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Detection of medical errors in management of traumatic hypovolemic shocked adult patients presented to emergency department in Suez Canal university hospital, Ismailia, Egypt

Adel Hamed Elbaih, Monira Taha Ismail, Emad Eldin Abd Elgwad, Fatma Hassan, Amer Helmy.

Abstract
Background: IN 2010, Institute of Medicine in USA report that medical errors are estimated to result in about between 44,000 and 98,000 preventable deaths and 1,000,000 excess injuries each year in U.S. hospitals. The annual cost of treating medical injuries in USA has been estimated to be $9 billion. The objective of this study was to follow up guidelines in treatment of Traumatic hypovolemic shocked patients.
Methods: The design of this study is a cross sectional descriptive study was conducted on traumatic patients who presented to the emergency department between the periods from October 2012 to October 2013. This study was conducted at the emergency department Suez Canal University Hospital, Ismailia, Egypt. On 100 patients with traumatic hypovolemic shock male or female within the age ranges from 18 years till 65 years old. Patients admitted to the hospital with other types of shock with trauma, non-traumatic hypovolemic shock, pregnant females, advanced malignancy, patients below 18 years old or patients more than 65 years old should excluded from the study. Questionnaire was filled by the researcher during resuscitation of the patient diagnosed as traumatic hypovolemic shock by the medical team in details; medical error was identified by comparing the actual management plan to the standard plan according to the guidelines from "The Washington manual of critical care".
Results: This study was conducted on 100 patients who presented to the Emergency Department, Seuz Canal University Hospital, Ismailia, Egypt. Between the period from October 2012 to October 2013 in order to detect medical errors in treatment of Traumatic hypovolemic shocked patients and to reach the optimal scheme of management. 1-More than half of the patients were in age group (≥30-45). And most of them were males about 70% of the studied patients and females were 30%. 2- Most of the patients were delayed in hospital arrival as we found that 50% reached in more than 40 min. 3-The initial medical help in the pre-hospital period was given to almost all of the patients (94%). 4- Incomplete exposure of patients is a very frequent medical error occurs during hospital assessment in about 22% of patients.
Conclusions: Failure in oxygen saturation monitoring and forgetting complete exposure of the patient has statistically significant relation with mortality during in hospital assessment of the patient. Delayed insertion of 2 large cannula or central line, Fluid given not warmed and blood received not at the proper time all of them show statistically significant Relation with mortality during in hospital resuscitation of the patient with traumatic hypovolemic shock.

Key words: Unwarmed fluids, Incomplete exposure, Temperature monitoring



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