African Journal of Emergency Medicine最新文献

{"title":"Consensus-based research priorities for post-collision care in the Western Cape province of South Africa","authors":"Naseef Abdullah ,&nbsp;Tim Nutbeam ,&nbsp;Colleen J. Saunders ,&nbsp;Craig Wylie ,&nbsp;Nigel Lang ,&nbsp;Willem Stassen","doi":"10.1016/j.afjem.2025.100900","DOIUrl":"10.1016/j.afjem.2025.100900","url":null,"abstract":"<div><h3>Introduction</h3><div>Road traffic injuries constitute a significant global health burden, causing 1.3 million deaths and 50 million injuries annually, with 92 % of fatalities occurring in low-and middle-income countries (LMICs). Despite this disproportionate impact, research priorities in post-collision care often reflect high-income country contexts, creating a critical misalignment between evidence generation and contextual realities in LMICs.</div></div><div><h3>Methods</h3><div>This mixed-methods study employed a three-phase approach to identify research priorities for post-collision care in the Western Cape, South Africa. Phase 1 consisted of a comprehensive literature review to identify preliminary thematic areas and research questions. Phase 2 involved a stakeholder engagement workshop using modified nominal group techniques (NGT) with purposively sampled participants representing emergency medical services, fire services, law enforcement, community members and academia. Phase 3 entailed systematic prioritisation, where participants independently scored each theme and associated research questions on a Likert scale.</div></div><div><h3>Results</h3><div>Eight thematic domains were identified and ranked in order of priority. EMS safety (highest priority), communication and coordination, public awareness and prevention, transportation and access to care, first-responder capabilities, training implementation, resource optimisation, disaster and mass casualty management, and specialised care accessibility. The highest-ranked individual research question concerned the minimum set of practical skills and resources required by first responders to effectively provide immediate post-collision care. Technological integration emerged as a cross-cutting priority across multiple themes.</div></div><div><h3>Conclusion</h3><div>The study represents the first published systematic approach to identifying post-collision care research priorities in South Africa. Diverging from previous exercises that emphasise advanced interventions or system integration, this study highlights foundational challenges of EMS safety and communication as top priorities, reflecting the contextual realities of emergency service delivery in South Africa. The findings provide a strategic roadmap for researchers, funders, and policymakers to direct resources toward questions with maximal potential to improve post-collision care and strengthen health systems in similar LMIC contexts.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100900"},"PeriodicalIF":1.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004446","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":"Acute paediatric pain management: A survey of doctors’ knowledge, attitudes and reported practices at regional hospitals in KwaZulu-Natal, South Africa","authors":"Shannon Pillay,&nbsp;Bavani Naicker,&nbsp;Kamlin Ekambaram","doi":"10.1016/j.afjem.2025.100897","DOIUrl":"10.1016/j.afjem.2025.100897","url":null,"abstract":"<div><h3>Background</h3><div>Despite advances in both pharmacological and non-pharmacological pain management, children remain vulnerable to oligoanalgesia. Understanding clinical practices and barriers encountered by treating clinicians is essential to inform targeted interventions. This study aimed to examine knowledge, attitudes and reported practices of doctors managing acute paediatric pain in rural regional hospitals in KwaZulu-Natal, South Africa.</div></div><div><h3>Methods</h3><div>An electronic survey was distributed between January and February 2024 to doctors working in the departments of Emergency Medicine, Paediatrics, Surgery, and Orthopaedics at three regional hospitals. The survey included both closed- and open-ended questions addressing analgesic choices, awareness of clinical protocols, and perceived barriers to effective pain management. Descriptive statistics were used to summarise overall trends. Post hoc subgroup analyses were conducted using Chi-square and Fisher’s exact tests. Odds ratios were calculated to describe significant associations.