African Journal of Emergency Medicine最新文献

筛选
英文 中文
Global Health research abstracts: June ‘24
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2025-01-11 DOI: 10.1016/j.afjem.2024.10.226
Jonathan Kajjimu
{"title":"Global Health research abstracts: June ‘24","authors":"Jonathan Kajjimu","doi":"10.1016/j.afjem.2024.10.226","DOIUrl":"10.1016/j.afjem.2024.10.226","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 1","pages":"Pages 535-536"},"PeriodicalIF":1.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053917","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}
引用次数: 0
Needs assessment and Acceptability of a Community First Aid Responder programme to increase Out-of-hospital capacity in Kinshasa, Democratic Republic of Congo: A qualitative study
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2025-01-08 DOI: 10.1016/j.afjem.2024.12.003
K Diango , J Pigoga , E Mafuta , J Yangongo , L Wallis , C Cunningham , P Hodkinson
{"title":"Needs assessment and Acceptability of a Community First Aid Responder programme to increase Out-of-hospital capacity in Kinshasa, Democratic Republic of Congo: A qualitative study","authors":"K Diango ,&nbsp;J Pigoga ,&nbsp;E Mafuta ,&nbsp;J Yangongo ,&nbsp;L Wallis ,&nbsp;C Cunningham ,&nbsp;P Hodkinson","doi":"10.1016/j.afjem.2024.12.003","DOIUrl":"10.1016/j.afjem.2024.12.003","url":null,"abstract":"<div><h3>Objective</h3><div>Despite efforts in recent years to expand the availability of prehospital care in low- and middle-income countries, its availability remains limited in many regions. The World Health Organization advocates the development of layperson first responder programmes as a supportive step in building functioning prehospital systems. This study aimed to identify the need for, and acceptability of, a community first responder programme to increase out-of-hospital capacity in Kinshasa, Democratic Republic of Congo.</div></div><div><h3>Methods</h3><div>We conducted five focus group discussions using purposive sampling. We included health system planners, emergency care providers, community health volunteers, and community members in both urban and peri‑urban areas. Interviews were recorded and transcribed verbatim, validated, and subjected to inductive content analysis to identify themes and sub-themes.</div></div><div><h3>Results</h3><div>Several areas of the emergency care system were identified for improvement, starting with the initial response to emergencies in the community. Barriers included planning and governance issues; inadequate resources such as trained staff; cost; transportation issues; and reliance on alternative forms of care. There was a dominant view that sustainably addressing these barriers and building on identified facilitators requires a multi-pronged approach involving government, healthcare, and community members. Perspectives about the acceptability and sustainability of a community first responder programme were largely positive, and numerous actionable recommendations were provided.</div></div><div><h3>Conclusion</h3><div>A community first responder programme was deemed a useful and acceptable intervention to help increase out-of-hospital emergency care capacity in Kinshasa. Key potential facilitators and barriers to its implementation and sustainability were identified.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 1","pages":"Pages 526-534"},"PeriodicalIF":1.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068842","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}
引用次数: 0
Acute coronary syndrome prevalence and outcomes in a Tanzanian emergency department: Results from a prospective surveillance study 坦桑尼亚急诊科的急性冠状动脉综合征患病率和结果:一项前瞻性监测研究的结果。
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-14 DOI: 10.1016/j.afjem.2024.11.003
Julian T Hertz , Francis M Sakita , Wai Yan Min Htike , Kilonzo G Kajiru , Blandina T Mmbaga , Tumsifu G Tarimo , Godfrey L Kweka , Jerome J Mlangi , Amedeus V Maro , Lauren Coaxum , Sophie W Galson , Alexander T Limkakeng , Gerald S Bloomfield
