• Yuanting Zha, Mojisola Ariyo, Olabiyi Olaniran, Promise Ariyo, Camila Lyon, Queeneth Kalu, Asad Latif, Byron Edmond, and John B Sampson.
• Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; University of California Irvine School of Medicine, Irvine, CA, USA.
• J Natl Med Assoc. 2018 Aug 1; 110 (4): 407-413.

IntroductionLittle is known about the state of resuscitation services in low- and middle-income countries (LMICs), including Nigeria, Africa's most populous country. We sought to assess the cardiopulmonary resuscitation (CPR) care in referral hospitals across Nigeria to better inform capacity-building initiatives.MethodsWe designed a survey to evaluate infrastructure, equipment, personnel, training, and clinical management, as no standardized instrument for assessing resuscitation in LMICs was available. We included referral teaching hospitals with a functioning intensive care unit (ICU) and a department of anaesthesiology. We pilot-tested our tool at four hospitals in Nigeria and recruited participants electronically via the Nigerian Society of Anaesthetists directory.ResultsOur survey included 17 hospitals (82% public, 12% private, 6% public-private partnership), although some questions include only a subset of these. We found that 20% (3 out of 15) of hospitals had a cardiac arrest response team system, 21% (3/14) documented CPR events, and 21% (3/14) reviewed such events for education and quality improvement. Most basic supplies were sufficient in the ICU (100% [15/15] availability of defibrillators, 94% [16/17] of adrenaline) but were less available in other departments. While 67% [10/15] of hospitals had a resuscitation training program, only 27% [4/15] had at least half their physicians trained in basic life support.ConclusionIn this first large-scale assessment of resuscitation care in Nigeria, we found progress in training centre development and supply availability, but a paucity of cardiac arrest response team systems. Our data indicate a need for improved capacity development, especially in documentation and continuous quality improvement, both of which are low-cost solutions.Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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