ASSESSMENT OF THE KNOWLEDGE, ATTITUDES AND PRATICES OF RESUSCITATION OF PATIENTS AMONG RADIOGRAPHERS DURING RADIOLOGICAL EMERGENCIES: A CASE STUDY OF TERTIARY HOSPITALS IN ENUGU

ABSTRACT The study was undertaken to assess the knowledge, attitude and practices of resuscitation of patients among radiographers’ during emergency cases in three tertiary hospitals in Enugu State, Nigeria. It is a descriptive cross-sectional study with the use of questionnaire to obtain information from the radiographers. The survey was carried out between March and June, 2013. This assessed the knowledge, attitude, practice of universal precaution rule and the protective measures adopted when handling a tuberculosis case. A total of 52 radiographers participated in the study. The result showed that radiographers have poor knowledge, positive attitude and good practice towards patients in need of resuscitation. From the findings, 90% of the radiographers were not satisfied with their knowledge of resuscitation. The result also shows that 96% of the respondents indicated that the department has not organized any form of training for them and  72% of the radiographers have a good attitude towards compulsory training in resuscitation. Emergency drugs and other resuscitation materials were not readily available in the department. Also the result shows that 70% of the radiographers have good attitude towards patients in need of resuscitation. Recommendations were also made in line with obvious deficiencies in knowledge.
LIST OF TABLES Table 1: Age and Sex distribution of the respondents  Table 2: Place of work and the highest educational qualifications of the respondents Table 3: Respondents years of practice Table 4: Respondents knowledge of resuscitation practices and emergency care Table 5: Availability of resuscitation materials Table 6: Respondents feeling towards patients in need of resuscitation Table 7: Respondents reactions to handling emergency everyday Table 8: Radiographers percentage outcome on if they follow the American Heart             Association guidelines Table 9: Respondent’s responses on hand positions during CPR Table 10: Respondent’s opinion on means of improving the knowledge of resuscitation practices.
LIST OF FIGURES Figure 1: Anatomy of the respiratory system Figure 2: Respondents attitude to compulsory resuscitation training.    TABLE OF CONTENTS Title page----------i Certification page---------ii Approval page----------iii Dedication----------iv Acknowledgement---------v Abstract----------vi List of tables----------vii List of figures----------viii Table of content---------ix CHAPTER ONE 1.1 Background of study --------1 1.2 Statement of problems --------3 1.3 Purpose of study               -           -           -     - 3   1.4 Significance of study     -       -        -          -          -         -3 1.5 Scope of study   ---------3 1.6 Operational definition of terms--------3 1.7 Literature Review -------- -4 CHAPTER TWO 2.1.2 Anatomy of the respiratory system ------18  2.1.3 Assessment---------22 2.2 Attitudes----------23 2.3 Practices ----------24 2.3.1 Resuscitation Techniques --------25 2.3.2 Barriers to Resuscitation --------29 2.3.3 Possible complications in the practice of CPR -----29 2.4 Patients - ---------- 30 2.5 History of resuscitation ---------30 2.6 Radiological Emergencies -------32 CHAPTER THREE  3.1 Research Design ----------34 3.2 Target Population ---------34 3.3 Sampling Method ---------34 3.4 Tool for Data Collection ---------35 3.5 Method of Data collection --------35 3.6 Method of Data Analysis --------35 CHAPTER FOUR 4.1 Data Presentation ---------36 CHAPTER FIVE 5.0 Discussion of findings ---------47 5.1 Summary of findings ---------49 5.2 Limitations of Study ---------50 5.3 Recommendations ---------50 5.4 Area of further studies ---------50 5.5 Conclusion ----------50 REFERENCES ----------51 APPENDIX----------56   INTRODUCTION          Resuscitation is one of the most evolving areas of modern medicine while cardiopulmonary resuscitation (CPR) is a treatment modality aimed at preventing sudden, unexpected death in life threatening situations. 1 In 1773, physician William Hawes(1736-1808)  began publicizing the efficacy of artificial respiration to resuscitate people who superficially seem drowned.  For a year he paid a reward from his pocket to anyone bringing him bodies rescued from the water within a reasonable time of immersion. Thomas Cogan another English physician joined him later. In summer 1774, Hawes and Cogan each brought fifteen friends to a meeting where Royale Humane Society was formed. Artificial respiration is the act of assisting or stimulating respiration a metabolic process referring to an overall exchange of gases in the body by pulmonary ventilation, external respiration and internal respiration. Assistance takes many forms but generally entails providing air for persons not breathing or is not making sufficient respiratory efforts on their own(although it must be used on a patient with a beating heart or as part of the CPR to achieve the internal respiration.)2 The practice of CPR dates back to biblical times.1 In 2 Kings 4:34, Prophet Elisha revived an apparently dead child using mouth-to-mouth breathing. Nevertheless it was not until 1954 that Elam et al demonstrated that mouth- to- mouth respiration (kiss of life) with the operator’s expired air was physiologically adequate to produce ventilation. Though the method of internal defibrillation was described in 1933, its use was not possible until the development of external cross chest defibrillator in 1956 and 1957. The modern era of CPR began in 1960 in a paper authored by Kouwenhoven, Jude and Knickerboker entitled Close Chest Cardiac Compression, Artificial Ventilation and Electrical Defibrillation.1 CPR is always indicated for any person who is unresponsive with no breathing or only breathing in occasional agonal gasps as it is most likely that they are in cardiac arrest. It is also indicated in those that are unresponsive with no breathing or abnormal breathing. 3 Previously, when the heart of a patient stops, a patient is considered dead but presently, it is known that certain procedures when carried out within 4 minutes would make the patient survive 1. The main aim of CPR is to restore the partial flow of oxygenated blood to the brain and heart but when used alone cannot restart the heart. It can be used to delay tissue death and to extend the brief window of opportunities for a successful resuscitation without brain damage3.  Insufflation also known as rescue breaths or ventilations is the act of mechanically forcing air into a patient’s respiratory system. It can be achieved by a number of methods which will depend on the situation and the equipment available 3. Serious emergencies are fortunately rare in routine radiology practice and consequently with the increasing complexity of radiological emergencies may become frequent. The most urgent complications are cardiac arrest and respiratory failure4. Cardiac arrest may be the result of any other complications or it may occur completely without warning in any department.  The radiographer is likely to be the first medical practitioner on the scene of emergencies like contrast reactions, anaphylaxis and other common medical emergencies that occur in the department6 It is therefore essential that every radiology department should be organized and the radiographers well equipped and ready to deal with any emergency.