{"title":"Acute coronary syndrome prevalence and outcomes in a Tanzanian emergency department: Results from a prospective surveillance study","authors":"Julian T Hertz ,&nbsp;Francis M Sakita ,&nbsp;Wai Yan Min Htike ,&nbsp;Kilonzo G Kajiru ,&nbsp;Blandina T Mmbaga ,&nbsp;Tumsifu G Tarimo ,&nbsp;Godfrey L Kweka ,&nbsp;Jerome J Mlangi ,&nbsp;Amedeus V Maro ,&nbsp;Lauren Coaxum ,&nbsp;Sophie W Galson ,&nbsp;Alexander T Limkakeng ,&nbsp;Gerald S Bloomfield","doi":"10.1016/j.afjem.2024.11.003","DOIUrl":"10.1016/j.afjem.2024.11.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Preliminary data suggests that the burden of acute coronary syndrome (ACS) is high in Tanzania. After efforts to improve ACS care, we sought to describe ACS diagnosis rates, care processes, and outcomes in a Tanzanian Emergency Department (ED).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Adults presenting to a northern Tanzanian ED with acute chest pain or shortness of breath were enrolled from November 2020 to January 2023. ACS was defined as per Fourth Universal Definition of Myocardial Infarct criteria. All treatments given in the ED were observed and recorded. Thirty-day follow-up was conducted with all participants via telephone or home visit.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 568 participants with chest pain or shortness of breath, 129 (22.7 %) had ACS, including 61 (47 %) with STEMI and 68 (53 %) with non-STEMI. Of participants with ACS, 77 (59.7 %) were male, and the mean (SD) age was 64.5 (16.6) years. The mean duration of symptoms among ACS participants prior to presentation was 2.9 (3.0) days, and 26 (20.2 %) reported no known medical comorbidities. In the ED, 39 (30.2 %) participants with ACS received aspirin and 33 (25.6 %) received clopidogrel. Follow-up was achieved for all 129 ACS participants; 42 (32.6 %) of participants with ACS died within 30 days of presentation. Participants with ACS were significantly more likely to die within 30 days than participants without ACS (32.6 % vs 16.4 %, OR 2.45, 95 % CI: 1.56–3.83, &lt;em&gt;p&lt;/em&gt; &lt; 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;ACS is common in a northern Tanzanian ED. Interventions are needed to improve uptake of evidence-based ACS care and reduce ACS-associated mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;African relevance&lt;/h3&gt;&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;The study found that 22.7 % of adults presenting with chest pain or shortness of breath in the Tanzanian emergency department (ED) had acute coronary syndrome (ACS). This high prevalence highlights the critical need for enhanced cardiovascular diagnostic and treatment capabilities in Tanzanian and similar African healthcare settings.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;The research reveals significant challenges in managing ACS within resource-constrained settings, where limited access to advanced diagnostic tools like ECGs and cardiac biomarkers contributes to delayed or missed diagnoses, ultimately leading to worse patient outcomes. This situation reflects broader healthcare limitations across sub-Saharan Africa.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Thirty-day mortality among ACS patients in this study was extremely high (32.6 %), which is substantially higher than ACS mortality rates in high-income countries. These findings underscore the need for urgent interventions to address critical gaps in ACS care in African emergency departments.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;By providing the first prospective data on ACS prevalence and outcomes in a Tanzanian ED, this stud","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 1","pages":"Pages 518-525"},"PeriodicalIF":1.4,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932511","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}
引用次数: 0
Evaluation of the use of intraosseous access on adult patients presenting to the emergency department in urban South Africa 对南非市区急诊科成年患者骨内通道使用的评价
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-06 DOI: 10.1016/j.afjem.2024.11.001
Keabetsoe Hlanze , Kylen Swartzberg , Mike Wells
{"title":"Evaluation of the use of intraosseous access on adult patients presenting to the emergency department in urban South Africa","authors":"Keabetsoe Hlanze ,&nbsp;Kylen Swartzberg ,&nbsp;Mike Wells","doi":"10.1016/j.afjem.2024.11.001","DOIUrl":"10.1016/j.afjem.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access. The objectives of this study were to describe the knowledge, attitudes, and practice of doctors in the ED about the use of intraosseous access in critically ill adult patients.</div></div><div><h3>Methods</h3><div>A descriptive study was performed in the EDs of four hospitals in Gauteng, South Africa. Questionnaires were distributed to doctors working in the ED, including intern medical doctors, community service medical doctors, emergency medicine medical officers, emergency medicine registrars, as well as emergency medicine consultants.</div></div><div><h3>Results</h3><div>Of 88 participants 64.8 % of participants had never used intraosseous access on adult patients in a resuscitation in the ED. Those who do use intraosseous access, use it 1.5 times a month, per clinician. Reasons for not using intraosseous access included: lack of equipment availability, lack of experience, and other preferable methods.