</div></div><div><h3>Results</h3><div>Of 165 clinicians approached, 131 responded (response rate: 80%). Over half (55.7%) reported inadequate training for paediatric pain management, and only 42% were aware of departmental protocols. Paracetamol was the most commonly used analgesic agent. Key barriers included time constraints, limited drug access, and departmental culture. Awareness of departmental paediatric pain protocols was highest (82,9%) in Paediatrics (χ², p&lt;0.001). Paediatric doctors reported significantly greater use of non-pharmacological methods across multiple conditions and procedures. Emergency Medicine respondents more frequently reported opioids for severe abdominal pain (OR=4.24, <em>p</em>&lt;0.001, 95% CI 1.96-9.14). Barriers varied by discipline. Paediatrics cited difficulties with pain assessment, while Orthopaedics primarily reported time and staffing constraints.</div></div><div><h3>Conclusion</h3><div>Paediatric pain remains common yet inadequately addressed in Southern Africa. This study identifies insufficient training, poor access to analgesia, and departmental practices as key barriers. Context-specific, cost-effective, multimodal strategies and tailored education are needed to improve care. Sustainable progress requires cultural change, better training, and interdisciplinary collaboration to ensure equitable pain management.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100897"},"PeriodicalIF":1.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989287","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":"Artificial intelligence in clinical toxicology in Africa: Emerging applications and barriers","authors":"Mikiyas G. Teferi,&nbsp;Biruk T. Mengistie,&nbsp;Helina K. Teklehaimanot,&nbsp;Chernet T. Mengistie,&nbsp;Fitsum A. Gemechu,&nbsp;Michael A. Negussie,&nbsp;Tilahun J. Jufara,&nbsp;Getaw W. Hassen","doi":"10.1016/j.afjem.2025.100901","DOIUrl":"10.1016/j.afjem.2025.100901","url":null,"abstract":"<div><div>Artificial intelligence (AI) has a supplementary role in clinical toxicology in Africa, addressing key challenges such as delayed diagnoses, limited expertise, and inadequate healthcare infrastructure. This method has the potential to increase diagnostic accuracy, optimize treatment strategies, and advance research on toxic substance exposure and poisoning cases. AI-driven tools, including machine learning algorithms and decision-support systems, enhance the early detection and risk assessment of toxicities. AI-powered predictive models facilitate precision medicine by designing treatment plans for individual patient profiles. Integrating this in telemedicine expands access to toxicology expertise, particularly in resource-limited settings. Additionally, AI accelerates research by analyzing large datasets, identifying trends, and predicting toxicological risks, thus contributing to public health interventions. Despite these advancements, challenges such as data poverty, ethical issues, and restrictive policies hinder its full potential in African healthcare. These gaps can be bridged through policy reforms, capacity-building initiatives, and robust AI frameworks, which will be crucial in maximizing AI benefits for clinical toxicology. This narrative review highlights the emerging applications of AI in Africa, emphasizing the need for collaborative efforts to ensure equitable and effective implementation. However, its adoption is limited by financial constraints, scarce datasets, weak infrastructure, and ethical concerns.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100901"},"PeriodicalIF":1.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933369","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":"Acute non-traumatic abdominal pain presenting to emergency unit of a university teaching hospital in Rwanda.","authors":"Faustin Turamyimana, Jean Paul Dushime, Appolinaire Manirafasha, Deninson Martin Kyle, Doris Lorette Uwamahoro, Francois Regis Twagirumukiza, Pascal Mugemangango, Seraphina Negash, Anna Dobbins","doi":"10.1016/j.afjem.2025.100895","DOIUrl":"10.1016/j.afjem.2025.100895","url":null,"abstract":"<p><strong>Background: </strong>Emergency Department consultation for non-traumatic abdominal pain is one of the common reasons for presentation; accounting for 5.76-20 % of all Emergency Department consultations. Research about non-traumatic abdominal pain is limited in Rwanda and East Africa. This study aims to understand the clinical profile and outcomes of non-traumatic abdominal pain at the largest tertiary hospital in Rwanda.</p><p><strong>Methodology: </strong>A prospective cohort study of patients presenting with non-traumatic abdominal pain was undertaken.</p><p><strong>Results: </strong>During the 5-month study, two hundred sixty-one patients were enrolled in the study. The mean age was 39.7 years and male patients accounted for 57.5 % of the cohort. Nearly half of the cohort were triaged as a high priority (11.1 % red, 31.8 % orange), and 42.9 % were hemodynamically unstable at or shortly after presentation. More than half of the patients (57 %) had surgical conditions, including 40.2 % who underwent surgery and 17.6 % who were treated conservatively. The most common diagnoses were intestinal obstruction (25.7 % of all cases) and hollow viscus perforation (18.8 %). Mortality was 11.1 %, and the mean hospital length of stay was 9.1 days. Predicting factors for death outcome (p-value<0.05) were advanced age, altered mental status, jaundice at presentation, peritonitis, known malignancy, and acute kidney injury.