The saying “when a mystery is discovered part of it is solved” should give hope to patients whose ailments have been diagnosed, with the belief that the treatment which would ultimately restore their health would commence immediately.
Ironically patients’ experiences in some of our hospitals negate this saying because they seem not to get the emergency medical care they require even after they have been diagnosed. Over time, some patients who are in need of emergency medical care have complained over the manner at which they have been constantly turned down by hospitals or in some cases booked for appointments when their emergency cases ought to be attended to immediately.
Sadly, what they get is that appointment date to see medical doctor is postponed for to a future date. Patients that require an emergency medical care over one form of care or the other are always at the receiving end of this constant postponement of attending to their emergency medical cases.
It is heartbreaking that many medical cases put as booked surgical interventions in our hospitals should have been handled as emergency cases. It has been observed that in the Department of Orthopedics in our general hospitals, for example, patients who have fractured femur shaft, which should have been handled as immediate surgical intervention, was given appointment of two weeks to return to hospital for treatment.
Some patients have attributed the delay in attending to their emergency medical care in our hospitals to bottlenecks in the existing health system in the country and the fact that surgical schedules are influenced based on who you are/who you know in the society.
A lady who identified herself as Mrs. Grace told New Telegraph HEALTH that she was booked for a thoracic surgery at Lagos State University Teaching Hospital (LASUTH) since eight months ago and as at the time of filing this report, the surgery has not been done. “I have persistent severe pain in my throat and I was told there would be surgery to tackle it. So, I was given a date to come for the surgery. It has been over eight months since I was told there would be a surgery and each time I come for the surgery I would be given some drugs and a new date.
“I am fed-up. I believe if I had been one important personality in the society or know someone in the higher authority in the hospital my case would have been settled long ago”, added Grace. Numerous cases like that of Mrs. Grace abound in our hospitals especially the public health facilities today and in most cases the patients do not live to tell their stories.
They die while waiting for the surgery to be performed. Not handling emergency surgical cases as emergencies or delaying booked surgeries has led to increased morbidity and mortality of some patients. In another case which occurred in Lagos, a journalist who gave his name as Henry Ogudu was on his way home after closing very late at work, got involved in an accident.
He was riding in a tricycle popularly known as ‘Keke Napep’ when suddenly officials of the Lagos State Traffic Management Authority (LASTMA) gave the driver a hot chase following a traffic violation. During the pursuit, the tricycle upturned warranting its occupants to be thrown out in motion.
“I landed on my left shoulder and fractured it badly,” Ogudu lamented. On being rushed to LASUTH, the closest facility with an Orthopaedic Unit, officials at that unit surpris-ingly booked Ogudu for another appointment due three weeks away.
The reason given was that some patients had previously been booked to see doctors on the day Henry was rushed to the hospital. Shocked Ogudu with slinged left hand began contacting all the ‘who is who’ among his contacts.
It took the intervention of the Public Relations Officer (PRO) of that hospital to influence for Ogudu to get doctors’ attention the following day. What happens to millions of other poor and less privileged patients who may not have anyone to help them influence such?
Dr. Iheukwumere Nwaiwu, who works in the Emergency Department Unit, Federal Medical Center, Bayelsa State said not handling emergency medical cases as early as possible has effects on the patient and the medical personnel.
“Emergency medical cases that are not handled promptly could lead to loss of lives. It could lead to complications; it increases morbidity and poor clinical outcome. “Also on the part of the medical personnel, it can lead to litigation, low selfesteem and poor satisfaction”, Nwaiwu said.
A former 2nd Vice Chairman, Nigeria Medical Association (NMA), Lagos State Chapter, Dr. Olusegun Akinwotu said this usually happens in government hospitals because the list of surgery cases is always long. However, he is of the view that emergency care should be based on first come first served and the emergency nature of the cases. “Patients must be attended to based on one; emergency nature of the case and not because I know a high ranking somebody in the hospital.
Secondly, it should be based on ‘first come first served’. But you know the way our society is, “who knows who”, people would like to use that influence to get things done,” Akinwotu said. “However in some cases for some reasons, maybe if there are so many people on that list and somebody who was booked before may suddenly become an emergency. Emergency can arise at any time. So the person’s case might now be prioritised over those who came before him,” he added.
Dr. Akinwotu identified a number of factors which may lead to delay or cancellation of emergency or booked surgeries, which range from unavailability of power supply, unavailability of disposables used in the theater and shortage of specialist manpower. “If there are inadequate sterilised kits for the surgery.
Most at times, you find out that electricity is required to do the sterilisation and most often the gadgets are electrically powered; it can lead to delay or cancellation of surgery. “If we need to do a kind of surgery that the person has to bleed beyond normal we may need to do some transfusion on the patient so that the blood loss can be replenished.
If there is no blood available they may not go ahead with the surgery and the blood must be compatible with the receiver’s blood,” said Akinwotu. He also said that if any of the specialists who are on the roaster for the surgery fails to show up and there is nobody to replace him that can lead to either a delay or cancellation of emergency or booked surgery.
Akinwotu advised that there has to be proper planning and retraining of specialised personnel in other to correct the menace of delay or cancellation of emergency or booked surgeries in our hospitals. “To prevent all these proper planning is required and high level management potentials need to be put in place.
We need to ensure that everything required to be on ground are provided; the man power is well staffed and there is no shortage of doctors. “We need to continue training and re-training experts so that we can have people that have specialised skills in the kind of surgery we are talking about. There must be availability of water because proper cleansing and washing is required in the theater,” he added.
By: Eleazar Nwanti
New Telegraph News
ABUJA: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
PORTHARCOURT: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
LAGOS: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
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