African Journal of Emergency Medicine最新文献

Barriers to thrombolysis in acute ischaemic stroke: an epidemiological review from a tertiary hospital in the Eastern Cape, South Africa 急性缺血性卒中溶栓障碍：来自南非东开普省一家三级医院的流行病学回顾

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-29 DOI: 10.1016/j.afjem.2026.100945

Roswyn Pasio , Roshen Maharaj , Kevin Pasio

Introduction

Stroke is one of the leading causes of morbidity and mortality globally, with a significant impact on health systems. In South Africa, especially the Eastern Cape, the epidemiology of acute stroke and the barriers to optimal care remain poorly described.

Methods

This retrospective cohort study included adult patients (≥18 years) presenting with acute stroke at a hospital in Gqeberha, Eastern Cape, from 1 July 2019 to 30 June 2020.

Results

A total of 403 patients met the inclusion criteria, with 38 excluded from time-based analysis. The median patient age was 60.4 years (IQR 51.6 – 70.6); 54 % were female. Most patients (56 %) arrived via private transport, and 58 % had radiological evidence of an ischaemic stroke. Common stroke risk factors included hypertension, diabetes, and smoking. The median time from symptom onset to hospital presentation was 06 h and 30 min; with 9 % of patients presenting with a wake-up stroke. The median door-to-doctor time was 52 min with 51.8 % seen within 60 min. The median door-to-CT time was 5 h 7 min. A higher proportion of imaging occurred after hours. 99 patients presented within the 4.5-hour thrombolytic window (hyperacute stroke). Of these, 32 had radiological evidence of an intracranial haemorrhage. In the hyperacute stroke cohort, the median door-to-doctor and door-to-CT times were shorter: 25 min and 2 h 19 min respectively. Of those with ischaemic stroke, 35 % were excluded from thrombolysis due to time related factors, 34 % had contraindications, and 31 % were not offered treatment due to clinical and physician related factors. No patients admitted via the emergency department received thrombolysis. None of the national or international time-based quality metrics for acute stroke care were met.

Conclusion

This study provides valuable insights into the region’s stroke epidemiology and identifies areas for improvement for acute stroke care.

卒中是全球发病和死亡的主要原因之一，对卫生系统产生重大影响。在南非，特别是东开普省，急性中风的流行病学和获得最佳护理的障碍仍然缺乏描述。方法本回顾性队列研究纳入2019年7月1日至2020年6月30日在东开普省Gqeberha一家医院出现急性卒中的成年患者（≥18岁）。结果403例患者符合纳入标准，38例患者被排除在时间分析之外。患者中位年龄为60.4岁（IQR为51.6 - 70.6）；54%是女性。大多数患者（56%）通过私人交通到达，58%的患者有缺血性中风的放射证据。常见的中风危险因素包括高血压、糖尿病和吸烟。从症状出现到住院的中位时间为06小时30分钟；9%的患者表现为醒脑卒中。中位上门就诊时间为52分钟，其中51.8%在60分钟内就诊。门到ct的中位时间为5 h 7 min。下班后出现的显像比例较高。99例患者出现在4.5小时溶栓窗内（超急性卒中）。其中32例有颅内出血的放射学证据。在超急性卒中队列中，上门到医生和上门到ct的中位时间较短，分别为25分钟和2小时19分钟。在缺血性卒中患者中，35%的患者由于时间相关因素被排除在溶栓治疗之外，34%的患者有禁忌症，31%的患者由于临床和医生相关因素未接受治疗。经急诊科入院的患者均未接受溶栓治疗。急性卒中护理的国家或国际时间质量指标均未达到。结论本研究为该地区卒中流行病学提供了有价值的见解，并确定了急性卒中护理的改进领域。

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引用次数: 0

Assessment of emergency care services in Nigerian hospitals: A cross-sectional study 尼日利亚医院急诊护理服务评估：一项横断面研究

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-29 DOI: 10.1016/j.afjem.2025.100939

Kelechi Umoga , Muzzammil Muhammad , Melissa A. Meeker , Jessica Rayo , Kehinde Olawale Ogunyemi , Christine Ngaruiya

Background

The Accident and Emergency (A&E) unit is a key entry point for healthcare in Nigeria, yet data on its functionality and capacity for emergency care remain limited. This study evaluates the functional capacity of A&E units in Nigeria using a modified Emergency Care Assessment Tool (ECAT).

