Introduction: Nepal faces significant challenges in addressing trauma-related injuries, with falls, road traffic accidents, and burns being the leading causes of injury. A pilot study evaluated emergency care capacity at tertiary hospitals in Kathmandu, Nepal, using the World Health Organization’s (WHO) newly deployed Hospital Emergency Unit Assessment Tool (HEAT). A focused secondary analysis of the HEAT tool results was conducted to assess emergency trauma capacity. Methods: This cross-sectional mixed-method study uses the WHO HEAT Tool to assess resources for trauma care delivery through descriptive statistics and comparative analysis. The tool combines open-ended questions, scaled responses, and discrete answers to evaluate facility signal functions, focusing on “trauma interventions” and signal functions that reflect emergency trauma care capacity. Results: Across all sites (n=7), an average 6.6 out of 10 trauma interventions were adequately available. All sites had adequate availability of resources for endotracheal intubation, bag-valve-mask ventilation, and oxygen saturation monitoring. Three sites reported adequate availability of mechanical ventilation but only one site had adequate availability of rescue surgical airway procedures. All sites reported adequate availability of needle decompression for tension pneumothorax and placement of tube thoracostomy. Only 1 out of 7 sites had interosseous access, while 4 had central venous access. All sites reported adequate availability of external hemorrhage control, wound packing, and suturing. Five sites reported adequate availability of pelvic binders. None of the sites reported utilizing the WHO Trauma Care checklist. Conclusion: Integrating trauma care-related questions into the HEAT tool was a feasible methodology for assessing strengths and identifying critical gaps in trauma care delivery in Nepal. Major gaps were identified in care, such as capacity for rescue surgical airway procedures, mechanical ventilation, and utilization of trauma care checklists. Further validation of this tool in application to emergency trauma care can improve trauma care delivery in resource-limited settings like Nepal.
Jaffry et al. (Sun,) studied this question.