African Journal of Emergency Medicine最新文献

{"title":"Utilisation of WhatsApp for Emergency Medical Services in Garissa, Kenya","authors":"J. Austin Lee ,&nbsp;Benjamin W. Wachira ,&nbsp;John Kennedy ,&nbsp;Nicholas Asselin ,&nbsp;Nee-Kofi Mould-Millman","doi":"10.1016/j.afjem.2024.01.002","DOIUrl":"https://doi.org/10.1016/j.afjem.2024.01.002","url":null,"abstract":"<div><p>Garissa county, Kenya is a geographically large county with a mobile pastoralist population that has developed a method for emergency medical services (EMS) coordination using the WhatsApp communication platform. This work was based on a site visit, to better understand and describe the current operations, strengths, and weaknesses of the EMS communication system in Garissa. The use of WhatsApp in Garissa county seems to work well in the local context and has the potential to serve as a cost-effective solution for other EMS systems in Kenya, Africa, and other LMICs.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X24000028/pdfft?md5=fdede4fb71b05cb4071f5bebfe27f47f&pid=1-s2.0-S2211419X24000028-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139505430","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 initiative for medical equity and global health (IMEGH) resuscitation training program: A model for resuscitation training courses in Africa","authors":"Eugene Tuyishime ,&nbsp;Alain Irakoze ,&nbsp;Celestin Seneza ,&nbsp;Bernice Fan ,&nbsp;Jean Paul Mvukiyehe ,&nbsp;Jackson Kwizera ,&nbsp;Noah Rosenberg ,&nbsp;Faye M Evans","doi":"10.1016/j.afjem.2023.12.003","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.12.003","url":null,"abstract":"<div><p>In high-income countries, outcomes following in hospital cardiac arrest have improved over the last two decades due to the introduction of rapid response teams, cardiac arrest teams, and advanced resuscitation training. However, in low-income countries, such as Rwanda, outcomes are still poor. This is due to multiple factors including lack of adequate resuscitation training, few trainers, and lack of equipment.</p><p>To address this issue, the Initiative for Medical Equity and Global Health Equity (IMEGH), a training organization founded in 2018 by 5 local anesthesiologists has regularly taught resuscitation courses such as Basic Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support in hospitals throughout Rwanda. The aims of the organization include developing a sustainable model to offer context relevant resuscitation training courses, building a cadre of local instructors to teach on the courses, as well as engaging funding partners to help support the effort. From October 2018 until September 2022, 31 courses were run in 11 hospitals across Rwanda training 1,060 healthcare providers (mainly of non-physician anesthetists, nurses, midwives, and general practitioners). Ongoing challenges include lack of local protocols, inability to tracking resuscitation outcomes, and continued inaccessibility by many healthcare providers. Despite these challenges, the IMEGH program is an example of a successful context-relevant model and has potential to inform the design of resuscitation programs in other similar settings. This article describes the development of the IMEGH program, accomplishments as well as lessons learned, challenges, and next steps for expansion.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000678/pdfft?md5=54f9d7a5d2fc1e4d47d6e29164d48260&pid=1-s2.0-S2211419X23000678-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100190","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":"Emergency department overcrowding and its associated factors at HARME medical emergency center in Eastern Ethiopia","authors":"Melaku Getachew ,&nbsp;Ibsa Musa ,&nbsp;Natanim Degefu ,&nbsp;Lemlem Beza ,&nbsp;Behailu Hawlte ,&nbsp;Fekede Asefa","doi":"10.1016/j.afjem.2023.12.002","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.12.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Emergency department (ED) overcrowding has become a significant concern as it can lead to compromised patient care in emergency settings. Various tools have been used to evaluate overcrowding in ED. However, there is a lack of data regarding this issue in resource-limited countries, including Ethiopia. This study aimed to validate NEDOCS, assess level of ED overcrowding and identify associated factors at HARME Medical Emergency Center, located in Hiwot Fana Comprehensive Specialized Hospital, Harar, Ethiopia.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted at the HARME Medical Emergency Center, Hiwot Fana Comprehensive Specialized Hospital, involving a total of 899 patients during 120 sampling intervals. The area under the receiver operating characteristic curves (AUC) was calculated to evaluate the agreement between objective and subjective assessments of ED overcrowding. A multivariable logistic regression analysis was employed to identify factors associated with ED overcrowding and statistically significant association was declared using 95 % confidence level and a p-value &lt; 0.05.