African Journal of Emergency Medicine最新文献

{"title":"Leveraging tele-mentoring and remote learning to strengthen the emergency care capacity of health workers in Uganda","authors":"Irene Atuhairwe ,&nbsp;Annet Alenyo Ngabirano ,&nbsp;Bonaventure Ahaisibwe ,&nbsp;Allan Nsubuga ,&nbsp;Andrew Marvin Kanyike ,&nbsp;Raymond Bernard Kihumuro ,&nbsp;Thomas Balizzakiwa ,&nbsp;Helen Ewing ,&nbsp;Randall Ellis ,&nbsp;Leigh Forbush ,&nbsp;Oumo Joseph ,&nbsp;Marion Jane Nakyeyune ,&nbsp;John Baptist Waniaye","doi":"10.1016/j.afjem.2023.04.001","DOIUrl":"10.1016/j.afjem.2023.04.001","url":null,"abstract":"<div><h3>Background</h3><p>A robust emergency care system is a cost-effective method of reducing preventable death and disability, especially in low-and middle-income countries. To scale emergency care expertise across the country, the Uganda Ministry of Health and Seed Global Health established the Emergency Medical Services (EMS) ECHO program. We describe the process of establishing the program in a resource-limited setting, best practices, and lessons learned in Uganda.</p></div><div><h3>Methods</h3><p>Investigators conducted a mixed-methods evaluation to assess the initial 4 months’ implementation of the EMS ECHO. We conducted pre/post-program assessments of healthcare worker knowledge, self-efficacy, and professional's satisfaction with the program. The analysis compared the differences between pre/post-test scores descriptively.</p></div><div><h3>Results</h3><p>The EMS ECHO was initiated in November 2021. A phased curriculum was developed with the initial phase focusing on the ABCDE (Airway, Breathing, Circulation, Disability, and Exposure) approach to the emergency patient. This phase reached 2,030 health workers cumulatively across 200 health facilities. The majority of the participants were medical doctors (<em>n</em> = 751, 37%), and nurses (<em>n</em> = 568, 28%). Majority of participants (95%) rated the sessions as informative. On whether the ECHO sessions diminished professional isolation, 66% agreed or strongly agreed.</p></div><div><h3>Conclusions</h3><p>Similar to other ECHO program evaluation results, Uganda's EMS ECHO program improved knowledge, skills, and the development of a virtual community of practice thereby diminishing professional isolation. It also demonstrates that through a planned stepwise process, virtual learning and telementorship can be used efficiently to improve healthcare worker knowledge,skills and multiply the limited number of emergency care experts available in the country.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global health research abstracts: March ‘23","authors":"Dr. Jonathan Kajjimu","doi":"10.1016/j.afjem.2023.03.004","DOIUrl":"10.1016/j.afjem.2023.03.004","url":null,"abstract":"<div><p>The African Journal of Emergency Medicine, in partnership with several other regional emergency medicine journals, publishes abstracts from each respective journal. Abstracts are not necessarily linked to open access papers however, all abstracts are accessible without subscription.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9406367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Health research abstracts: January ‘22","authors":"","doi":"10.1016/j.afjem.2023.01.005","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.01.005","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49732543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight estimation in two groups of Ghanaian children with chronic diseases using Broselow, Mercy, PAWPER XL and PAWPER XL-MAC tapes","authors":"Rafiuk Cosmos Yakubu ,&nbsp;Vivian Paintsil ,&nbsp;Samuel Blay Nguah","doi":"10.1016/j.afjem.2023.04.003","DOIUrl":"10.1016/j.afjem.2023.04.003","url":null,"abstract":"<div><h3>Introduction</h3><p>The performance of various weight estimation methods in children with sickle cell disease (SCD) and heart disease (HD) has not been studied. We aimed to determine and compare the accuracies of the Broselow, Mercy, PAWPER XL and PAWPER XL-MAC tapes in Ghanaian children with no known chronic diseases (controls), SCD and HD.</p></div><div><h3>Methods</h3><p>We prospectively recruited 631 children (199 with HD, 209 SCD and 223 controls) from the Komfo Anokye Teaching Hospital (KATH). Their weights were estimated using the Broselow, Mercy, PAWPER XL and PAWPER XL-MAC tapes. These estimated weights were compared to measured weight using mean percentage error (MPE), the proportion of weight estimates within ±10% (P10) and ±20% (P20) of measured weight. Bland-Altman limits of agreement (LOA) were determined to assess the precision of weight estimation and agreement with measured weight.</p></div><div><h3>Results</h3><p>The PAWPER XL, Mercy and PAWPER XL-MAC were the most accurate in all groups of children studied. All methods except the Broselow tape (BT), which performed best in the control group, had their best performance among children with SCD with negligible critical error rates (proportion of children with weight estimates &gt; 20% of their actual weight). The P20 in the various groups of children using the BT were 88.36%, 80.21% and 51.10% respectively in the control, SCD and HD groups. The Mercy, PAWPER XL and PAWPER XL MAC tapes were generally above 90% in all groups.