Burns : The neglected epidemic in Oman

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Outcomes of Multi-Trauma Road Traffic Crashes at a Tertiary Hospital in Oman : Does attendance by trauma surgeons versus non-trauma surgeons make a difference?

Objectives: Trauma surgeons are essential in hospital-based trauma care systems. However, there are limited data regarding the impact of their presence on the outcome of multi-trauma patients. This study aimed to assess the outcomes of multi-trauma road traffic crash (RTC) cases attended by trauma surgeons versus those attended by non-trauma surgeons at a tertiary hospital in Oman. Methods: This retrospective study was conducted in December 2015. A previously published cohort of 821 multi-trauma RTC patients admitted between January and December 2011 to the Sultan Qaboos University Hospital, Muscat, Oman, were reviewed for demographic, injury and hospitalisation data. In-hospital mortality constituted the main outcome, with admission to the intensive care unit, operative management, intubation and length of stay constituting secondary outcomes. Results: A total of 821 multi-trauma RTC cases were identified; of these, 60 (7.3%) were attended by trauma surgeons. There was no significant difference in mortality between the two groups (P = 0.35). However, patients attended by trauma surgeons were significantly more likely to be intubated, admitted to the ICU and undergo operative interventions (P <0.01 each). The average length of hospital stay in both groups was similar (2.6 versus 2.8 days; P = 0.81). Conclusion: No difference in mortality was observed between multi-trauma RTC patients attended by trauma surgeons in comparison to those cared for by non-trauma surgeons at a tertiary centre in Oman

Proboscis lateralis: A case report of a rare giant craniofacial teratoma in an infant

Teratomas can occur in almost any region of the body and are the most common extragonadal germ cell childhood tumors. However, craniofacial teratomas are rare. Craniofacial teratomas can present unique features and cause significant functional and aesthetic concerns. There are complex lesions that can have components intra-cranially and extra-cranially. Therefore, their management requires significant multi-stage multidisciplinary surgical procedures. Herein, we present a case of craniofacial teratoma in a child with the phenotype of proboscis lateralis that highlights some of the pertinent point of the diagnosis and management of congenital neonatal teratomas

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

Care or Cry: Three years from Cyclone Gonu. What have we learnt?

ABSTRACT:Objectives: This article examines and evaluates the history of natural disasters in Oman and presents the health care response to cyclone Gonu, and highlights the health care lessons learnt from the Cyclone as narrated by frontline personnel and it puts forward some practical recommendations for health care policy makers in order to strengthen the health care disaster preparations to combat future natural and man-made disasters.Methods: The lessons presented in this article are based on the reflections of frontline health care personnel who witnessed Cyclone Gonu. The reflections of experience collected as a part of a qualitative 17 semi-structured interviews conducted in Oman between December 2009 and January 2010.Results: The study found that the lessons from passes events went by un-noticed and exposed some serious fragmentation in the coordination of different governmental sectors involved in emergency management and that there was no well-plannedmechanism of alert and warning dissemination to people and communities.Conclusion:Overall, the major lessons that learnt from Cyclone Gonu would have been very useful if they had been taken into consideration and implemented during the health care response to cyclone Phet

Models of International Emergency Medical Service (EMS) Systems."Oman Medical Journal

An Emergency Medical Service (EMS) can be defined as "a comprehensive system which provides the arrangements of personnel, facilities and equipment for the effective, coordinated and timely delivery of health and safety services to victims of sudden illness or injury." 1 The aim of EMS focuses on providing timely care to victims of sudden and life-threatening injuries or emergencies in order to prevent needless mortality or long-term morbidity. The function of EMS can be simplified into four main components; accessing emergency care, care in the community, care en route, and care upon arrival to receiving care at the health care facility. Today's global EMS has advanced so much that it contributes widely to the overall function of health care systems. The World Health Organization regards EMS systems as an integral part of any effective and functional health care system. Since 1970s, the mode of emergency health care delivery in pre-hospital environment evolved around two main models of EMS with distinct features. These are the Anglo-American and the Franco-German model. These categorical distinctions were obvious during the 1970s until the end of the 20th century. Today, most EMS systems around the world have varied compositions from each model. The delivery of emergency medical services in pre-hospital settings can be categorized broadly into Franco-German or Anglo

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

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

Boletín Oficial de la Provincia de Oviedo: Número 277 - 1944 diciembre 12

Background Mass emergencies are growing globally. They are frequent and cause significant human and economic loss. New Zealand and the Sultanate of Oman have suffered from devastating mass emergencies including the Canterbury earthquakes and Cyclone Gonu respectively. Healthcare services are central in mass emergency response. Acute healthcare services are usually the first to respond to mass emergencies. Successful mass emergency response is determined by the level of preparedness. The state of the New Zealand and Omani acute healthcare systems’ preparedness to deal with mass emergencies is yet to be systematically studied. Objectives The goals of this project were to: 1) Describe and compare the state of strategic healthcare mass emergency preparedness in New Zealand and the Sultanate of Oman. 2) Assess and compare the training, willingness, and perceived preparedness of acute care providers in Oman and New Zealand to respond to mass emergencies. Methods Mixed qualitative and quantitative methods were used in this project. First, semi-structured interviews with strategic emergency planners were utilized to answer the first objective. The second objective was answered using a mass emergency preparedness survey that was conducted among 1,500 doctors, nurses and ambulance officers from each country between 2009 and 2010. Results Seventeen key informants from each country participated in the qualitative study. The study highlighted that New Zealand has a well-established national strategy for emergency preparedness unlike Oman in which planning is a relatively new initiative. There is a gap between strategic and operational preparedness in New Zealand unlike Oman in which senior clinicians are in charge of the little emergency planning activities that exist in the country. Issues such as communication, responders’ welfare, and surge capability are critical challenges for both countries. The survey response rate was 61% in both countries. The study found that 59.2% of Omani and 44.8% of New Zealand acute care providers have no prior training in mass emergency response. The willingness of acute care providers is event-dependent with the lowest being for infectious disease mass emergencies. 34% of acute care personnel in both countries were not willing to report to work during an infectious disease mass emergency. In addition, about 40% of acute care providers in both countries reported not being able to locate a written emergency plan. Training was associated with a 2.5 (CI 1.71-3.29, P<0.05) fold increase in preparedness of acute care providers to respond to mass emergencies. Providers who participated in a drill were 2.7 (CI: 1.92-3.79, P <0.05) times more likely to self-report being prepared to deal with mass emergencies than those who did not. Conclusion This project highlighted several areas for improvement. In New Zealand, there is an urgent need to integrate clinical providers into strategic planning for emergencies in order to ensure that acute care providers are involved in emergency preparedness. In Oman, there is a need to establish a standardized national healthcare preparedness strategy. In order to ensure that emergency preparedness is effective and continuous, the process has to be integrated into the daily operation of the wider healthcare system and should not be developed de novo. There is a need to establish a specific training programme in mass emergency response for all acute care providers in both countries. Training is associated with an increase in self-reported preparedness of acute care providers to deal with victims of mass emergencies. Training is also associated with increased willingness of acute care providers to report to work during a mass emergency. Therefore, healthcare systems in New Zealand and Oman need to invest in the training of human resources for mass emergencies. Finally, the Canterbury earthquakes in New Zealand and tropical cyclones Gonu and Phet in Oman have highlighted lessons for both countries. Emergency preparedness should continue to be a national priority because the hazards and risks are an integral part of today’s society and will never be completely eliminated