</div></div><div><h3>Conclusion</h3><div>The advantages of using the intraosseous route for circulatory access include its reliability, ease of teaching, rapid use, and low complication rates. Despite sufficient knowledge of intraosseous access and training received at various courses; provider preference and other systemic barriers, lead to an overall reduction in intraosseous access being used in the clinical setting. Intraosseous access remains a cost-effective, life-saving technique for gaining circulatory access. These results can be used to create awareness regarding the availability of other alternatives for gaining circulatory access, enhancing education and training, and improve the standard of health care, particularly in resource-limited settings.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 1","pages":"Pages 513-517"},"PeriodicalIF":1.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886432","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}
引用次数: 0
Framework first: Key insights on developing emergency medical care policy in low- and middle-income countries 框架第一:关于在低收入和中等收入国家制定紧急医疗护理政策的关键见解。
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.afjem.2024.11.002
Hendry Robert Sawe
{"title":"Framework first: Key insights on developing emergency medical care policy in low- and middle-income countries","authors":"Hendry Robert Sawe","doi":"10.1016/j.afjem.2024.11.002","DOIUrl":"10.1016/j.afjem.2024.11.002","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 534-535"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014389","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}
引用次数: 0
Developing emergency medical care policy across Kenya: A framework for policy development 制定肯尼亚全国紧急医疗保健政策:政策制定框架。
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.afjem.2024.10.222
Zoe Siegel , Trina Swanson , Emily Nyagaki , Adam R. Aluisio , Benjamin W. Wachira
{"title":"Developing emergency medical care policy across Kenya: A framework for policy development","authors":"Zoe Siegel ,&nbsp;Trina Swanson ,&nbsp;Emily Nyagaki ,&nbsp;Adam R. Aluisio ,&nbsp;Benjamin W. Wachira","doi":"10.1016/j.afjem.2024.10.222","DOIUrl":"10.1016/j.afjem.2024.10.222","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The Kenya Emergency Medical Care (EMC) Policy 2020–2030 was created to guide the advancement of EMC throughout Kenya. This report describes and maps the ongoing EMC policy development process across Kenya's 47 counties, serving as a real-world example of EMC policy development within a decentralized healthcare system in a low—or middle-income country (LMIC).</div></div><div><h3>Methods</h3><div>This report evaluates the development of county-specific EMC policies using the Kenya Institute for Public Policy Research and Analysis (KIPPRA) six stages for policy development: 1) problem identification, 2) agenda setting, 3) policy design, 4) approval, 5) implementation, and 6) monitoring and evaluation. Meeting minutes, workshop proceedings, and draft and final EMC policy documents were used to analyze the policy development process and provide a snapshot of current EMC policy statuses by county.</div></div><div><h3>Results</h3><div>As of August 2024, 23 counties have engaged in EMC policy development. Thirteen have finalized and are implementing their EMC policies, while 10 await approval. The remaining 24 counties are still in the planning stages. This process included gathering baseline emergency medical care standards to identify areas for improvement in each county. A core vision, mission, and goal aligned with the national policy were established and tailored to the county's needs. County-specific strategies were developed to address gaps between the existing system and national objectives. EMC policies were drafted, collaboratively reviewed, revised, and finalized before official approval. The next steps will be implementation, monitoring, and evaluation. Growth and improvement will be measured post-implementation based on baseline EMC metrics.</div></div><div><h3>Conclusion</h3><div>Kenya's strategy for EMC policy development across the 47 counties, utilizing KIPPRA's guidelines for public policy formulation, established a structured approach that included engaging stakeholders, conducting situational analyses, and aligning policy objectives with national goals. It is a comprehensive example of developing EMC policies for LMICs within decentralized healthcare systems.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 527-533"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014388","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}
引用次数: 0
Pelvic sheet binders: Are doctors placing them in the correct position? 骨盆片夹:医生是否将其放置在正确的位置?
