Radiographic Care Of Trauma Patient: Case Study Of University Of Nigeria Teaching Hospital Enugu (unth), And National Orthopedic Hospital Enugu (nohe)

This is a prospective non experimental survey study design aimed at describing radiographic care of trauma patients: case study of UNTH and NOHE. The questionnaires for the study were distributed among radiographers in the above mentioned hospitals. The objectives and purpose of the research were explained by the researcher. Medical radiography plays a very vital role in the care, diagnosis and good management of traumatic patients in the radiology department. Some of the roles include:  ensuring immediate movement of the patients in and out of the department for radiological investigations without further delay, patient reassurance, and usage of good lifting technique to move the patient to avoid further complications to their present condition, ensuring less movement of the patient during positioning. The findings from the research, patient’s waiting time is not long but the patient waiting time could be long in some certain circumstances as a result of power breakdown, equipment breakdown and sometimes non-readiness of the radiographers. Findings indicated that there are no dedicated rooms nor dedicated equipment for trauma examinations in the hospitals but there are adequate radiographers that care for the patients in the department.

CHAPTER ONE: INTRODUCTION

CHAPTER TWO: Literature review=   =  = =  =  = =   = =  =  =  =  =  =    6

CHAPTER THREE: RESEARCH METHODOLOGY

CHAPTER FOUR:

CHAPTER FIVE

REFERENCES

APPENDICES

Trauma has been described as any event which is overwhelming or unpredictable, according to the  American Psychiatric Association [APA], 2000 specifically defines trauma as direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate.1

A traumatic condition is also considered as a serious shock to the body which may need Modifications or variations in patient positioning and minimal movement of the body part2.

Most countries of the world are experiencing an epidemic of trauma, but the most spectacular increase has been in the developing countries.3Proliferation of roads and use of vehicles have led to a rapid increase in injuries and deaths and many peripheral medical facilities find themselves faced with multiple casualties from bus crashes or other disasters. Severe burns are also common in both urban and rural areas. A number of important differences between high and low-income countries make development of a specifically designed Trauma Care Course beneficial.

They include:

• The great distances over which casualties may have to be transported to reach a medical facility.

• The time taken for patients to reach medical care.

• The absence of high-tech equipment and supplies.

• The absence of skilled people to operate and service it.

A traumatic patient is in pain due to injuries and every minute can make the difference between life and death. Trauma is the sixth leading cause of death worldwide, accounting for 10% of all mortalities, and is therefore a serious public health problem with significant social and economic costs.4

Radiographic care of trauma patient is the care given to the traumatic patient during his/her stay in the radiology department; this involves proper patient handling, proper patient reassurance, use of good lifting techniques to move the patient to avoid further complications to their present condition, proper exposure factors, correct patient positioning, ensuring immediate movement of the patients in and out of the department for radiological investigations without delay thereby reducing patient waiting time in the department etc. The radiographer must be able to provide physical and emotional support to the patient during the x-ray procedure and be able to respond to situations involving trauma, as well as provide care until the physician or appropriate personnel are contacted.5

Radiographic care of trauma patient is based on the classification of trauma, e.g. Head injury, Chest trauma, abdominal trauma, Extremity trauma, Facial trauma, Spinal cord injury6etc. all these radiographic presentations have different ways of handling them. There are also traumas of different demographic groups, e.g. trauma involving a pregnant woman, pediatric, or geriatric patients etc. all these also require specific radiographic care. 

When the traumatic patient is brought to the radiology department, his/her airway should be checked for proper ventilation and delivery of oxygen to already-depleted cells, as a patent airway results in a better patient outcome. 

Some traumatic conditions have posed a challenge to the radiographers in the radiology departments. An example is when a pediatric traumatic patient is brought in the department for immediate radiologic examination, Pain fear of the machines and new environment can make the child not to respond to the direction given by the radiographer, this is a big challenge to radiographers who have little knowledge in pediatric trauma patient care.

Elderly patients today also have an increased risk of trauma from an increasingly active life style and from impaired motor and cognitive functions. The elderly require far less mechanism to produce injuries. For all of these reasons the dramatic growth experienced in the number and severity of geriatric trauma patients can be expected to continue.7for this, the elderly patients should be given greater health care unlike the younger patients who have similar injuries.

There are factors that can pose a challenge the safe radiographic care 0f the patient, they are: the x-ray unit, when a floor mounted x-ray machine is used the positioning of the patient is limited because the movement of the couch is only on one direction, unlike the floating couch x-ray machine that can move in all directions needed.

Lack or absence of dedicated equipment in the radiology department may lead to production of poor quality radiographs. Poor radiographic technique may contribute to the increase of patient waiting time because it may lead to the repetition of the examination and this worsens the patient’s condition. An isocentric skull unit  with high specialized table which is necessary for moving of patients from the trolley to the x ray couch to make radiographic examinations comfortable for the trauma patient, and  convenient for the radiographer. 

Many delays experienced in diagnoses of traumatic patients are linked to delays in radiological examinations which may lead to further complications.8For example, a patient with internal bleeding, or obstruction may change from a mild to a severe condition or even lead to death of the patient as a result of delay in attending to his condition.

As a result of wide spread occurrence of traumatic patients, and an increase in the traumatic in patient, It will be of great benefit to access the radiographic care given to trauma patients in the above mentioned hospitals and  compare it with the  international practice.