African Journal of Emergency Medicine最新文献

{"title":"Paediatric procedural sedation and or analgesia in the emergency unit; A descriptive study of practice at a Ugandan Referral Hospital","authors":"Anna Meridah Kaguna ,&nbsp;John Mark Mayanja Kasumba ,&nbsp;Mary Ellen Lyon ,&nbsp;Jonathan Byasi ,&nbsp;Celine Jacobs ,&nbsp;Rachael Parke","doi":"10.1016/j.afjem.2025.100929","DOIUrl":"10.1016/j.afjem.2025.100929","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric Procedural Sedation and/ or Analgesia (PPSA) is the recommended standard of practice for children undergoing painful and distressing procedures outside the operating room; however, global practice may vary. In Sub-Saharan Africa, data on the practice of PPSA is lacking. This study aimed to determine the current practice and outcomes of PPSA in the Emergency unit of Mulago National Referral Hospital to inform future standardisation of care.</div></div><div><h3>Methods</h3><div>We conducted a descriptive study from 1st October to 31st December 2023 in the surgical section of the emergency unit of Mulago National Referral Hospital. Data was collected using specifically designed and pretested observational checklists, documenting demographics, pre-procedure assessment and preparation, intra-procedural and post-procedural care, average sedation scores attained, pain control and adverse events observed. Data was coded using EPI-Data and analysed to describe PPSA practice and outcomes.</div></div><div><h3>Results</h3><div>We recruited 183 children undergoing procedures at the surgical section of the emergency unit. Majority were male, 104(56.8 %), and the median age (IQR) was 8 (4–12)years. Most procedures performed were orthopaedic, 149(81.4 %). Only 15(8.2 %) children got both sedation and analgesia, 4(2.2 %) got sedation only while 164(89.6 %) got analgesia only. Propofol was the most used sedative, while lignocaine with paracetamol was the most used analgesia. Most children, 92(50.3 %), had pain scores ≥8, and adverse events occurred in 6(3.3 %), all of whom belonged to the sedation and analgesia group. Anaesthetic officers were the primary providers in 75 % of the sedation-only cases and 46.7 % of the sedation and analgesia group.</div></div><div><h3>Conclusion</h3><div>PPSA practice in this Emergency setting deviates from recommended standards with limited monitoring and inadequate pain control. The clustering of adverse events among children receiving both sedation and analgesia underscores safety risks. Safer sedative choices, clear provider roles, local guidelines, and targeted training are needed to improve the safety and quality of PPSA.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100929"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing junior doctors' knowledge and attitude on advanced life support in Egypt: a cross-sectional study","authors":"Yasser Ahmed Khalid ,&nbsp;Mohamed Bosily Saad ,&nbsp;Mohamed Ezzat Nasreddin","doi":"10.1016/j.afjem.2025.100927","DOIUrl":"10.1016/j.afjem.2025.100927","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiovascular diseases are a leading cause of mortality worldwide, with cardiac arrest survival heavily dependent on timely and effective resuscitation efforts. Junior doctors often serve as first responders in hospitals, yet their advanced life support (ALS) knowledge and training adequacy remain underinvestigated in Egypt. This study assessed the knowledge and attitudes of junior doctors in Egypt regarding basic life support (BLS) and ALS, identified knowledge gaps, and suggests improvements in resuscitation training programs.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 184 junior doctors, including house officers, general practitioners, and residents, across multiple healthcare centres in Egypt. Data was collected via an online questionnaire based on European Resuscitation Council guidelines, evaluating demographic factors, BLS/ALS knowledge, and attitudes toward cardiac arrest management. Statistical analysis explored associations between knowledge scores and participant characteristics.</div></div><div><h3>Results</h3><div>Participants demonstrated inadequate knowledge with mean BLS and ALS scores of 59 % and 61.8 %, respectively. Significant deficiencies were noted in pediatric resuscitation, cardiac arrest diagnosis, IV access, and capnography interpretation. Residents and those attending ALS workshops scored significantly higher (<em>p</em> &lt; 0.05), while prior clinical exposure did not correlate with higher knowledge scores. Most participants (91.3%) expressed a need for further ALS training.</div></div><div><h3>Discussion</h3><div>Junior doctors in Egypt show deficient ALS knowledge with critical gaps that may impact patient outcomes. Structured ALS training and curriculum reforms are urgently needed to enhance emergency preparedness and improve cardiac arrest survival.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100927"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital care utilization and associated factors among trauma patients during armed conflict: A mixed-methods study in west Amhara, Ethiopia referral hospitals","authors":"Temesgen Ayenew ,&nbsp;Mengistu Abebe Messelu ,&nbsp;Haile Amha ,&nbsp;Mamaru Getie Fetene ,&nbsp;Fentahun Minwuyelet Yitayew ,&nbsp;Anteneh Belayneh ,&nbsp;Abere Kassie ,&nbsp;Getinet Nibret ,&nbsp;Bekele Getenet Tiruneh","doi":"10.1016/j.afjem.2025.100931","DOIUrl":"10.1016/j.afjem.2025.100931","url":null,"abstract":"<div><h3>Background</h3><div>Prehospital care is vital for reducing mortality from traumatic injuries, especially in low- and middle-income countries. This study determined prehospital care utilization and associated factors among trauma patients in referral hospitals in West Amhara, Ethiopia.