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.afjem.2024.12.001
Marcus William Kruger , Jana du Plessis , Pravani Moodley
{"title":"Pelvic sheet binders: Are doctors placing them in the correct position?","authors":"Marcus William Kruger ,&nbsp;Jana du Plessis ,&nbsp;Pravani Moodley","doi":"10.1016/j.afjem.2024.12.001","DOIUrl":"10.1016/j.afjem.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Unstable pelvic fractures cause significant bleeding, morbidity, and mortality. Commercially available Pelvic Circumferential Compression Devices (PCCDs) are used in the initial resuscitation and management of these cases. In the trauma-burdened, resource limited setting of Southern Africa, the available alternative is a pelvic sheet binder (PSB). For optimal results placement should be at the greater trochanters (GTs). Prior studies have shown that practitioners are inaccurate in their placement. This study aimed to describe placement of PSBs by doctors and factors influencing placement.</div></div><div><h3>Methods</h3><div>This was a multicentre, prospective, observational, simulation-based study. Doctors working in Emergency Departments (EDs) and Trauma Emergency Units (TEUs) in Johannesburg were asked to place a PSB on two healthy male models of differing body mass index (BMI), as simulated patients (SPs). Outcomes were based on PSB position relative to the GTs, marked using an ultraviolet pen, and photographed under ultraviolet light. Data on techniques of placement, as well as practitioner factors, were also collected to investigate their influence on accuracy.</div></div><div><h3>Results</h3><div>In this study 147/176 (83.5 %) of the PSBs placed were correct (trochanteric). Of those placed on the normal BMI SP 71/88 (81 %) were correct and 76/88 (86 %) of those on the increased BMI SP. BMI did not appear to influence accuracy of placement. Practitioner factors that had statistically significant association with accurate placement included the following: Working in the TEU, work experience of ≥6 years, a diploma in primary emergency care (DipPEC, College of emergency medicine, South Africa), all methods of placing the PSB and inspecting to find the GTs.</div></div><div><h3>Conclusion</h3><div>The overall accuracy of PSBs placement was high (83.5 %). Additional postgraduate training (DipPEC) and work experience improved placement accuracy. This study highlighted the importance of additional trauma training and areas of possible future research, such as optimal binder width and method of securing PSBs.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 512-517"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985120","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}
引用次数: 0
Editorial—AfJEM Dec 2024 社论- afjem 2024年12月
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.afjem.2024.12.002
Peter Hodkinson (Editor in Chief, African Journal of Emergency Medicine (AfJEM))
{"title":"Editorial—AfJEM Dec 2024","authors":"Peter Hodkinson (Editor in Chief, African Journal of Emergency Medicine (AfJEM))","doi":"10.1016/j.afjem.2024.12.002","DOIUrl":"10.1016/j.afjem.2024.12.002","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 518-519"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985115","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}
引用次数: 0
Triage implementation audit at the adult emergency department of Debre Tabor Comprehensive Specialized Hospital in Ethiopia 埃塞俄比亚Debre Tabor综合专科医院成人急诊科分诊分类实施审计。
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.afjem.2024.10.001
Belayneh Dessie Kassa , Mebratu Libanos , Kumlachew Geta , Natnael Moges
{"title":"Triage implementation audit at the adult emergency department of Debre Tabor Comprehensive Specialized Hospital in Ethiopia","authors":"Belayneh Dessie Kassa ,&nbsp;Mebratu Libanos ,&nbsp;Kumlachew Geta ,&nbsp;Natnael Moges","doi":"10.1016/j.afjem.2024.10.001","DOIUrl":"10.1016/j.afjem.2024.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>In an emergency room, triage is a crucial element that determines the clinical urgency of patients. Triage can dictate important decisions on the use of resources and the treatment that patients need. Many patients are seen later than necessary, wasting resources and time, and some may even be discharged without being seen, risking their lives. This study aimed to determine whether the triage tool was fully completed, properly measured, and documented, the triage early warning score (TEWS) was calculated, and whether patients were examined, distributed, and managed in appropriate areas.