Pan African Journal of Emergency Medicine and Critical Care最新文献

{"title":"Strengthening prehospital care to ensure quality health care","authors":"Akililu Azazh","doi":"10.58904/2023/69","DOIUrl":"https://doi.org/10.58904/2023/69","url":null,"abstract":"Pre-hospital care provides timely care in emergent and urgent health conditions and in so doing it addresses quality, access, and equity. (1) The large burden of acute disease in Africa can be substantially addressed by effective, integrated emergency care systems, of which non-hospital emergency care plays a critical role. (2) In the past decade, FMOH has exerted significant efforts in the development and expansion of ambulance services. Before 2010, ambulance service was being provided only by the Ethiopian Red Cross Society (ERCS). (3) Since 2010, the FMOH allocated fund that was enhanced by additional community mobilization efforts, and as of 2020, it purchased several thousands of ambulances. Besides, there are Private ambulance systems with noticeable development as well as expansion of ERCS ambulances underway. (4) Despite these visible developments, there are formidable challenges in this domain of practice. Ambulances are mainly giving maternal referral transport services while they hardly respond to other emergency problems. The dispatch and call system is not strong in many areas. As the call system doesn’t work and response time is significantly delayed it created public distrust. Consequently, most emergency patients are transported to health facilities with other transport systems.","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116935950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude and Practice of Physicians and Nurses Working in Addis Ababa on Oxygen therapy","authors":"Mohammed Kalifa, Menbeu Sultan, Yemane G/Medhin","doi":"10.58904/2023/41","DOIUrl":"https://doi.org/10.58904/2023/41","url":null,"abstract":" \u0000Background: Oxygen is a commonly used drug in the clinical setting and like other drugs its use must be considered carefully. It is administered daily to a wide number of patients in the emergency care setting. But the knowledge and skill of health care providers is not well known.\u0000Objective: The study sought to gain full understanding on physicians and nurses’ knowledge, attitude and practice on clinical administration of oxygen and factors associated with it.\u0000Methodology: A cross-sectional descriptive study design was used. The target population was all physicians and nurses working in the emergency department during the study period. Data was collected using structured questioners that measured physicians and nurses’ knowledge, attitude and practice about oxygen therapy including associated factors.  \u0000Results: This study proved that overall mean and standard deviation of knowledge and practice of physicians on oxygen therapy are satisfactory with respective result of 72&7, and 71&20 while their attitude on oxygen therapy is unsatisfactory, 49&23. Among nurses all variables were unsatisfactory with respective mean value of knowledge, attitude and practice of 35 ,32and 46.\u0000Conclusion: This study concluded that, majority of the studied sample of physicians had satisfactory level of knowledge and practice, but unsatisfactory level of attitude towards oxygen therapy. The majority of studied sample of nurses had unsatisfactory level of knowledge, attitude and practice regarding oxygen therapy. Lack of proper training, absence of guide lines on oxygen therapy, inadequate supply and delivery system of oxygen in the ER, heavy workload, and incomplete written prescription for oxygen therapy were the contributing factors.\u0000 ","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124015604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of nurses in the prevention of Ventilator-Associated Pneumonia among critically ill patients at Muhimbili National Hospital in Dar Es Salaam","authors":"Joan P. Zenas, D. Mwakawanga, Mathew David Ndomondo, M. Ndile","doi":"10.58904/2023/60","DOIUrl":"https://doi.org/10.58904/2023/60","url":null,"abstract":" \u0000Background: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections that occur more than 48 hours after intubation and initiation of mechanical ventilation. It is associated with morbidity and mortality, increased health costs, and prolonged hospital stays. The estimated incidence of VAP globally is about 5-40% whereby in low and middle-income countries is about 47.9 per 1000 ventilator days. However, there is limited literature about VAP prevention in hospitals in Tanzania. Therefore this study aimed to explore nurses’ experience in the prevention of VAP.\u0000Methods: An exploratory descriptive study design was conducted with 15 nurses who were purposefully recruited from medical and surgical ICUs. A semi-structured interview guide consisting of main questions and probes was used to collect data. All interviews were audio-recorded and transcribed verbatim. Data were analyzed using an inductive thematic analytical approach.\u0000Results: Four main themes emerged; nurses’ roles in the prevention of VAP, nurses’ challenges toward care provision, nurses’ competency in implementing VAP prevention strategies, and enablers toward the implementation of VAP. The revealed prevention strategies were suctioning, early weaning, head of bed elevation of 30-45°, oral care, administration of medication, and implementation of IPC measures. The study has also revealed important barriers such are inadequate equipment, lack of VAP prevention protocols, shortage of staff, and inadequate knowledge. However, the major facilitators were responsible leadership, a quality control team, the availability of IPC guidelines, and individual motivation.