Methods

A cross-sectional study was conducted from September to October 2020 in seven tertiary hospitals across Nigeria. Six hospitals, one from each of the country’s six geopolitical zones, were randomly selected, while the seventh-Nigeria’s main trauma center located in the capital-was purposively included. Doctors and nurses routinely working in A&E units were interviewed using a modified Emergency Care Assessment Tool (ECAT), which evaluates the availability of essential medical interventions (signal functions) for managing six common, life-threatening sentinel conditions: Maternal and Child emergencies, Respiratory failure, Trauma, Shock, Altered mental status, and Severe pain.

Results

Among 503 healthcare providers surveyed (393 doctors and 110 nurses), significant differences were observed in the performance of signal functions across all six sentinel conditions (p < 0·001) and across the seven study sites (p < 0·001). The overall average capacity score was 2·69 out of 3. Federal Medical Center Katsina (North-West zone) recorded the highest mean score of 2·92 (95% CI: 2·77 - 3·07), while UCTH (South-South zone) had the lowest at 2.44 (95% CI: 2·27 - 2·60). Among the conditions assessed, respiratory failure had the lowest mean score at 2·55 (1·88–3·21).

Conclusion

This study reveals a higher-than-expected national average A&E capacity score (2·69 out of 3) in Nigerian tertiary hospitals but highlights ongoing challenges, particularly in managing respiratory emergencies. Notable regional disparities were observed, with the Northern region outperforming others. Findings emphasize the need for objective, on-site evaluations and broader inclusion of facilities, along with targeted, region-specific investments to improve equitable emergency care nationwide.

背景事故和紧急情况（A&；E）股是尼日利亚医疗保健的一个关键切入点，但关于其功能和紧急护理能力的数据仍然有限。本研究使用改进的紧急护理评估工具（ECAT）评估尼日利亚急症室的功能能力。方法于2020年9月至10月在尼日利亚7家三级医院进行横断面研究。随机选择了六家医院，分别来自该国六个地缘政治区域，而有意将位于首都的尼日利亚主要创伤中心——第七家医院包括在内。使用改进的紧急护理评估工具（ECAT）对在急症室例行工作的医生和护士进行了访谈，该工具评估了基本医疗干预措施（信号功能）的可用性，以管理六种常见的危及生命的前哨状况：孕产妇和儿童紧急情况、呼吸衰竭、创伤、休克、精神状态改变和严重疼痛。结果接受调查的503名医疗服务提供者（393名医生和110名护士）在所有6个哨点条件（p < 0.001）和7个研究地点（p < 0.001）的信号功能表现存在显著差异。总体平均能力得分为2.69分（满分3分）。卡齐纳联邦医疗中心（西北区）平均得分最高，为2.92 (95% CI: 2.77 ~ 3.07)， UCTH（南南区）平均得分最低，为2.44 （95% CI: 2.27 ~ 2.60）。在评估的疾病中，呼吸衰竭的平均评分最低，为2.55分（1.88 - 3.21）。本研究揭示了尼日利亚三级医院的急诊能力得分高于预期（2.69分），但也强调了持续的挑战，特别是在处理呼吸道紧急情况方面。观察到明显的地区差异，北部地区表现优于其他地区。调查结果强调，需要进行客观的现场评价，更广泛地纳入设施，同时进行有针对性的区域投资，以改善全国范围内公平的急诊护理。

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引用次数: 0

Rural-urban disparities in Emergency Medical Services: a qualitative study of barriers and opportunities in Rivers State, Nigeria 紧急医疗服务的城乡差异：尼日利亚河流州障碍和机会的定性研究

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-28 DOI: 10.1016/j.afjem.2026.100946

Adaeze Oreh , Folake Owodunni , Oluwaseun Adebayo Adewunmi , Ihuoma Opelia-Ezeh , Olufemi Onasanya , Sylvanus Ojum , Dede Siyeofori , Kinikanwo Green

Introduction

Emergency Medical Services (EMS) are critical for reducing morbidity and mortality in low- and middle-income countries (LMICs), yet significant disparities persist between urban and rural areas. This qualitative study explores barriers and opportunities in EMS utilisation among residents of Rivers State, Nigeria.