</p></div><div><h3>Results</h3><p>The interrater agreement showed a strong correlation with a Cohen's kappa (κ) of 0.80. The National Emergency Department Overcrowding Study Score demonstrated a strong association with subjective assessments from residents and case team nurses, with an AUC of 0.81 and 0.79, respectively. According to residents' perceptions, ED were considered overcrowded 65.8 % of the time. Factors significantly associated with ED overcrowding included waiting time for triage (AOR: 2.24; 95 % CI: 1.54–3.27), working time (AOR: 2.23; 95 % CI: 1.52–3.26), length of stay (AOR: 2.40; 95 % CI: 1.27–4.54), saturation level (AOR: 2.35; 95 % CI: 1.31–4.20), chronic illness (AOR: 2.19; 95 % CI: 1.37–3.53), and abnormal pulse rate (AOR: 1.52; 95 % CI: 1.06–2.16).</p></div><div><h3>Conclusion</h3><p>The study revealed that ED were overcrowded approximately two-thirds of the time.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000666/pdfft?md5=b311e8608358397ee3ba1adb6ac7a9fd&pid=1-s2.0-S2211419X23000666-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100382","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 new injury severity score underestimates true injury severity in a resource-constrained setting","authors":"Smitha Bhaumik ,&nbsp;Krithika Suresh ,&nbsp;Hendrick Lategan ,&nbsp;Elmin Steyn ,&nbsp;Nee-Kofi Mould-Millman","doi":"10.1016/j.afjem.2023.12.001","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.12.001","url":null,"abstract":"<div><h3>Background</h3><p>The new injury severity score (NISS) is widely used within trauma outcomes research. NISS is a composite anatomic severity score derived from the Abbreviated Injury Scale (AIS) protocol. It has been postulated that NISS underestimates trauma severity in resource-constrained settings, which may contribute to erroneous research conclusions. We formally compare NISS to an expert panel's assessment of injury severity in South Africa.</p></div><div><h3>Methods</h3><p>This was a retrospective chart review of adult trauma patients seen in a tertiary trauma center. Randomly selected medical records were reviewed by an AIS-certified rater who assigned an AIS severity score for each anatomic injury. A panel of five South African trauma experts independently reviewed the same charts and assigned consensus severity scores using a similar scale for comparability. NISS was calculated as the sum of the squares of the three highest assigned severity scores per patient. The difference in average NISS between rater and expert panel was assessed using a multivariable linear mixed effects regression adjusted for patient demographics, injury mechanism and type.</p></div><div><h3>Results</h3><p>Of 49 patients with 190 anatomic injuries, the majority were male (<em>n</em> = 38), the average age was 36 (range 18–80), with either a penetrating (<em>n</em> = 23) or blunt (<em>n</em> = 26) injury, resulting in 4 deaths. Mean NISS was 16 (SD 15) for the AIS rater compared to 28 (SD 20) for the expert panel. Adjusted for potential confounders, AIS rater NISS was on average 11 points (95 % CI: 7, 15) lower than the expert panel NISS (<em>p</em> &lt; 0.001). Injury type was an effect modifier, with the difference between the AIS rater and expert panel being greater in penetrating versus blunt injury (16 vs. 7; <em>p</em> = 0.04). Crush injury was not well-captured by AIS protocol.</p></div><div><h3>Conclusion</h3><p>NISS may under-estimate the ‘true’ injury severity in a middle-income country trauma hospital, particularly for patients with penetrating injury.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000654/pdfft?md5=b669775613425e04a405d05b9065f4b5&pid=1-s2.0-S2211419X23000654-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138739209","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":"Developing an Emergency Medicine assessment tool for medical interns within the South African context – A Modified Delphi Study","authors":"Laurryn Ah Yui ,&nbsp;Luan Taljaard ,&nbsp;Sian Geraty ,&nbsp;Roshen Maharaj","doi":"10.1016/j.afjem.2023.11.008","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.11.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Emergency Medicine is a relatively new specialty in South Africa. Limited data is available regarding junior doctors’ competence in managing emergencies, however previous surveys have identified limited teaching and supervision of junior doctors in Emergency Medicine. Currently there is no formal standardised assessment tool to assess an intern's Emergency Medicine competence. The aim of the study was to, through expert opinion and consensus, develop an Emergency Medicine assessment tool to identify a level of appropriate Emergency Medicine knowledge at the end of internship.</p></div><div><h3>Methods</h3><p>The Modified Delphi Methodology was used to create an assessment tool via interaction with a panel of experts and took place over 4 rounds via an online survey platform. The initial round identified the high-priority topics within each intern domain. A questionnaire was created based on these topics and was presented to the panel for consensus during the following round/s. Rounds continued until each question met consensus of 75 %.