</p></div><div><h3>Discussion</h3><p>The Mercy, PAWPER XL and PAWPER XL-MAC tapes performed significantly better than the BT in all groups of children studied. These methods of weight estimation performed best in children with SCD with very little critical error.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10154971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9485693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The views and experiences of candidates and graduates from a South African emergency medicine doctoral programme","authors":"Craig W ,&nbsp;Khan W ,&nbsp;Rambharose S ,&nbsp;Stassen W","doi":"10.1016/j.afjem.2023.03.005","DOIUrl":"10.1016/j.afjem.2023.03.005","url":null,"abstract":"<div><h3>Introduction</h3><p>With the emergency medicine speciality in its nascency in Africa, EM doctoral programmes will need to be developed to facilitate the establishment of an evidence base that is responsive to the African populace. This study aimed to understand the thoughts, experiences, and opinions of current and past candidates of a South African EM PhD programme.</p></div><div><h3>Methods</h3><p>Descriptive, qualitative, semi-structured interviews were used to gather data on PhD EM candidates and graduates.</p></div><div><h3>Findings</h3><p>Four candidates, and four graduates were interviewed. Four categories emerged from the data 1) interviewees had various motivations for starting a PhD in EM, 2) candidate expectations and learning needs were not always aligned with reality, and the challenges and opportunities for success in the PhD programme are related both 3) intrinsically (candidate) and 4) extrinsically (system).</p></div><div><h3>Discussion</h3><p>Many of the barriers noted by the participants can be related to the nascency of the EM in Africa. Participants felt underprepared for their doctorate in terms of their baseline research literacy and skill. Candidates did not receive the level of student-supervisor engagement they desired. Candidates who are also clinicians faced both academic challenges and a resource-limited healthcare system. Pre-doctoral training may upskill prospective candidates in research literacy before they officially register. Distance-learning can be sub-optimal in terms of social interaction and collaboration. A well-curriculated, competency-based programme with clear outcomes, structured teaching-learning opportunities, intentional academic support throughout the programme, can mitigate the above. Protected academic time, promotion criteria which acknowledges academic contributions, financial incentives and more joint positions between universities and clinical services are potential solutions for clinician researcher challenges. An African PhD EM programme should produce graduates who are independent researchers, skilled in academic supervision and who are impactful to African needs when contributing to the African EM knowledge economy.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Man-O-War simulator: a Low-cost manikin for training on chest tube management","authors":"Abdennour Nasri ,&nbsp;Mouna Jerbi ,&nbsp;Rim Karray ,&nbsp;Haifa Snoussi ,&nbsp;Amal Samet ,&nbsp;Aziza Talbi ,&nbsp;Hana Ksentini ,&nbsp;Imen Rejeb ,&nbsp;Olfa Chakroun-Walha ,&nbsp;Noureddine Rekik","doi":"10.1016/j.afjem.2023.01.004","DOIUrl":"10.1016/j.afjem.2023.01.004","url":null,"abstract":"<div><p>Simulation-based medical education is becoming a cornerstone in health education. Simulators are commonly expensive and not available in developing countries.</p><p>We propose a very low-cost simulator that any educator can realize. We describe here the steps to follow to develop this proposed simulator.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9970889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10826948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses and emergency nursing care in Botswana","authors":"Tebogo T Mamalelala ,&nbsp;Kefalotse S. Dithole ,&nbsp;Dorcas Basetsana Maripe-Perera","doi":"10.1016/j.afjem.2023.03.002","DOIUrl":"10.1016/j.afjem.2023.03.002","url":null,"abstract":"<div><p>The emergency nursing role is incredibly challenging in Africa, and Botswana is no exception due to the lack of qualified nursing staff, the lack of specialty training, and the demanding work environment. Botswana's use of the primary healthcare system to provide treatment to all, including those in need of urgent care, demonstrates the necessity of integrating emergency care services into primary healthcare. Our objective with this manuscript is to demonstrate the value of emergency nursing as a specialty in Botswana.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9545588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute organophosphorus toxicity in a regional hospital in Johannesburg, South Africa: A retrospective chart review","authors":"Vanessa Khonje ,&nbsp;Jedd Hart ,&nbsp;Jakus Venter ,&nbsp;Saisha Deonarain ,&nbsp;Saul Grossberg","doi":"10.1016/j.afjem.2023.04.002","DOIUrl":"10.1016/j.afjem.2023.