Methods

Using a hybrid deductive-inductive approach guided by the Levesque framework for healthcare access, we conducted a focus group discussion with 20 purposively selected stakeholders representing nine categories, including healthcare providers, policymakers, community leaders and EMS users. Data was analysed thematically to identify barriers and opportunities in EMS utilisation.

Results

Analysis revealed systemic barriers across five dimensions: accessibility (delayed response times, poor communication), acceptability (cultural beliefs favouring faith-based interventions), availability (inadequate infrastructure and staffing), affordability (high out-of-pocket costs), and appropriateness (gender and mental health disparities). These challenges were more pronounced in rural areas where they faced more compounded barriers, including geographic isolation and limited ambulance coverage. Several opportunities for improvement emerged, including community first-responder training, technology integration (e.g., GPS tracking), and multi-level collaborations, both inter-agency and with local non-governmental organisations (NGOs).

Conclusion

The findings underscore the urgent need for policy reforms to decentralise EMS management, enhance public awareness, and address socioeconomic inequities. This study contributes to the discourse on healthcare disparities in LMICs and provides actionable recommendations for stakeholders to strengthen EMS systems in Nigeria through multi-sectoral collaboration.

急诊医疗服务（EMS）对于降低低收入和中等收入国家（LMICs）的发病率和死亡率至关重要，但城市和农村地区之间仍然存在显著差异。本定性研究探讨了尼日利亚河流州居民利用EMS的障碍和机会。方法在Levesque医疗保健可及性框架的指导下，采用混合演绎-归纳方法，我们与有目的选择的20名利益相关者进行了焦点小组讨论，这些利益相关者代表9个类别，包括医疗保健提供者、政策制定者、社区领袖和EMS用户。对数据进行了专题分析，以确定EMS利用中的障碍和机会。结果分析揭示了五个方面的系统性障碍：可及性（反应时间延迟、沟通不畅）、可接受性（支持基于信仰的干预的文化信仰）、可获得性（基础设施和人员配备不足）、可负担性（高自付费用）和适当性（性别和心理健康差异）。这些挑战在农村地区更为明显，农村地区面临着更为复杂的障碍，包括地理隔离和救护车覆盖范围有限。出现了一些改进的机会，包括社区第一反应者培训、技术整合（例如GPS跟踪）以及机构间和与当地非政府组织的多层次合作。结论研究结果强调，迫切需要进行政策改革，以分散EMS管理，提高公众意识，并解决社会经济不平等问题。本研究有助于讨论中低收入国家的医疗保健差距，并为利益相关者提供可操作的建议，通过多部门合作加强尼日利亚的EMS系统。

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引用次数: 0

Knowledge and practice of adult cardiopulmonary resuscitation among nurses in the Emergency Department of a tertiary hospital in Ghana 加纳某三级医院急诊科护士成人心肺复苏知识与实践

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-23 DOI: 10.1016/j.afjem.2026.100947

Alice Oppong Damprane , Isaac Nyanor , Augustine Kwakye Sampah , Gloria Achempim-Ansong , Nicholas Adjei , Bernard Arhin , Paa Kobina Forson

Introduction

Cardiopulmonary Resuscitation (CPR) is an important emergency care skill for all healthcare professionals. The success of CPR is determined by multiple patient and healthcare professional factors, such as CPR training and adhering to the guidelines for managing sudden cardiac arrest. Nurses have a high chance of identifying a patient in sudden cardiac arrest and initiating CPR for a better health outcome. This study assessed the knowledge and practice of adult CPR among nurses at the Emergency Department (ED) of a tertiary Hospital in Ghana.