</div></div><div><h3>Methods</h3><div>A concurrent triangulation mixed-methods design was employed from March–August 2024 in Debre Markos, Tibebe Ghion, and Felege Hiwot hospitals. Quantitative data were collected from 518 trauma patients via questionnaire, with proportional allocation based on patient flow, and analyzed using logistic regression to identify factors associated with prehospital care use. Qualitative data were collected through semi-structured interviews with healthcare professionals and trauma patients, reported in line with the Consolidated criteria for reporting qualitative research (COREQ) checklist. Reflexive thematic analysis guided by the WHO Emergency Care System Framework was used, integrating quantitative and qualitative findings while maintaining reflexivity to understand prehospital care utilization.</div></div><div><h3>Results</h3><div>The prehospital care utilization rate was 49.8 %. The majority of patients (84.2 %) arrived at hospitals via taxi or on foot, reflecting reliance on non-EMS transport. Rural residence (AOR = 4.80), lower education (AOR = 0.54), violence/quarrel-related injuries (AOR = 2.60), motor vehicle accidents (AOR = 2.00), gunshot injuries (AOR = 8.61), and penetrating injuries (AOR = 0.34) were significantly associated with prehospital care use.</div></div><div><h3>Qualitative findings revealed challenges across four themes</h3><div>Limited awareness and lack of emergency communication systems during initial contact and dispatch (<em>Scene</em>); scarce ambulances, long response times, and reliance on non-EMS transport in prehospital treatment and transportation (<em>Transport</em>); resource and personnel shortages that indirectly affect prehospital response within facility-based emergency care linkages (<em>Facility</em>); and the need for <em>Advocacy and Public Education.</em></div></div><div><h3>Conclusion</h3><div>Prehospital care utilization is sub-optimal, influenced by sociodemographic and injury-related factors. Qualitative insights reveal systemic and community challenges that warrant further investigation through larger, more representative studies.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100931"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the availability, effectiveness, and impact of primary trauma care training in Sub-Saharan Africa: A comprehensive review","authors":"Cherinet Osebo ,&nbsp;Tarek Razek ,&nbsp;Victoria Munthali ,&nbsp;Respicious Boniface","doi":"10.1016/j.afjem.2025.03.003","DOIUrl":"10.1016/j.afjem.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Trauma is a leading cause of morbidity and mortality in sub-Saharan Africa (SSA), contributing to over 90 % of global injury-related deaths. Limited healthcare infrastructure, insufficient access to skilled healthcare professionals, and resource constraints exacerbate the trauma burden. While Advanced Trauma Life Support (ATLS) has demonstrated effectiveness in high-income settings, its high cost and limited adaptability make it less feasible in SSA. The Primary Trauma Care (PTC) course offers a cost-effective and context-appropriate alternative to ATLS. However, its implementation and impact in SSA remain underexplored. This review evaluates the availability, effectiveness, impact, and affordability of PTC courses in SSA.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted across Medline, PubMed, Embase, and African Journals Online to identify studies on PTC training in SSA. Studies examining PTC's impact on injury management, knowledge, skills, patient outcomes, and cost-effectiveness were included. Inclusion criteria focused on studies conducted between 2000 and 2024 in SSA, with a focus on PTC implementation.</div></div><div><h3>Results</h3><div>Four published PTC training studies were identified in both urban and rural settings across SSA, highlighting significant underutilization due to limited funding, infrastructure challenges, and insufficient institutional support. Among 2758 trainees, the majority were nurses (1625, 58.9 %) and clinical officers (1624, 58.8 %), followed by physicians (979, 35.5 %) and medical students (155, 5.6 %). Three studies demonstrated significant improvements in participants' knowledge, confidence, and skills. One study reported a reduction in trauma-related mortality rates. However, only one study directly assessed patient outcomes, indicating a gap in evaluating long-term impacts.</div></div><div><h3>Conclusion</h3><div>To the best of our knowledge, this is the first comprehensive review of PTC training in SSA, offering novel insights into its effectiveness and addressing critical gaps in trauma care research for resource-limited settings. The findings demonstrate that PTC significantly enhances trauma care knowledge, confidence, and departmental capacity, making it a cost-effective and scalable training program for resource-constrained settings. However, the limited scope and frequency of PTC courses call for policymakers to prioritize expanding access to these programs and integrating them into national trauma care strategies. Collaborative efforts are needed to secure funding, increase institutional support, and conduct more institution-based studies to evaluate the long-term impact of PTC on patient outcomes, morbidity, and quality of life in SSA.