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Implementation of electronic medical records at an Emergency Medicine Department in Tanzania: The information technology perspective
Publication date: Available online 22 October 2019Source: African Journal of Emergency MedicineAuthor(s): Ramadhani Jumanne Mashoka, Brittany Murray, Upendo George, Natalia Lobue, Juma Mfinanga, Hendry Sawe, Libby WhiteAbstractIn 2015, the Emergency Medicine Department at Muhimbili National Hospital (MNH) installed and implemented the first Electronic Medical Record (EMR) tailored to the emergency centre (EC). The EMR deployed was designed for emergency centre use only (Emergency Department Information System (EDIS)) and linked with the existing EMR that focused on registration and billing. This very collaborative experien...
Source: African Journal of Emergency Medicine - October 24, 2019 Category: Emergency Medicine Source Type: research

The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach
ConclusionFifty percent of trauma deaths were DP/PP. Multiple episodes of varying types of inappropriate care occurred. More efficient surgical evaluation and appropriate treatment of hemorrhage could reduce trauma morality. Large amounts of missing and incomplete clinical data suggest considerable selection bias. A major implication of this study is the importance of having a robust, prospective trauma registry to collect clinical information to increase the number of cases for review. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - October 19, 2019 Category: Emergency Medicine Source Type: research

The burden of acute coronary syndrome, heart failure, and stroke among emergency department admissions in Tanzania: A retrospective observational study
ConclusionsThe burden of heart failure and stroke on hospital admissions in Tanzania is substantial, and the volume of stroke admissions is rising precipitously. ACS is a rare diagnosis, and the distribution of cardiovascular disease phenotypes in Tanzania differs from what has been observed outside of Africa. Further research is needed to ascertain the reasons for these differences. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - August 9, 2019 Category: Emergency Medicine Source Type: research

Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa
ConclusionsNone of the different scoring systems performed better in predicting mortality in this high-trauma burden area. The results are limited by the low number of recorded deaths and further studies are needed. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - August 9, 2019 Category: Emergency Medicine Source Type: research

Identifying quality indicators for prehospital emergency care services in the low to middle income setting: The South African perspective
ConclusionWithin the South Africa setting, there are a multitude of QIs that are relevant and appropriate for use in PEC. This was evident in the number, variety and type of QIs reaching consensus agreement in our study. Furthermore, both the methodology employed, and findings of this study may be used to inform the development of PEC specific QIs within other LMIC settings. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - August 8, 2019 Category: Emergency Medicine Source Type: research

Rapid, remote education for point-of-care ultrasound among non-physician emergency care providers in a resource limited setting
ConclusionsRemotely delivered quality assurance feedback is an effective educational tool to enhance provider skill and foster continued and sustainable use of ultrasound in LMICs. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 9, 2019 Category: Emergency Medicine Source Type: research

Triage conducted by lay-staff and emergency training reduces paediatric mortality in the emergency department of a rural hospital in Northern Mozambique
ConclusionIn a rural setting with nurse-led clinical care and non-clinician staff working at the triage reception, implementation of a three-coloured triage system was feasible. Triage and ETAT training was associated with a decrease of 45% of paediatric deaths. The impact on mortality, low cost, and ease of the implementation supports scaling this intervention in similar settings. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 2, 2019 Category: Emergency Medicine Source Type: research

Clinical presentation and diagnostic work up of suspected pulmonary embolism in a district hospital emergency centre serving a high HIV/TB burden population
ConclusionsPE remains a diagnostic challenge. In our study, the retrospectively calculated CDR was not predictive of PE in a population with a high prevalence of HIV and TB. Emergency physicians should be cautious when making a clinical probability assessment of PE in this setting. However, further studies are needed to develop a predictive CDR for the local environment. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 2, 2019 Category: Emergency Medicine Source Type: research

Needs assessment for a formal emergency medicine residency program in southern Madagascar
ConclusionsWhile the needs assessment indicates substantial need for emergency medicine development in southern Madagascar, the yield (particularly for the metropolitan Fianarantsoa area) would serve the population well. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 2, 2019 Category: Emergency Medicine Source Type: research

Retrospective review of the patient cases at a major trauma center in Nairobi, Kenya and implications for emergency care development
ConclusionsTrends toward NCDs and traumatic diseases have been described by this study and merit further investigation in both the urban and rural setting. Specifically, the significance of head injury on healthcare cost, utilisation, and patient death and disability points to the growing need of additional resources at Kenyatta National Hospital for acute care. It further demonstrates the mounting impact of trauma in Kenya and throughout the developing world.African relevance•This is a comprehensive description of the emergency centre at Kenya's largest public tertiary hospital•It adds to descriptions of trends of non...
Source: African Journal of Emergency Medicine - July 2, 2019 Category: Emergency Medicine Source Type: research

Nervous breakdown! A registry of nerve blocks from a South African emergency centre
ConclusionThis study illustrates the use of nerve blocks as an effective, safe and timeous analgesic solution to a wide variety of musculoskeletal injuries in an academic emergency centre in South Africa. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - June 26, 2019 Category: Emergency Medicine Source Type: research

Guest Editorial: Introduction to the Trauma Special Issue
Publication date: 2019Source: African Journal of Emergency Medicine, Volume 9, SupplementAuthor(s): Timothy Craig Hardcastle, George Oosthuizen, Charlie Mock, Tarek Razek (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - March 14, 2019 Category: Emergency Medicine Source Type: research

A cross-sectional description of open access publication costs, policies and impact in emergency medicine and critical care journals
ConclusionsWe present a single database that captures emergency medicine and critical care journal impact rankings alongside its respective open access cost and green open access policies. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - March 7, 2019 Category: Emergency Medicine Source Type: research

A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt
Publication date: Available online 6 March 2019Source: African Journal of Emergency MedicineAuthor(s): Willem Stassen, Lee Wallis, Maaret Castren, Craig Vincent-Lambert, Lisa KurlandAbstractThe incidence of cardiovascular disease and STEMI is on the rise in sub-Saharan Africa. Timely treatment is essential to reduce mortality. Internationally, prehospital 12 lead ECG telemetry has been proposed to reduce time to reperfusion. Its value in South Africa has not been established. The aim of this study was to determine the effect of prehospital 12 lead ECG telemetry on the PCI-times of STEMI patients in South Africa. A multicen...
Source: African Journal of Emergency Medicine - March 7, 2019 Category: Emergency Medicine Source Type: research

The cost of time: A randomised, controlled trial to assess the economic impact of upfront, point-of-care blood tests in the Emergency Centre
ConclusionUpfront, POC blood tests can be utilised in the resource-constrained EC to manage patients more efficiently by saving time. This time-saving can, in fact, be more cost effective than traditional EC workflow making it an economically viable option for implementation in LMIC. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - March 4, 2019 Category: Emergency Medicine Source Type: research