Methods

A quantitative cross-sectional study was employed, where 132 nurses were randomly selected and interviewed from June 2020 to November 2020. Data was collected by trained research assistants with a structured questionnaire and analysed with STATA Version 16.0

Results

Majority (n = 117, 86.64%) of the respondents could identify a patient in sudden cardiac arrest, and 94.70% (n = 125) had performed CPR at least once within the last two years. Availability of guidelines and protocol based on the AHA guidelines for managing sudden cardiac arrest (p = 0.020) and good CPR practice (p = 0.044) were associated with good knowledge of CPR in this study.

Conclusion

Our study found respondents generally had good knowledge and good practice of CPR. Making AHA guidelines available to ED nurses for managing sudden cardiac arrest was significantly associated with good knowledge of CPR. Therefore, regular CPR training and providing AHA guidelines for managing sudden cardiac arrest are recommended to increase the level of knowledge of adult CPR.

心肺复苏（CPR）是所有医疗保健专业人员的一项重要急救技能。心肺复苏术的成功取决于多种患者和医疗保健专业因素，如心肺复苏术培训和坚持处理心脏骤停的指导方针。护士有很高的机会识别出心脏骤停的病人，并启动心肺复苏术以获得更好的健康结果。本研究评估了加纳一家三级医院急诊科（ED）护士对成人心肺复苏术的知识和实践。方法采用定量横断面研究方法，于2020年6月至2020年11月随机抽取132名护士进行访谈。数据由训练有素的研究助理使用结构化问卷收集，并使用STATA Version 16.0进行分析。结果大多数（n = 117, 86.64%）的受访者能够识别出心脏骤停患者，94.70% （n = 125）的受访者在过去两年内至少进行过一次心肺复苏术。在本研究中，心脏骤停治疗指南和方案的可用性（p = 0.020）和良好的心肺复苏术实践（p = 0.044）与良好的心肺复苏术知识相关。结论调查对象普遍对心肺复苏有较好的认识和操作。将心脏协会指南提供给急诊科护士用于处理心脏骤停与良好的心肺复苏术知识显著相关。因此，建议定期进行心肺复苏术培训，并提供心脏骤停的AHA指南，以提高成人心肺复苏术的知识水平。

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引用次数: 0

Maintenance of competence in rarely performed clinical skills by advanced life support providers in Gauteng, South Africa: A mixed-methods study 高级生命支持提供者在南非豪登省很少执行临床技能的能力维持：一项混合方法研究

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-21 DOI: 10.1016/j.afjem.2025.100932

Jared Eric Surtees, Craig Vincent Lambert

Introduction

Advanced Life Support (ALS) providers are highly trained emergency care professionals with a broad range of clinical skills. Confidence and competence to perform a clinical skill or intervention has been linked to frequency of application. Differences in training, caseloads, and the context in which ALS providers operate can influence how often they get to perform different skills. Although the Health Professions Council of South Africa (HPCSA) mandates Continuing Professional Development (CPD), there is no requirement for ALS providers to demonstrate maintenance of procedural competence. In this study we investigated approaches to the maintenance of competency in rarely performed clinical skills among a sample of Gauteng-based ALS providers.

Methods

An exploratory, descriptive mixed-methods design was employed. A quantitative survey of 41 ALS providers assessed frequency of performance and self-reported confidence across 55 clinical skills was performed in March 2023. This was followed by two focus group discussions to explore in greater depth participant’s experiences with regard to maintenance of clinical skills.

Results

More than half of the 55 skills we assessed were reported to be “rarely” performed. Confidence to perform a particular skill generally mirrored the frequency with which the skill was performed. Focus group participants identified valuable strategies for maintaining skills that included clinical rotations across diverse work environments, peer discussions, instructional videos, and CPD-accredited courses that included a practical component. Limitations were identified in the current CPD system with regard to maintenance of clinical skills.

Conclusion

Skill decay and a reduction in confidence among ALS providers can be linked to infrequent performance of certain clinical skills and interventions. A more purposeful coordinated strategy involving education and training providers, employers and practitioners is required to better support the maintenance of clinical skills that are infrequently performed.

