data is extracted from medical records. RESULTS: A total of 47 patients were evacuated from Yemen after 2 suicide bombings and treated initially in Oman. All patients were males and their mean age was 31 years, (range 6–66 years). Long bone fractures were the most common injury type (n = 39, 84%). Complex wounds were present in 36 (78%) patients, which required surgical intervention. Blast burns occurred in 7 patients (15%) and 10 patients (21%) had abdominal and chest injuries. Unfortunately, two patients succumbed to their injuries. The average length of stay for survivors was 25 days (6–156 days). CONCLUSION: This study highlighted the complexity of injuries created by modern civil unrest situations. The study also indicated the regional impact of such situations on nearby countries. This study is a pioneering in describing the first wave of repatriated victims from the recent Yemeni conflict.

Burns : The Neglected Epidemic in Oman = الحروق : وباء مهمل في عمان

Burns, whether intentional or non-intentional, are increasingly emerging as a worldwide problem. The World Health Organization (WHO) states that 195,000 deaths annually are caused by fire alone, and many more people are left disabled or permanently injured.1 However, the WHO also notes that there is not enough data to determine the number of deaths caused from other types of burns such as scalding, electrical burns and other burns, thus indicating that the true figure is much higher.2 Chandran et al. found that the burden of intentional injuries is disproportionately higher in low and middle income countries. Data analysis of the Global Burden of Diseases (GBD) project shows that 9% of the deaths in the Middle Eastern region were caused by fire; whereas the rate of disability-adjusted life years (DALYs) was 2,825 per 100,000 life years, comparable to that of Southeast Asia and Africa, and almost double the DALYs caused by injuries in developed countries. The analysis provides an indication of the magnitude of the problem, although it does not classify burns specifically.3

Are we ready? Preparedness of acute care providers for the Rugby World Cup 2011 in New Zealand

New Zealand is hosting the Rugby World Cup (RWC) 2011. It is the largest sporting event in New Zealands history, with around 70 000 fans estimated to visit the country from September to October 2011. This influx of tourists will have an impact on its already stretched healthcare services. The preparedness of New Zealands healthcare system to handle this mass event is unclear. Objectives The two main objectives of this study were (1) to determine the perceived preparedness of acute care providers in New Zealand to respond to the healthcare demands of RWC 2011; and (2) to determine the factors associated with perceived strong preparedness among acute care providers in New Zealand. Method A cross-sectional survey of 1500 doctors, nurses and ambulance officers working in acute care services in New Zealand was conducted between June 2010 and March 2011. Results 911 surveys were completed (response rate 60.7%). Only 12.7% of acute care providers felt they were prepared to deal with possible health issues arising from RWC 2011. Perceived preparedness was highest among ambulance officers and lowest among providers in intensive care units (16.3% vs 4.1%, p<0.01). Acute care providers who were aware of their role in a mass emergency were more likely to report preparedness with a prevalence OR of 3.5 and a 95% CI of 2.1 to 5.7. Conclusion Only 12.7% of acute care providers in New Zealand perceived preparedness for RWC 2011. Perceived preparedness followed a stepwise decline from prehospital services, emergency department, to surgery and then finally to intensive care services. This indicates that current preparedness activities are focusing on prehospital emergency services and neglecting surgical and intensive care services. Awareness about the role of acute care providers during emergencies, training and previous experience were associated with perceived strong preparedness for RWC 2011.