</p><p><strong>Conclusion: </strong>Abdominal pain is a common presenting problem, accounting for approximately 1 in 10 patients presenting to a tertiary care centre in Rwanda, with 2 in 5 patients requiring operative interventions. Identification of potential risk factors for mortality requires a multidisciplinary approach to decrease mortality and morbidity.</p>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"100895"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adrenaline vs noradrenaline: Equity, context, and the realities of best practice.","authors":"Clint Hendrikse","doi":"10.1016/j.afjem.2025.100891","DOIUrl":"10.1016/j.afjem.2025.100891","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"100891"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A silent epidemic: Exploring the clinico-epidemiological impact of explosion and gunshot injuries in the emergency department of a tertiary hospital in Somalia","authors":"Hussein Hassan Mohamed ,&nbsp;Hassan Adan Ali Adan ,&nbsp;Selim Turfan ,&nbsp;Murat Aysin ,&nbsp;Mohamed Farah Yusuf Mohamud","doi":"10.1016/j.afjem.2025.100898","DOIUrl":"10.1016/j.afjem.2025.100898","url":null,"abstract":"<div><h3>Background</h3><div>Mass casualty incidents, such as explosions and gunshot wounds (GSWs), pose significant public health challenges. This study analyzes the clinico-epidemiological profile and outcomes of patients with explosive injuries and GSWs in Somalia.</div></div><div><h3>Method</h3><div>A retrospective analysis was conducted on 225 patients admitted to the Emergency Department of a tertiary hospital in Somalia between January and December 2021. Data collected included injury type, anatomical distribution, demographics, hospital admissions, and outcomes.</div></div><div><h3>Results</h3><div>Of the 225 explosion and GSW injuries, explosive injuries accounted for 58 %, while GSWs made up 42 %. The majority of patients were male (85.3 %), with 89.5 % in the GSW group and 82.3 % in the explosion group. More than half(58.7 %) of the patients were aged 18 to 30 years, with 59.2 % in the explosion group and 57.9 % in the GSW group. Anatomical analysis revealed that head injuries were most common(21 %), particularly in explosion cases, as well as higher rates of head (26.2 %), maxillofacial(7.7 %), and lower-limb injuries (12.3 %) compared to GSW patients. Some 21.7 % of patients were discharged from ED, 19 % admitted to ICU and an inpatient death rate of 12.9 %, including three patients (1.3 %) who died in the Emergency Department, all from the explosion injury group.</div></div><div><h3>Conclusion</h3><div>The rising incidence of traumatic injuries necessitates a multifaceted approach, including enhanced emergency response systems and public health initiatives. This data serves as a call to action for healthcare providers and policymakers to prioritize the management and prevention of explosion and gunshot-related injuries in Somalia.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100898"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912852","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":"Exhaled carbon monoxide concentration in correlation to clinical parameters to detect carbon monoxide poisoning among fire victims in an Egyptian Emergency Department","authors":"Ahmed KhalafAllah Mohamed ,&nbsp;Amany Atef ElKareem Abouzeid ,&nbsp;Mohamed Galal Morsi ,&nbsp;Amira Ismail Alamelden ,&nbsp;Aisha Safwat Saif Eldeen ,&nbsp;Marwa Mohammed Fouad","doi":"10.1016/j.afjem.2025.100899","DOIUrl":"10.1016/j.afjem.2025.100899","url":null,"abstract":"<div><h3>Background</h3><div>Fire victims are at risk of inhaling potentially toxic gases contained within smoke. Carbon monoxide gas (CO) is the most significant and may contribute to morbidity and mortality of patients. Early detection of CO poisoning by measuring exhaled CO in correlation to the clinical parameters suggestive of CO poisoning in mild to moderate burn injuries among fire victims was our aim.</div></div><div><h3>Methods</h3><div>Case-control study involving 40 fire victims presenting with flame burn injuries within 24 h who were assessed for CO poisoning. Control group involved 40 healthy nonsmoker individuals. Exhaled CO level was measured using a CO Check Pro Device, which was correlated to clinical parameters suggestive of CO poisoning in addition to elevated lactate level.</div></div><div><h3>Results</h3><div>The median exhaled CO level was significantly higher in cases compared to controls (4.5 ppm vs. 1.5 ppm, <em>p</em> &lt; 0.001). Among fire victims, 37.5 % had mild CO poisoning. Significant positive correlations were found between exhaled CO levels and lactate levels (<em>r</em> = 0.54, <em>p</em> &lt; 0.001), duration of flame exposure (<em>r</em> = 0.59, <em>p</em> &lt; 0.001), and crowding index (<em>r</em> = 0.49, <em>p</em> = 0.009).