高级生命支持（ALS）提供者是训练有素的紧急护理专业人员，具有广泛的临床技能。执行临床技能或干预的信心和能力与应用频率有关。培训、病例量和ALS提供者操作环境的差异会影响他们执行不同技能的频率。尽管南非卫生专业委员会（HPCSA）要求持续专业发展（CPD），但没有要求渐冻症提供者证明维持程序能力。在这项研究中，我们调查的方法，以维持能力在很少执行的临床技能在豪登省为基础的ALS提供者的样本。方法采用探索性、描述性混合方法设计。2023年3月，对41名ALS提供者进行了定量调查，评估了55项临床技能的表现频率和自我报告的信心。随后进行了两次焦点小组讨论，以更深入地探讨参与者在维持临床技能方面的经验。结果在我们评估的55项技能中，超过一半的技能被报告为“很少”被执行。执行特定技能的信心通常反映了执行该技能的频率。焦点小组参与者确定了保持技能的有价值的策略，包括在不同的工作环境中进行临床轮岗、同行讨论、教学视频和包含实践部分的cpd认证课程。目前的CPD系统在维持临床技能方面存在局限性。结论渐冻人服务提供者的技能衰退和信心下降可能与某些临床技能和干预措施的不频繁表现有关。需要一项涉及教育和培训提供者、雇主和从业人员的更有目的的协调战略，以更好地支持维持不经常执行的临床技能。

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引用次数: 0

Leave no one behind: An African perspective on the first World Health Organization Global Status Report on Drowning Prevention 不让任何人掉队：非洲对世界卫生组织第一份《预防溺水全球现状报告》的看法

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-17 DOI: 10.1016/j.afjem.2026.100944

Colleen J. Saunders , Frederick Oporia , Caroline Lukaszyk , Binta Sako

Drowning is a significant but under-recognised public health challenge in the African region. The 2024 World Health Organization Global Status Report on Drowning Prevention provides the first comprehensive overview of national drowning prevention efforts across 139 countries and territories, including 33 from Africa. This commentary explores key findings from the report through an African lens, highlighting persistent disparities in drowning burden and response. The African region recorded only a 3% reduction in drowning mortality between 2000 and 2021, compared to 38% globally. Weak civil registration systems, limited data on non-fatal drowning, and under-reporting of flood and transport-related incidents contribute to a significant underestimation of the true burden. Policy and legislative gaps remain widespread, with few countries having national strategies, enforceable legislation, or adequately resourced multisectoral coordination mechanisms. While some countries have implemented vessel safety laws and appointed national focal points, legislation mandating lifejacket use, pool fencing, and alcohol regulation around water is inconsistent and poorly enforced. Critically, only a minority of countries offer community-based child drowning prevention interventions, swimming or water safety education, or lifeguard and bystander rescue training. The African region's high exposure to water during everyday life, work, and disaster, exacerbated by vulnerabilities including poverty, rurality, and climate volatility, underscores the need for urgent investment in locally relevant, evidence-informed drowning prevention efforts. This commentary calls for strong leadership, improved data systems, and equitable, sustainable partnerships to support whole-of-society responses to drowning in Africa.

在非洲区域，溺水是一项重大但未得到充分认识的公共卫生挑战。《2024年世界卫生组织预防溺水全球现状报告》首次全面概述了139个国家和地区（包括33个非洲国家和地区）的国家预防溺水工作。本评论从非洲的角度探讨了报告的主要发现，强调了溺水负担和应对方面的持续差异。2000年至2021年期间，非洲区域溺水死亡率仅下降了3%，而全球下降了38%。薄弱的民事登记制度、有限的非致命性溺水数据以及对洪水和交通相关事件的漏报，都导致了对真实负担的严重低估。政策和立法差距仍然普遍存在，很少有国家有国家战略、可执行的立法或资源充足的多部门协调机制。虽然一些国家实施了船舶安全法并指定了国家协调中心，但有关使用救生衣、泳池围栏和水周围酒精管制的立法并不一致，而且执行不力。至关重要的是，只有少数国家提供以社区为基础的儿童溺水预防干预措施、游泳或水上安全教育，或救生员和旁观者救援培训。非洲地区在日常生活、工作和灾害中高度接触水，而贫困、农村和气候波动等脆弱性又加剧了这一问题，这突显出迫切需要投资于与当地相关的、基于证据的溺水预防工作。本评论呼吁加强领导，改进数据系统，建立公平、可持续的伙伴关系，支持全社会应对非洲溺水事件。