</div></div><div><h3>Methods</h3><div>An institution-based cross-sectional study with a retrospective chart review was conducted at Debre Tabor Comprehensive Specialized Hospital by selecting patients’ charts using simple random sampling among patients who visited the adult Emergency Department from January 1, 2021, to December 31, 2023. The descriptive statistics were presented to characterize individual variables, and cross-tabulation was used to see the relationship between individual patient-related factors and their final triage status.</div></div><div><h3>Results</h3><div>From the randomly selected 345 patients’ charts, 67 (19.4 %) didn't contain a triage sheet. The total triage early warning score was correctly calculated for only 21 (7.6 %) patients and properly triaged. Most of the patients were improperly triaged (92.4 %, <em>n</em> = 257), of which 253 (91 %) were under-triaged and four (1.4 %) were over-triaged. Fischer's exact test revealed a statistically significant relationship between patients’ color-coding category, triage early warning score documentation, and the use of clinical discriminators and final triage assessment (p = 0.007, p = 0.000, and p = 0.000 respectively).</div></div><div><h3>Conclusion</h3><div>The status of our triage implementation is alarming and specifically the level of under-triage. There is a significant gap regarding the application of clinical discriminators and TEWS calculations.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 506-511"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886428","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}
引用次数: 0
Exploring trauma surgeons' views on trauma care in Nigeria: A qualitative study 探讨尼日利亚创伤外科医生对创伤护理的看法:定性研究
IF 1.4 4区 医学
African Journal of Emergency Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.afjem.2024.03.001
Oluwafunmilayo Akinlade , Adebisi Adeyeye , Brandon L. Ellsworth , Christopher W. Reynolds , Chiamaka Eneh , Ayobami Olufadeji
{"title":"Exploring trauma surgeons' views on trauma care in Nigeria: A qualitative study","authors":"Oluwafunmilayo Akinlade ,&nbsp;Adebisi Adeyeye ,&nbsp;Brandon L. Ellsworth ,&nbsp;Christopher W. Reynolds ,&nbsp;Chiamaka Eneh ,&nbsp;Ayobami Olufadeji","doi":"10.1016/j.afjem.2024.03.001","DOIUrl":"10.1016/j.afjem.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><div>In Nigeria, trauma care faces challenges due to high injury and death rates from road traffic accidents and violence. Improvements are underway, but gaps in service availability, training, and coordination persist, necessitating evidence-based interventions.</div></div><div><h3>Purpose</h3><div>To evaluate trauma care practices in Nigeria, focusing on practitioners' perceptions of training, resources, and care quality to inform policy and practice enhancements.</div></div><div><h3>Methods</h3><div>An exploratory qualitative study was conducted with seven trauma surgeons across Nigeria, using semi-structured interviews and an Interpretive Description analysis approach, adhering to SRQR standards.</div></div><div><h3>Results</h3><div>Analysis of interviews with seven Nigerian trauma surgeons highlighted a trauma care system burdened by high incidences of traffic-related injuries. Despite varying caseloads—from 20 cases per month to 65 weekly—common challenges included delayed care, leading to complications like infection and misaligned wound healing. Surgeons noted strengths in motivated staff and sub-specialization but stressed barriers such as underdeveloped prehospital care, financial constraints, and resource shortages, which hindered effective trauma management and outcomes.</div></div><div><h3>Conclusions</h3><div>Effective trauma care in Nigeria is crucial and achievable through policy reforms, better resource distribution, and enhanced training. Systematic data collection and a national trauma care protocol are recommended to improve patient outcomes and guide future research and policymaking.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 520-526"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706841","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信