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Intentional and accidental organophosphorus exposures pose a significant healthcare-related burden on South African communities. This study will review the demographics, characteristics and clinical course of patients presenting with features of acute organophosphorus toxicity to a regional Emergency Centre in Johannesburg, South Africa.</p></div><div><h3>Methods</h3><p>This was a retrospective chart review of all patients treated for possible acute organophosphorus toxicity from January 2020 to August 2021.</p></div><div><h3>Results</h3><p>A total of 205 patients were identified of which 134 patients were included in the study. The median age was 26 years with a male predominance (male= 56%, female=44%). 109 patients (81.3%) survived, 18 patients (13.4%) demised and the outcome of 7 patients (5.2%) was unknown. The median hospital length of stay was 8 days, (IQR= 5-13 days), and the longest hospital stay was 37 days in ICU. Atropinisation dose was significantly higher for intubated patients (median=140.0mg; IQR=90mg-219.5mg) compared to patients who were not intubated (median=60mg; IQR=20.5mg-120mg, <em>p</em> &lt; 0.05). The length of stay was significantly higher for intubated patients (median=11 days; IQR=7-15 days) compared to patients who were not intubated (median=5 days; IQR=3-8 days, <em>p</em> &lt; 0.00). There was a moderate positive correlation between atropinisation dose and length of stay (Correlation coefficient = 0.37, <em>p</em> &lt; 0.00). There was a moderate negative correlation between atropinisation dose and cholinesterase level (Correlation coefficient= - 0.39, <em>p</em> &lt; 0.00). Of those reported to have adverse effects 78.6%, were related to atropine toxicity.</p></div><div><h3>Conclusion</h3><p>Our study shows a high mortality rate secondary to organophosphorus toxicity. Significant exposures and thus higher doses of atropine were associated with increased length of stay and need for intubation. We found a high incidence of atropine-related adverse effects. More studies are needed to further establish the balance between the therapeutic and adverse effects of high-dose atropine as a treatment modality for organophosphorus toxicity.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10160343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9485691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of National Emergency X-Radiography Utilization Study (NEXUS) chest algorithm and extended focused assessment with sonography for trauma (E-FAST) in the early detection of blunt chest injuries in polytrauma patients","authors":"Yasmin Z. Attia ,&nbsp;Nashwa M. Abd Elgeleel ,&nbsp;Hazem M. El-Hariri ,&nbsp;Gouda M. Ellabban ,&nbsp;Maged El-SETOUHY ,&nbsp;Jon Mark Hirshon ,&nbsp;Adel H Elbaih ,&nbsp;Mohamed El-Shinawi","doi":"10.1016/j.afjem.2023.02.003","DOIUrl":"10.1016/j.afjem.2023.02.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Chest imaging plays a prominent role in the assessment of patients with blunt trauma. Selection of the right approach at the right time is fundamental in the management of patients with blunt chest trauma^.<span>[1]</span> A reliable, economic, bedside, and rapidly accomplished screening test can be pivotal. <span>[2]</span></p></div><div><h3>Objective</h3><p>The aim of this study was to compare the accuracy of extended- focused assessment with sonography for trauma (E-FAST) to that of the National Emergency X-Radiography Utilisation Study (NEXUS) chest algorithm in detecting blunt chest injuries.</p></div><div><h3>Methods</h3><p>This descriptive cross-sectional study included 50 polytrauma patients with blunt chest trauma from the emergency centre of Suez Canal University Hospital. E-FAST and computed tomography (CT) were conducted, followed by reporting of NEXUS criteria for all patients. Blinding of the E-FAST performer and CT reporter were confirmed. The results of both the NEXUS algorithm and E-FAST were compared with CT chest results.</p></div><div><h3>Results</h3><p>The NEXUS algorithm had 100% sensitivity and 15.3% specificity, and E-FAST had 70% sensitivity and 96.7% specificity, in the detection of pneumothorax.</p><p>In the detection of hemothorax, the sensitivity and specificity of the NEXUS algorithm were 90% and 7.5%, respectively, whereas E-FAST had a lower sensitivity of 80% and a higher specificity of 97.5%.</p></div><div><h3>Conclusion</h3><p>E-FAST is highly specific for the detection of hemothorax, pneumothorax, and chest injuries compared with the NEXUS chest algorithm, which demonstrated the lowest specificity. However, the NEXUS chest algorithm showed a higher sensitivity than E-FAST and hence can be used effectively to rule out thoracic injury.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/f5/main.PMC10014268.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Health research abstracts: February ‘23","authors":"","doi":"10.1016/j.afjem.2023.02.002","DOIUrl":"10.1016/j.afjem.2023.02.002","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43485283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}