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引用次数: 0

The competency requirements for emergency medical services call takers and dispatchers - a scoping review 紧急医疗服务呼叫员和调度员的能力要求——范围审查

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-14 DOI: 10.1016/j.afjem.2025.100933

Wynand Van Der Net , Andrew Makkink , Peter Hodkinson , Willem Stassen

Introduction

: An effective Emergency Medical Service (EMS) depends on a well-functioning Emergency Medical Dispatch (EMD), which influences response times, resource allocation, and patient outcomes. Competent EMD staff are essential for gathering information, making rapid decisions, dispatching resources, and providing life-saving pre-arrival instructions. While high-income countries use standardized computer-aided dispatch systems, many low- and middle-income countries (LMICs), including South Africa, lack such systems and rely on staff competencies. This scoping review sought to identify the competencies for EMD staff.

Methods

: We searched the international literature using the keywords “Emergency Medical Service”; “EMS call centre”; “competencies” and their synonyms. Two reviewers independently reviewed the identified articles. The articles were tabled highlighting findings focused on EMD system requirements; EMD staff competency requirements; education and training for EMD staff.

Results

: Among the 35 articles identified, five (14%) originated from LMICs with no articles specifically addressing the competency requirements for staff working in an EMD. A total of 16 (46%) studies highlighted the need for qualified staff (nurses, physicians and paramedics). The use of computer aided dispatch and Medical Priority Dispatch System in an EMD was identified in 13 (37%). The review of existing programs identified eight EMD programs emphasizing effective interview and communication skills, use of technology, medical terminology, first aid, stress management, resource allocation, effective reporting and feedback. Literature showed a renewed interest in EMD research within the last 5 years, particularly in LMICs where EMS are poorly developed.

Discussion

: The scoping review highlighted a lack of evidence on the competencies and performance needs of EMD staff. While key skills such as information gathering, decision-making, and resource allocation are recognized, further research is needed to define core competencies and develop context-appropriate training, especially in LMICs where such evidence is scarce.

一个有效的紧急医疗服务（EMS）依赖于一个运作良好的紧急医疗调度（EMD），它影响到响应时间、资源分配和病人的结果。称职的EMD工作人员对于收集信息、快速决策、调度资源和提供救命的到达前指示至关重要。虽然高收入国家使用标准化的计算机辅助调度系统，但包括南非在内的许多低收入和中等收入国家缺乏这种系统，并依赖于工作人员的能力。这项范围审查旨在确定EMD员工的能力。方法：以“紧急医疗服务”为关键词检索国际文献；“紧急服务电话中心”；“胜任力”及其同义词。两名审稿人独立审查了确定的文章。这些文章被列在表格中，重点强调了EMD系统要求的研究结果；机电工程部员工的能力要求；为EMD员工提供教育和培训。结果：在确定的35篇文章中，有5篇（14%）来自中低收入国家，没有专门针对EMD工作人员能力要求的文章。共有16项（46%）研究强调需要合格的工作人员（护士、医生和护理人员）。13例（37%）确定在EMD中使用计算机辅助调度和医疗优先调度系统。对现有方案的审查确定了八个EMD方案，强调有效的面谈和沟通技巧、技术的使用、医学术语、急救、压力管理、资源分配、有效的报告和反馈。文献显示，在过去的5年里，人们对EMD的研究重新产生了兴趣，特别是在EMS不发达的中低收入国家。讨论：范围检讨强调缺乏证据证明机电工程部员工的能力和工作表现需要。虽然信息收集、决策和资源分配等关键技能得到认可，但需要进一步研究以确定核心能力并制定适合具体情况的培训，特别是在缺乏此类证据的中低收入国家。