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100872"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial - AfJEM Dec 2025","authors":"","doi":"10.1016/j.afjem.2025.100930","DOIUrl":"10.1016/j.afjem.2025.100930","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100930"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Service utilisation and outcomes of transfers by a specialised paediatric and neonatal retrieval service in the Western Cape, South Africa","authors":"Shama Patel ,&nbsp;Liezl Smit ,&nbsp;Grant Felix ,&nbsp;Baljit Cheema ,&nbsp;Andrew Redfern","doi":"10.1016/j.afjem.2025.100925","DOIUrl":"10.1016/j.afjem.2025.100925","url":null,"abstract":"<div><h3>Introduction</h3><div>Development of emergency care systems and provision of quality pre-hospital care have been identified as a priority to reduce childhood morbidity and mortality in low-resource settings. A dedicated paediatric and neonatal retrieval transfer team (SPRINTT) service was established in the Western Cape, South Africa, in 2016. This study describes the utilisation of Emergency Medical Services (EMS) for children and neonates identified as requiring SPRINTT. Additionally, the indications, clinical profile, and outcomes for a sub-group of children transferred to a tertiary paediatric emergency department (PED) are described.</div></div><div><h3>Methods</h3><div>This retrospective study reviewed cases requiring SPRINTT from November 2019 to November 2020. Data were obtained from EMS Electronic Patient Care Records (ePCR) and Computer Aided Dispatch (CAD) databases. A sub-group of cases transferred to a tertiary PED were reviewed using hospital records.</div></div><div><h3>Results</h3><div>A total of 2361 inter-facility transfers logged as SPRINTT incident-types occurred during the study period, with 54% being neonates &lt;29 days. The majority (87%) were from urban facilities. Most cases (82%) were high acuity, being triaged as an emergency or very urgent. Of the sub-group of 203 cases transferred to the PED, acute respiratory illnesses (42%) and gastroenteritis (24%) were the most frequent presenting complaints. Eight children (4%) died, and 16% of children were unstable on arrival. Cardiovascular instability and escalation of respiratory support within 60 min of PED arrival were associated with PICU admission and death (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study is the first description of the utilisation of the SPRINTT service that includes a description of patient outcomes. The large number of SPRINT-type transfers reflects the considerable burden of acutely ill paediatric and neonatal cases and highlights the need for specialised pre-hospital care services. For the PED sub-group, 84% were stable on arrival suggesting that the retrieval service performs an important role in pre-hospital care and transfer in this setting.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100925"},"PeriodicalIF":1.2,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and outcome of patients with acute kidney injury in the Emergency Department of a teaching hospital in Ethiopia","authors":"Berihu Assefa Berhe ,&nbsp;Benyam Bahta Gebrehiwot ,&nbsp;Frehiwot Worku Senbeta ,&nbsp;Dirijit Mamo Alemu ,&nbsp;Menbeu Sultan Mohammed ,&nbsp;Mohammed Kalifa Nuguse ,&nbsp;Yemane Gebremedhin Tesfay","doi":"10.1016/j.afjem.2025.100926","DOIUrl":"10.1016/j.afjem.2025.100926","url":null,"abstract":"<div><h3>Background</h3><div>Acute Kidney Injury (AKI) affects 13.3 million people annually, with 85% in low resource settings. This study aimed to identify AKI profiles and outcomes in Ethiopia's largest teaching hospital's emergency department, focusing on targeted therapy and preventative measures.</div></div><div><h3>Method and Materials</h3><div>A cross-sectional study was conducted at an Ethiopian teaching hospital's Emergency Department from June 1, 2021, to June 1, 2022. Descriptive statistics and binary logistic regression were analyzed. A paired samples T-test was used to compare patient findings.</div></div><div><h3>Results</h3><div>Among the 222 AKI patients included in the study, 110 (49.5 %) were males, and 112 (50.5 %) were females. The mean age of presentation was 48±18 years old. Most patients were from Addis Ababa (41.4 %) and the Oromia region (40.5 %). The most common causes of AKI were infections (26.2 %), acute glomerulonephritis (20.4 %), volume depletion (18.5 %), and obstructive uropathy (16.6 %). Uremic encephalopathy, infection, malignancy, and a low initial Glasgow Coma Scale significantly contributed to unfavorable outcomes. The presence of nephrotoxic antibiotics, infection, and hyponatremia significantly contributed to the admission rate to the wards and intensive care unit.</div></div><div><h3>Conclusion</h3><div>In conclusion, infection is the dominant cause and mortality predictor of AKI. The majority of patients with infections were sepsis (78.1 %), pyelonephritis (11.4 %), and pneumonia (10.3 %). Early initiation of antibiotics in the Emergency Department contributes to improved outcomes.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100926"},"PeriodicalIF":1.2,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Health research abstracts: July ‘25","authors":"","doi":"10.1016/j.afjem.2025.100924","DOIUrl":"10.1016/j.afjem.2025.100924","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100924"},"PeriodicalIF":1.2,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Health research abstracts: November ‘25","authors":"","doi":"10.1016/j.afjem.2025.100921","DOIUrl":"10.1016/j.afjem.2025.100921","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100921"},"PeriodicalIF":1.2,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Health research abstracts: September ‘25","authors":"","doi":"10.1016/j.afjem.2025.100923","DOIUrl":"10.1016/j.afjem.2025.100923","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100923"},"PeriodicalIF":1.2,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}