</p></div><div><h3>Results</h3><p>A total of 35 panellists consented to participate, representing 6 provinces. The majority were Emergency Medicine specialists. High-priority topics included acute respiratory distress, polytrauma, dehydration and shock in children, airway management, and the agitated patient. A 40-question, multiple choice questionnaire was created with all questions reaching consensus.</p></div><div><h3>Conclusion</h3><p>This study highlighted the core high-priority Emergency Medicine topics that interns should be exposed to during their internship and created a questionnaire aimed at evaluating them. The study findings provide a novel contribution to identifying gaps in Emergency Medicine knowledge during intern training, allowing for potential interventions to be implemented to improve intern EM training. The addition of a clinical skills component and increasing the question database is suggested to further develop this tool. Larger iterative studies involving the HPCSA, and health education experts provide avenues for future research.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000629/pdfft?md5=52bd42fb30461bbe9cf111dd512f50b5&pid=1-s2.0-S2211419X23000629-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138739210","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":"Emergency care drugs' chemical stability after eight weeks’ deployment in the prehospital setting","authors":"Simpiwe Sobuwa ,&nbsp;Thishana Singh ,&nbsp;Kerusha Kalicharan","doi":"10.1016/j.afjem.2023.11.009","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.11.009","url":null,"abstract":"<div><p>Temperature conditions vary in emergency service vehicles, which may pose a risk to the integrity of the drugs on board, possibly rendering them ineffective and increasing morbidity and mortality in patients.</p></div><div><h3>Aim</h3><p>This study assessed the stability of four emergency care drugs (adrenaline, etomidate, ketamine, and rocuronium) after eight weeks of deployment in the prehospital context.</p></div><div><h3>Methods</h3><p>The study adopted a longitudinal quantitative design to evaluate the chemical stability of emergency care drugs. The study was conducted at four emergency medical service bases in Ballito, Durban and Pietermaritzburg, South Africa. The primary outcome was the relative reduction in drug concentration from the labelled concentration after four and eight weeks. High-performance liquid chromatography-mass spectrometry (HPLC-MS) analysed samples to determine the concentration of active ingredients in the drug samples.</p></div><div><h3>Results</h3><p>HPLC analysis was done on 176 samples. The ambient temperature ranged from 18.7 to 44 °C in the first four weeks, averaging 26.8 °C ± 3.0. At 4 and 8 weeks, Adrenaline decreased 24.93 % and 22.73 %, respectively. Etomidate's control had 3.06 mg/ml, not the 2 mg/ml on the bottle. After 4 and 8 weeks, the samples had 3.10 and 3.15 mg/ml active components, respectively. Ketamine degraded over 30 % after four weeks but not beyond that. The Ketamine package states 10 mg/ml. However, we found 17.46 mg/ml. Rocuronium was 6.45 mg/ml in the control, although the manufacturer specified 10 mg/ml. At four weeks, the concentration was 6.70 mg/ml; at eight weeks, 6.56.</p></div><div><h3>Conclusion</h3><p>This study suggests that adrenaline and ketamine degrade by more than 20 % within four weeks of deployment in the prehospital field, whereas etomidate and rocuronium remain stable after eight weeks.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000630/pdfft?md5=b2dcf8c5659c271b87875834ab691365&pid=1-s2.0-S2211419X23000630-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138739208","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":"Determining the research priorities for emergency care within the Western Cape province of South Africa: A consensus study","authors":"Robert Holliman,&nbsp;Lee Wallis,&nbsp;Colleen Saunders","doi":"10.1016/j.afjem.2023.11.007","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.11.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Low- and middle-income countries (LMICs) are disproportionally affected by conditions requiring emergency care but there are limited contextually appropriate studies performed within these settings involving the patient population and healthcare systems they aim to benefit. Over the past five years, researchers in the Western Cape of South Africa have produced approximately 20 % of all emergency care publications from Africa, yet no agreed list of research priorities exists. Establishing research priorities, via recognised consensus methods, can ensure that efforts and resources in LMICs are more appropriately targeted to the need.</p></div><div><h3>Method</h3><p>Using a modified Delphi study, we invited a range of public and private representatives from different professional emergency care cadres within the Western Cape to identify current evidence gaps and consensus research priorities across the four areas of the WHO Emergency Care Systems framework: scene care, prehospital care, facility-based care, and the emergency care system itself. We then purposively selected eleven experts holding key academic and management positions to form a panel and perform a nominal group technique process to discuss these identified research priorities and establish a final list of priority research questions.