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引用次数: 0

Availability of emergency drugs and essential resuscitation equipment and associated barriers in Addis Ababa Health Centers, Ethiopia: a mixed-methods study 埃塞俄比亚亚的斯亚贝巴保健中心紧急药物和基本复苏设备的供应情况及相关障碍：一项混合方法研究

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-12 DOI: 10.1016/j.afjem.2025.100938

Lidia Dagne Mario, Yohannes Feleke, Finot Debebe, Melat Mezgebu Bawoke, Lidet Gizachew Amha, Merahi Kefyalew

Introduction

Essential medications, supplies, and equipment are crucial for emergency care; however, significant resource shortages in low- and middle-income countries, including Ethiopia, hinder the delivery of safe services. Although research on emergency capacity analysis has been conducted at the hospital level, data from lower levels, such as health centers, are lacking, despite numerous studies recommending the development of emergency services at the primary healthcare level to reduce the burden on hospital emergency departments. Therefore, this study primarily aims to assess the availability of emergency equipment and drugs and barriers to availability in health centers in Addis Ababa, Ethiopia.

Methods

An explanatory sequential mixed method design study was conducted in Addis Ababa, in September 2025. Quantitative data were collected from the six health centers selected through convenience and random sampling. Non-probability purposive sampling was used to select key informants for the qualitative interviews, and thematic content analysis was conducted to develop items that emerged from the transcribed information.

Results

The survey revealed a significant gap in availability of emergency equipment and drugs. While oxygen delivery devices and infection control materials were widely available, critical equipment and essential medications like crash carts, defibrillators, digoxin, and sodium bicarbonate were largely absent. Qualitative analysis identified the barriers to be ineffective management, disjointed logistics and health system, shortage of human resource and patients’ financial constraint.

Discussion

The readiness of health centers to provide emergency care in Addis Ababa is inadequate, largely due to resource shortages and systemic barriers. Urgent interventions are needed to improve emergency preparedness at the primary care level, including provision of crash carts, investment in staff training, and revision of procurement and policy frameworks.

基本药物、用品和设备对急诊护理至关重要；然而，包括埃塞俄比亚在内的低收入和中等收入国家严重的资源短缺阻碍了安全服务的提供。虽然在医院一级进行了关于应急能力分析的研究，但缺乏来自较低层次（如保健中心）的数据，尽管许多研究建议在初级保健一级发展应急服务，以减轻医院急诊科的负担。因此，本研究的主要目的是评估埃塞俄比亚亚的斯亚贝巴卫生中心的应急设备和药物的可用性以及可用性的障碍。方法于2025年9月在亚的斯亚贝巴进行解释顺序混合方法设计研究。通过方便和随机抽样的方法，选取6个卫生院进行定量数据收集。非概率有目的抽样用于选择定性访谈的关键举报人，并进行主题内容分析以开发从转录信息中出现的项目。结果调查显示，急救设备和药品的可得性存在显著差距。虽然输氧装置和感染控制材料可以广泛获得，但关键设备和基本药物，如急救车、除颤器、地高辛和碳酸氢钠，基本上没有。定性分析指出了管理效率低下、后勤与卫生系统脱节、人力资源短缺和患者经济拮据等障碍。讨论在亚的斯亚贝巴，保健中心提供紧急护理的准备不足，主要是由于资源短缺和体制障碍。需要采取紧急干预措施，改进初级保健一级的应急准备工作，包括提供应急车、对工作人员培训进行投资以及修订采购和政策框架。

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引用次数: 0

The critical role of emergency departments in managing infectious disease outbreaks: Lessons from the Rwanda Marburg virus response 急诊部门在管理传染病暴发中的关键作用：来自卢旺达马尔堡病毒应对的经验教训

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-10 DOI: 10.1016/j.afjem.2025.100941