\u0000Conclusion: This study provides insights into the experience of nurses in the prevention of VAP. Nurses face several challenges including a shortage of staff, shortage of equipment and supplies, lack of training, lack of VAP prevention protocols, and inadequate knowledge of VAP prevention. Despite these challenges nurses in their capacity are involved in VAP preventive measures.\u0000 \u0000Keywords: Ventilator-associated pneumonia, strategies, experience, nurses, critically ill patients.","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"175 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129513294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive practice and associated factors among health care workers towards COVID-19 in Addis Ababa covid care center","authors":"H. Asmare, Melsew Getnet, W. Chane, E. Getahun, Asaminew Habtamu, Taye Mezegebu, K. Gebeyehu, M. Sibhat","doi":"10.58904/2023/47","DOIUrl":"https://doi.org/10.58904/2023/47","url":null,"abstract":" \u0000Background: COVID-19 has made exceptional challenges to public health globally. Healthcare experts who are at the frontline of the outbreak reaction are at increased risk of getting infected. The high infection rate of COVID-19 has been reported amongst frontline health care workers which might be linked to low prevention practice. However, in the context of Ethiopia, studies ascribed to the prevention practice against COVID-19 among healthcare workers are limited. Therefore, this study aimed to assess the Preventive practice against COVID-19 and associated factors among health care workers.\u0000Methods and materials: Institution-based cross-sectional study design was conducted on 240 healthcare workers at millennium covid care center and a pretested structured questionnaire was used for the data collection. The data was entered into epi data version 4.4.2.2 and exported to SPSS window version 25 for analysis. Descriptive statics and binary logistic regression were used. Odds ratio with a 95% confidence interval and p-value ≤ 0.05 were quantified to measure effect sizes of independent variables and to declare statistical significance respectively.\u0000Result: This study showed that 55% of health care workers have good preventive practice and In line with this, lack of personal protective equipment(AOR=2.978, 95%CI(1.426-6.220)), designed isolation area (AOR=2.251, 95%CI(1.056-4.799)), availability of chemical disinfectant (AOR=5.055, 95%CI (2.283-11.191)), training on covid case management(AOR=6.04, 95%CI(2.569-14.204)), infection prevention guideline availability (AOR=2.59, 95%CI(1.192-5.627), and discomfort while using PPE (AOR=4.125 95%CI (1.779-9.561))  showed significant association with the preventive practice of frontline health care workers towards covid 19.\u0000Conclusion: The overall finding of this study revealed that healthcare workers had poor preventive practice (45%) towards covid 19. Addressing these identified factors will enable to reduce the infection rate among health care providers.\u0000Keywords:  covid 19, prevention practice, factors, frontline, Ethiopia\u0000 ","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114479601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethiopian Medico-Legal Practices need to improve to serving Justice","authors":"Menbeu Sultan","doi":"10.58904/2023/10","DOIUrl":"https://doi.org/10.58904/2023/10","url":null,"abstract":"<jats:p>NA</jats:p>","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121095657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude of Road Traffic Accidental (RTA) Death and Its associated factors among Adult Emergency Visit Patients at ALERT Hospital, A 2 Year Retrospective Review Study","authors":"Gemechu Jofiro, Bethelhem Teklu, M. Kumie","doi":"10.58904/2023/39","DOIUrl":"https://doi.org/10.58904/2023/39","url":null,"abstract":" \u0000Introduction: In low income countries, Road Traffic Accident (RTA) Death remains high. This describes that RTA are a major public health challenge. And also, the problem is increasing from time to time in resource-limited countries. The most economically active age groups (18-50) are at the greatest risk of dying as a result of RTA. This affects economically, social and political stability of the countries. Therefore, this study aimed to describe the pattern of RTA death and associated factors in the adult emergency department.\u0000Methods: A two-year retrospective chart review of RTA injury was conducted at ALERT Hospital. The data were collected by using a structured checklist. Descriptive statistic like frequencies, percentage, means, standard division, and proportion was computed for selected variables using SPSS version 21. Logistic regression was used to predict the measure of association between interest independent variables and death due to RTA injuries.\u0000Result: - The proportion rate of RTA death was 27(17.4%) from 155 of RTA injury patients presented Adult Emergency Department of ALERT Hospital. This result translates to a mortality rate of RTA was 34.8 deaths per 1000 patients per year. Multivariate analysis indicated that individuals who drank alcohol while driving were three times more likely to be died in RTA as compared to those who didn’t drink alcohol. And also, victims who had more year of experience in driving been less likely or reduced by a 65% chance of died in RTA than their counter parts.