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.

Impact of emergency medicine training implementation on mortality outcomes in Kigali, Rwanda: An interrupted time-series study
This study evaluated the impact of EM training and associated systems implementation on mortality among patients treated at the University Teaching Hospital-Kigali (UTH-K).MethodsAt UTH-K an EM post-graduate diploma programme was initiated in October 2013, followed by a residency-training programme in August 2015. Prior to October 2013, care was provided exclusively by general practice physicians (GPs); subsequently, care has been provided through mutually exclusive shifts allocated between GPs and EM trainees. Patients seeking Emergency Centre (EC) care during November 2012–October 2013 (pre-training) and August 2015–...
Source: African Journal of Emergency Medicine - October 13, 2018 Category: Emergency Medicine Source Type: research

Cola therapy for oesophageal food bolus impactions a case series
DiscussionWhile keenly aware of our retrospective study’s limitations, we found a promising success rate for cola as an acute intervention for oesophageal food bolus impactions. We registered no adverse events attributable to cola. Also, given that cola is cheap, widely available and seemingly safe we believe it can be considered in patients with oesophageal obstructions due to food, either as pre-endoscopy treatment or in case endoscopy is not available at all. We think our findings provide an impetus for prospective research on this intervention. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - October 13, 2018 Category: Emergency Medicine Source Type: research

Acute mesenteric ischaemia: A case of expedited diagnosis and management using point-of-care ultrasound
We describe the case of a 28-year-old male who presented to an urban Ethiopian emergency centre with three days of vomiting, bloody diarrhoea, and abdominal pain. He collapsed in triage with weak pulses and an undetectable blood pressure. Point-of-care ultrasound revealed a hyperechoic, mobile mass in the left ventricle of the heart. Small bowel dilation and thickening was visualised throughout the abdomen. Mesenteric ischaemia was rapidly identified as the working diagnosis, prompting early surgical consultation and aggressive, goal-directed resuscitation.DiscussionShort of elucidating a definitive diagnosis, ultrasound n...
Source: African Journal of Emergency Medicine - October 5, 2018 Category: Emergency Medicine Source Type: research

Respiratory failure requiring mechanical ventilation in critically ill adults in Ghana: A prospective observational study
ConclusionRespiratory failure requiring intubation and mechanical ventilation is common in patients presenting to the emergency centre or intensive care unit at an academic tertiary care centre in Ghana. The true incidence of ARDS was likely underestimated by our study. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - September 21, 2018 Category: Emergency Medicine Source Type: research

African Federation for Emergency Medicine’s Francophone Working Group – May 2018 Report
Publication date: September 2018Source: African Journal of Emergency Medicine, Volume 8, Issue 3Author(s): Müller M Mundenga, Ken Diango, Gabin Mbanjumucyo, Diulu Kabongo, Andrea G TennerAbstractEven though the African Federation for Emergency Medicine (AFEM) has been successfully developing emergency care in Africa for the past nine years, a considerable amount of potential AFEM members from the African-Francophone countries are not able to access AFEM resources. In response, an AFEM Francophone Working Group has been created to coordinate all existing and new initiatives to promote emergency care in African-Francophone ...
Source: African Journal of Emergency Medicine - August 30, 2018 Category: Emergency Medicine Source Type: research

The case for investing in public health surveillance in low- and middle-income countries
Publication date: Available online 31 July 2018Source: African Journal of Emergency MedicineAuthor(s): Kidist K. BartolomeosAbstractSurveillance is central to public health. In the absence of comparable data from most low-income and middle-income countries, national and international agencies use estimates to monitor health targets. Although morbidity and mortality estimations generated by statistical modelling can fulfill national and global reporting requirements, locally generated data are needed to guide evidence-based local action. The focus on measurement around the sustainable development goals provides an opportuni...
Source: African Journal of Emergency Medicine - August 1, 2018 Category: Emergency Medicine Source Type: research

The burden of trauma presenting to the government referral hospital in Freetown, Sierra Leone: An observational study
DiscussionInjury accounts for a high burden of disease at Connaught Hospital and consumes a significant proportion of EC and hospital resources. Efforts should be directed towards strengthening the pre-hospital and emergency trauma systems with accurate, formal data collection as well as targeting injury prevention initiatives and improving road safety to reduce morbidity and mortality. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 28, 2018 Category: Emergency Medicine Source Type: research

Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava?
DiscussionThere is no significant correlation between CVP and IVC-CI. Further validation research is required to support our preliminary findings of no significant correlation between CVP measurement and ultrasound assessment of the IVC. CVP and IVC ultrasound should be used as clinical adjuncts, and not as stand-alone measures of volume assessment. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 28, 2018 Category: Emergency Medicine Source Type: research

Chronic kidney disease in the emergency centre: A prospective observational study
This study aims to describe the pattern of EC presentation of adults with CKD in Southwest Nigeria.MethodsThis was a prospective observational study of 158 consecutively presenting CKD patients at the EC of two tertiary hospitals in Southwest Nigeria. Patients 18 years of age or older who were admitted into the EC at either study site with an admitting diagnosis of CKD and who consented to participate in the study were recruited. Socio-demographic characteristics, primary reason(s) for admission into the EC, requirement for dialysis, as well as the indication for dialysis were documented. The patients were followed-up fo...
Source: African Journal of Emergency Medicine - July 28, 2018 Category: Emergency Medicine Source Type: research

Imaging in trauma in limited-resource settings: A literature review
DiscussionAs imaging continues to evolve, its importance in the role of diagnostic algorithms in trauma settings is important. In most settings, imaging is relied upon as an adjunct to the primary survey. In most developed settings, CT scan remains the mainstay for imaging in trauma, but in limited-resource settings, other imaging studies such as LODOX, X-ray, and especially ultrasound can play a large role. As ultrasound is directly related to user operation, data are limited and variable; more research as this field evolves will be beneficial. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 27, 2018 Category: Emergency Medicine Source Type: research

Validity of the South African Triage Scale in a rural district hospital
This study aims to assess the validity of the SATS in a rural district hospital context.MethodsThis is a cross-sectional study. All patients presenting to the Zithulele Hospital emergency centre from 1 October 2015 to 31 December 2015 were triaged using the SATS system, routinely collected data was used to determine the correlation between assigned acuity and outcome to determine rates of under- and over-triage. Patient demographics were collected and waiting times were compared to existing standards of the SATS tool.ResultsOf the 4002 patients presenting to the emergency centre during the study period, 2% were triaged as ...
Source: African Journal of Emergency Medicine - July 27, 2018 Category: Emergency Medicine Source Type: research

Left pulmonary artery bullet embolism following a penetrating cardiac gunshot injury
ConclusionA brief overview of the literature regarding bullet emboli is provided in light of this unusual case, focusing specifically on thoracic bullet emboli. A high index of suspicion should be raised when the number of entry and exit wounds are incongruent, bullet location does not align with anticipated trajectory, or serial radiographs demonstrate missile migration. Radiological evaluation and bullet retrieval are dependent on haemodynamic stability of the patient. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 27, 2018 Category: Emergency Medicine Source Type: research

A descriptive analysis of endotracheal intubation in a South African Helicopter Emergency Medical Service
DiscussionIn this small sample of South African HEMS intubation cases, we found overall and first-pass success rates comparable to those reported in similar contexts. (Source: African Journal of Emergency Medicine)
Source: African Journal of Emergency Medicine - July 26, 2018 Category: Emergency Medicine Source Type: research

The burden on emergency centres to provide care for critically ill patients in Addis Ababa, Ethiopia
This study was conducted over three months in two ECs of urban tertiary care hospitals in Addis Ababa. Structured questionnaires were completed by six emergency and critical care nurses. EC patients were included if they met the Society for Critical Care Medicine (SCCM) intensive care unit (ICU) admission criteria and stayed in the EC for more than 6 h. We collected initial demographic and clinical information, data about the patients’ clinical course in the EC, and data regarding the patients’ disposition. We used descriptive statistics for analysis.ResultsA total of 291 patients, over the course of three months, ha...
Source: African Journal of Emergency Medicine - July 26, 2018 Category: Emergency Medicine Source Type: research

Intraoperative awareness and experience with a ketamine-based anaesthesia package to support emergency and essential surgery when no anaesthetist is available
The objective of this study was to assess intraoperative awareness when the ‘Every Second Matters for Emergency and Essential Surgery – Ketamine’ (ESM-Ketamine) package was used to support emergency and essential surgeries and painful procedures in rural Kenya when no anaesthetist was available.MethodsForty-seven consecutive adult patients that underwent an operative procedure under ESM-Ketamine at Sagam Community Hospital in Luanda, Kenya were enrolled. Participants underwent two semi-structured interviews that explored the patient’s experience with ESM-Ketamine both after the operative procedure and four to six w...
Source: African Journal of Emergency Medicine - July 26, 2018 Category: Emergency Medicine Source Type: research