Appolinaire Manirafasha , Jacob Carter , Laurent Gamy Kamunga , Ineza Nadine Vanessa , Mukarugwiza Florence , Doris L. Uwamahoro , Nkeshimana Menelas , Tsion Firew

The 2024 Marburg Virus Disease outbreak in Rwanda underscored the indispensable role of Emergency Departments in the early detection, containment, and management of novel infectious diseases. As public health crises continue to grow in complexity, the Emergency Department becomes uniquely positioned to bridge the gap between clinical care and public health responses. Using lessons learned from King Faisal Hospital, Rwanda during the outbreak, this report outlines how Emergency Departments serve as frontline defenses during crisis management and identifies strategies to strengthen and enhance their preparedness.

卢旺达2024年马尔堡病毒病暴发凸显了急诊科在早期发现、遏制和管理新型传染病方面不可或缺的作用。随着公共卫生危机的复杂性不断增加，急诊科在弥合临床护理和公共卫生反应之间的差距方面处于独特的地位。本报告利用在疫情爆发期间从卢旺达费萨尔国王医院吸取的经验教训，概述了急诊科如何在危机管理期间充当第一线防线，并确定了加强和加强其准备工作的战略。

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“More fun than studying or reading a textbook” – Perceptions of a boardgame intervention on toxicology education “比学习或阅读教科书更有趣”——桌游干预毒理学教育的看法

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

African Journal of Emergency Medicine

Pub Date : 2026-01-08 DOI: 10.1016/j.afjem.2025.100936

Carine Marks , Catharina E Du Plessis , Daniël J Van Hoving , Heinri Zaayman

Introduction

Undifferentiated poisoning cases are common presentations to emergency departments. Clinicians are required to be familiar and up to date with the identification and management of these cases. Game-based learning is a unique educational intervention that facilitates learning and has a proven track record in toxicology education. This study sought to explore the impact of a newly designed board game (ToxiTrail™) on improving the toxicological knowledge of clinicians.

Methods

An explorative, qualitative study was performed using focus group interviews on staff working in emergency departments in Tygerberg and Khayelitsha Hospitals, and students enrolled in the Postgraduate Diploma in Medical Toxicology at Stellenbosch University. Interviews were recorded, transcribed and analysed using Braun and Clarke’s reflexive thematic analysis, developing themes related to the educational experience and optimisation of the boardgame.

Results

Thirty participants participated in three distinct focus group interviews. Four primary themes were constructed following the interviews, namely: Educational value and clinical relevance of the board game; Engagement and learning experience; Ideal usage scenarios and target audience; and Recommendations for improvement.

Discussion

Our study showed that the boardgame intervention enhanced the learning and understanding of toxicology concepts amongst participants, identified knowledge gaps and promoted storytelling. The active engagement of the game promoted the retention of knowledge from a real-world perspective and was a fun alternative to other educational instruction methods. Furthermore, the interviews assisted in improving the boardgame.

未分化中毒是急诊科常见的病例。临床医生需要熟悉和最新的识别和管理这些病例。基于游戏的学习是一种独特的教育干预，有助于学习，并在毒理学教育中有良好的记录。本研究旨在探索新设计的棋盘游戏（ToxiTrail™）对提高临床医生毒理学知识的影响。方法采用焦点小组访谈的方法，对泰格伯格医院和卡耶利沙医院急诊科工作人员以及斯泰伦博斯大学医学毒理学研究生文凭课程的学生进行探索性质的研究。使用Braun和Clarke的反思性主题分析方法记录、转录和分析访谈内容，开发与教育经验和优化桌面游戏相关的主题。结果30名参与者参加了三个不同的焦点小组访谈。访谈后构建了四个主要主题，即：棋盘游戏的教育价值和临床相关性；参与和学习经验；理想的使用场景和目标受众；以及改进建议。我们的研究表明，桌面游戏的干预增强了参与者对毒理学概念的学习和理解，确定了知识差距，并促进了故事叙述。从现实世界的角度来看，游戏的积极参与促进了知识的留存，是其他教育教学方法的有趣选择。此外，采访有助于改进桌面游戏。

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