\u0000Conclusion: The prevalence of RTA death was high in this study. Use of alcohol while driving and year of experience in driving was most significant associated with road traffic accident-related death. To alleviate these problems awareness creation and measuring blood alcohol content levels and breathe analyzers for the driver during driving is more recommended.\u0000 ","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133818268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POCUS as an adjunct to clinical examination and management in resource-limited emergency and critical care setting","authors":"Ayalew Zewdie","doi":"10.58904/2023/68","DOIUrl":"https://doi.org/10.58904/2023/68","url":null,"abstract":"","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133112683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of Treatment Resources in Emergency Department for the Management of Acute Toxic Exposure and Poisionings in Governmental Hospitals in Dessie Town","authors":"L. Tilahun, H. Adal, D. Alemu, Erukya Shikur, A. Feleke","doi":"10.58904/2023/26","DOIUrl":"https://doi.org/10.58904/2023/26","url":null,"abstract":"Introduction: Accessibility of drugs and over the counter drugs in hospitals are not enough andsuch accessibility of drugs act as preparedness of a hospital emergency departments in health facilities in controlling of emergency poisoning. Methods: Institution wide retrospective cross-sectional study design was conducted.  Data was collected using semi-structured questionnaire. Three nurses were trained about the data collection of this study and data entry was done by using SPSS version 20.0. Results- There were a sum of 520 toxic cases were get service (169 from Boru Meda Hospital and 351 from Dessie Referral Hospital). The first cause of poisoning was Organophosphate poison with the case of 140 (26.9%). From decontamination resources sodium sulphate, sorbitol, ipecac syrup, polyethylene glycol and colloids not present from both hospitals. From stabilization resources there were no colloids in both hospitals. From antidots only atropine sulphate, calcium gluconate, polyvalent antivenom and sodium bicarbonate were accessible through all time of the study period in both hospitals. Conclusion and Recommendation: - The supply of drugs and over the counter drugs in those hospitals were partially present, apart from stabilization resources. It is recommended if selected antidotes, stabilization, decontamination and elimination treatments are accessible.","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134115990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency and critical care development in Ethiopia: a lot is achieved and yet farther to go.","authors":"Akililu Azazh","doi":"10.58904/2023/51","DOIUrl":"https://doi.org/10.58904/2023/51","url":null,"abstract":"","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129491095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of Acute coronary syndrome (ACS) at the Emergency Department of tertiary hospital, Addis Ababa, Ethiopia","authors":"Rakeb Mulugeta, Ayalew Zewdie","doi":"10.58904/2023/22","DOIUrl":"https://doi.org/10.58904/2023/22","url":null,"abstract":"BACKGROUND: Acute coronary syndrome (ACS) is the leading cause of death and disability-adjusted life years globally, with low- and middle-income countries (LMIC) bearing a high proportion of the burden. In this study, we aimed to assess the pattern of ACS  at  St Paul's hospital Emergency department.\u0000METHODS: A cross-sectional study was carried out from September 1, 2017, to October 31, 201at St Paul's Hospital Millenium Medical College . Patients age >18 years old,  presented to the Emergency department  and had diagnosis of Acute Coronary Syndrome were included. Structured checklist were used to collect data from patient charts. Data was analayzed  using SPSS version 25.\u0000RESULTS: 103 patients were enrolled during the study period. The majority were males (n = 69, 64.5%). The average age was 55.65 ±13.96 years. The majority of patients (n = 67, 65.1%) arrived to the emergency department by taxi, and 60 patients (58.3%) were referred. The most common chief complaints were chest pain (n = 79, 76.7%), easy fatigability (n = 58, 56.3%) and epigastric discomfort (n = 44, 42.7%).The mean duration of symptoms before presentation to the ED was 3.4 ± 2.83 days. The most common risk factors identified were hypertension (n = 47, 45.6%) and diabetes mellitus (n = 31, 30.1%). Types of ACS included ST-elevation myocardial infarction (STEMI)(n = 74,71.8%),non-ST-elevation myocardial infarction (NSTEMI)(n = 22, 21.4%) and unstable angina (n = 7, 6.8%). Heart failure was the most common complication at presentation. The most common echocardiography findings were wall motion abnormalities (85.4%) and decreased ejection fraction (60.2%). The ED mortality rate was 6.8%.\u0000CONCLUSION: The majority of patients with ACS used taxi and arrived at the hospital late.The most common presentations were chest pain and easy fatigability. STEMI was the most common type of ACS identified.","PeriodicalId":405884,"journal":{"name":"Pan African Journal of Emergency Medicine and Critical Care","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125463513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}