African Journal of Emergency Medicine This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Patterns and outcomes of paediatric trauma at a tertiary teaching hospital in Kenya
DiscussionPaediatric injuries remain a major public health problem and contribute a substantial proportion of all paediatric surgical admissions at the Aga Khan University Hospital in Nairobi. Based on the patterns and outcomes seen in this study, we therefore recommend for Nairobi (and possibly Kenya) to establish greater supervision and safety measures for children; targeting safety interventions at all children but particularly at boys, the very young, at home and in residential buildings; building pre-hospital emergency care that can accommodate children; and equipping paediatric trauma hospitals to especially handle b...
Source: African Journal of Emergency Medicine - February 5, 2019 Category: Emergency Medicine Source Type: research

Access to acute care resources in various income settings to treat new-onset stroke: A survey of acute care providers
ConclusionThe striking finding from this study was that there was essentially very little difference between the responses between LMIC and HIC respondents with a few notable exceptions. The findings also propose a universal lack of adherence to the 2013 AHA/ASA stroke management guideline by both groups, in contrast to the good reported knowledge thereof. Carefully planned qualitative research is needed to identify the barriers to achieving the 2013 AHA/ACA recommendations. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 20, 2019 Category: Emergency Medicine Source Type: research

Pre-hospital intercostal chest drains in South Africa: A modified Delphi study
ConclusionDefinitive care of a life-threating pneumothorax and/or haemothorax must be sought emergently. The insertion of an ICD, under select conditions, may be required in the pre-hospital setting in South Africa. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 20, 2019 Category: Emergency Medicine Source Type: research

The burden of trauma at a district hospital in the Western Cape Province of South Africa
ConclusionThis district hospital emergency centre, with a small complement of non-EM trained physicians and no trauma surgical services, cared for a high volume of trauma with over half presenting on weekends and overnight when personnel are limited. The high volume and rate of admission/ transfer of intentional injuries suggests the need for improving prehospital trauma triage and trauma referrals. The results suggest strengthening trauma care systems at and around this resource-limited district hospital in South Africa may help alleviate the high burden of post-trauma morbidity and mortality. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 20, 2019 Category: Emergency Medicine Source Type: research

Poor access to acute care resources to treat major trauma in low- and middle-income settings: A self-reported survey of acute care providers
ConclusionMajor trauma care requires a chain of successful, evidence-based events for outcomes to benefit. This small study suggests that many of the links of this chain are either missing or broken within low- and middle-income countries. These settings simply do not benefit from the currently available evidence-base in major trauma care. It is important that this evidence-base also be evaluated within low- and middle-income countries. The capacity of low- and middle-income country emergency care systems also needs better describing. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 18, 2019 Category: Emergency Medicine Source Type: research

Cochrane, evidence-based medicine and associated factors: A cross-sectional study of the experiences and knowledge of Ethiopian specialists in training
ConclusionEthiopian trainee specialists lacked formal EBM training, awareness and use of the Cochrane Library. To improve the healthcare quality and patient outcomes, EBM education should be integrated into residency curricula. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 18, 2019 Category: Emergency Medicine Source Type: research

Traumatic ocular lens dislocation
ConclusionOcular lens dislocation may be easily diagnosed with ultrasound. Direction of lens dislocation dictates management, however posterior dislocations may be amenable to outpatient management. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 18, 2019 Category: Emergency Medicine Source Type: research

Fifteen years of emergency medicine literature in Africa: A scoping review
ConclusionOur review revealed a considerable increase in the growth of African EM literature from 1999 to 2014. Overwhelmingly, articles were observational, studied all-comers, and focused on undifferentiated complaints. The articles discovered in this scoping review are reflective of the relatively immature and growing state of African EM. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 18, 2019 Category: Emergency Medicine Source Type: research

Are “virtual” paediatric weight estimation studies valid?
ConclusionsThe virtual and real weight estimates had very similar accuracy outcomes for both tapes in this study. However, if virtual studies are used, they should be followed by real-life studies in order to assess the impact of human and patient factor errors on the accuracy of the weight estimation systems. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 17, 2019 Category: Emergency Medicine Source Type: research

Development of a nurse-led tranexamic acid administration protocol for trauma patients in rural South Africa
ConclusionsNursing staff in resource poor rural settings can use a protocol based on the South African Triage Scale and the CRASH-2 study to safely administer TXA to trauma patients. We believe this to be the first published literature on nurse-led administration of TXA. Mortality from trauma may be reduced in rural settings by the timely administration of TXA in the prehospital and rural primary healthcare settings. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - January 9, 2019 Category: Emergency Medicine Source Type: research

Modified Delphi study to determine optimal data elements for inclusion in a pilot violence and injury observatory in Cape Town, South Africa
This study provides a research priority framework for violence and injury prevention work within South Africa. These expert-identified violence and injury indicators and datasets are context-appropriate and may serve to guide the development of additional VIOs within the region. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - December 11, 2018 Category: Emergency Medicine Source Type: research

Global emergency care clinical practice guidelines: A landscape analysis
We described the characteristics and quality of CPGs relevant to prehospital care worldwide, in order to strengthen guideline development in low-resource settings for emergency care.MethodsWe conducted a descriptive study of a database of international CPGs relevant to emergency care produced by the African Federation for Emergency Medicine (AFEM) CPG project in 2016. Guideline quality was assessed with the AGREE II tool, independently and in duplicate. End-user documents such as protocols, care pathways, and algorithms were excluded. Data were imported, managed, and analysed in STATA 14 and R.ResultsIn total, 276 guidelin...
Source: African Journal of Emergency Medicine - October 24, 2018 Category: Emergency Medicine Source Type: research

Procedural sedation and analgesia practices in the emergency centre
ConclusionAlthough the safe practice and awareness of procedural sedation and analgesia in both public-sector and private-sector emergency centres in Southern Gauteng appears to be on the increase, there is still a need to enhance practitioner training and promote awareness of current local and international trends, protocols and recommendations. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - October 14, 2018 Category: Emergency Medicine Source Type: research

A descriptive analysis of casualties evacuated from the Africa area of operations
We describe trauma cases reported in the Africa Command (AFRICOM) area of operations to date within the Department of Defense Trauma Registry (DODTR).MethodsWe queried the DODTR for all subjects evacuated from the AFRICOM area of operations from January 2002 to June 2017.ResultsThere were 49 subjects in the registry during our time frame from AFRICOM. Most of the evacuations came from Djibouti (53%). The median age was 29 years, most evacuees being male (92%). Non-battle injuries accounted for most of the injuries (82%), and most were US military (90%). All battle injuries were gunshot wounds (GSW). Composite injury scor...
Source: African Journal of Emergency Medicine - October 13, 2018 Category: Emergency Medicine Source Type: research

Developing a South African Helicopter Emergency Medical Service Activation Screen (SAHAS): A Delphi study
DiscussionThe combination of existing literature and participant opinions, established that call-out criteria are most efficient when based on clinical parameters and geographic considerations, as opposed to a specified list of criteria. The initial concept of our SAHAS should be investigated further. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - October 13, 2018 Category: Emergency Medicine Source Type: research