</p></div><div><h3>Result</h3><p>Forty of the sixty-six (61 %) emergency care professionals invited contributed to the Delphi phase of the study, with representation from all professional cadres. After deduplication, 154 research topics were identified in the first round. In the second round, 94 (61 %) topics were considered research priorities by at least 80 % of participants. Following the nominal group technique discussion, 26 questions were established as consensus research priorities having been ranked as a top ten priority by over 50 % of panellists.</p></div><div><h3>Conclusion</h3><p>We were able to successfully collate expert opinion and identify existing emergency care knowledge gaps within the Western Cape province of South Africa. Key topics identified for future work included questions on current health-seeking behaviour, dispatch, interfacility transfer, and staff burnout.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000642/pdfft?md5=1004bc9a24639d67c72d3de6699a3459&pid=1-s2.0-S2211419X23000642-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480566","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: August ‘23","authors":"Dr. Jonathan Kajjimu","doi":"10.1016/j.afjem.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.11.003","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":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000575/pdfft?md5=aa5180d0123268f9de3ab8571969bde9&pid=1-s2.0-S2211419X23000575-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138448429","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: September ‘23","authors":"Dr. Jonathan Kajjimu","doi":"10.1016/j.afjem.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.11.001","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":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000563/pdfft?md5=df2e3598bfe4c49ccd77c16b058d550f&pid=1-s2.0-S2211419X23000563-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138448430","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":"Palliative care needs and barriers in an urban Ugandan Emergency Department: A mixed-methods survey of emergency healthcare workers and patients","authors":"Eleanor Reid ,&nbsp;Michael Lukoma ,&nbsp;Dao Ho ,&nbsp;Peace Bagasha ,&nbsp;Mhoira Leng ,&nbsp;Liz Namukwaya","doi":"10.1016/j.afjem.2023.11.005","DOIUrl":"https://doi.org/10.1016/j.afjem.2023.11.005","url":null,"abstract":"<div><h3>Background</h3><p>Palliative Care offers patient-centered, symptom-focused relief for patients with incurable disease, and early integration of palliative care ensures quality of life and death while reducing medical impoverishment. The Emergency Department is an ideal yet understudied, under-utilized location to initiate palliative care.</p></div><div><h3>Objective</h3><p>To evaluate the palliative care needs of patients with incurable disease and perceived barriers amongst healthcare providers in the Emergency Department of Kiruddu National Referral Hospital, Kampala, Uganda.</p></div><div><h3>Methods</h3><p>A mixed methods survey of Emergency Department healthcare workers and patients was conducted. A crosse sectional survey of ninety-nine patients was conducted using the integrated Palliative Care Outcome Scale (IPOS). Eleven interviews were conducted with healthcare workers at Kiruddu Hospital, identified by purposive sampling. Descriptive and inferential statistics were used to analyze quantitative data.. Grounded theory approach was used to construct the in depth interview questions, code and analyze qualitative results and collapse these results into final themes.</p></div><div><h3>Results</h3><p>The most common diagnoses were HIV/HIV-TB (32 %), heart disease (18 %), and sickle cell disease (14 %). The prevalence of unmet palliative care needs was substantial: more that 70 % of patients reported untreated symptoms e.g., pain, fatigue, difficulty breathing. Seventy-seven percent of the population reported severe or overwhelming pain. The main barriers to provision of palliative care in the Emergency Department as identified by healthcare workers were: (1) lack of adequate training in palliative care; (2) Challenges due to patient volume and understaffing; (3) the misconception that palliative care is associated with pain management alone; (4) Financial constraints as the greatest challenge faced by patients with incurable disease.</p></div><div><h3>Conclusions</h3><p>We report a high prevalence of unmet palliative care needs among patients in this urban Ugandan Emergency Department, and important barriers reported by emergency healthcare providers. Identification of these barriers offers opportunities to overcome them including harnessing novel mHealth interventions such as clinical support apps or telehealth palliative care consultants. Integration of palliative care in this setting would improve the care of vulnerable patients, provide healthcare workers with an additional care modality while likely adding value to the health system.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X23000605/pdfft?md5=2eae22d69ac33967c9bc217380f0f86b&pid=1-s2.0-S2211419X23000605-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138436571","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}