</div></div><div><h3>Discussion</h3><div>Exhaled carbon monoxide levels is a valuable diagnostic tool for the early detection of CO poisoning among fire victims with mild to moderate burn injuries. The correlation between elevated exhaled CO levels and clinical symptoms, alongside serum lactate level, supports their use as reliable indicator of CO exposure in fire victims, thereby optimizing emergency response strategies.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100899"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917927","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":"Effects of a pilot simulation training on interdisciplinary closed-loop communication and time to critical actions at an emergency centre in Burundi","authors":"Eric Arnold ,&nbsp;Patricial Bulakali ,&nbsp;Elizabeth Burner ,&nbsp;Taylor Burkholder ,&nbsp;Carlan Wendler","doi":"10.1016/j.afjem.2025.100893","DOIUrl":"10.1016/j.afjem.2025.100893","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency medicine simulation is an effective training modality in both high and low resource settings. We describe the authors’ experiences conducting a four-week interdisciplinary, <em>in situ</em>, simulation training series at an emergency centre in Burundi.</div></div><div><h3>Methods</h3><div>Training emphasized effective closed loop communication, early airway, breathing, and circulation assessment, as well as time to vital signs, IV placement, and oxygen administration when appropriate. Six doctor-nursing teams participated in four training sessions as well as pre- and post-test simulation cases which were graded by an independent evaluator.</div></div><div><h3>Results</h3><div>The training resulted in a statistically significant improvement in closed loop communication as well as notable narrowing in standard deviation of times to critical actions after the training intervention. Although the small sample size and large variation of data limited their statistical significance, these results may indicate a short-term benefit towards early assessment, management and team communication when simulating management of critical patients. Additionally, we found that interdisciplinary, <em>in situ</em> simulation was a safe and likely beneficial option for training and team building in a resource-limited emergency centre.</div></div><div><h3>Conclusion</h3><div>While this pilot study establishes feasibility of low-cost, interdisciplinary emergency simulation training in resource-limited settings, further research is needed to establish educational effectiveness on quality-of-care measures and its generalizability to other contexts prior to implementing similar trainings.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100893"},"PeriodicalIF":1.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908579","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":"Factors contributing to extended length of stay in the emergency department and potential strategies for improving patient flow in a central hospital in the Gauteng Province, South Africa","authors":"L. Motimele ,&nbsp;V. Lalloo ,&nbsp;T. Sefala ,&nbsp;A. Engelbrecht ,&nbsp;L. Majake-Mogoba ,&nbsp;D. Basu","doi":"10.1016/j.afjem.2025.100896","DOIUrl":"10.1016/j.afjem.2025.100896","url":null,"abstract":"<div><h3>Background</h3><div>Length of stay (LOS) is an integral part of inpatient care in hospitals, particularly in Emergency Departments (EDs). It is an essential performance indicator for the National Indicator Data Set in South Africa. Multiple studies have indicated a correlation between an increased LOS and worse patient outcomes in a variety of acute medical conditions. The study aims to establish the key factors of LOS in the ED at a central hospital in the Gauteng Province of South Africa.</div></div><div><h3>Methodology</h3><div>A cross-sectional study was conducted over seventeen months (Aug 2023 to Dec 2024) based on 2927 entries of patients admitted at the ED for more than 48 hours. No intervention was done as part of this study.</div></div><div><h3>Results</h3><div>The median LOS was 2.81 days (IQR: 2-3) with a minimum of 2 days and a maximum of 12 days. A regression analysis demonstrated that the most significant determinants for prolonged LOS were gender and disease group of boarded patients awaiting ward transfer.Significant differences (p &lt; 0.001) in the LOS between clinical disciplines were noted, with medical (45%) and surgical departments (46%) accounting for most boarding patients compared to all other clinical disciplines.</div></div><div><h3>Conclusions</h3><div>Data demonstrated that 80% of patients in the ED wait an average of 3 days before transfer into the wards. This extended ALOS in the ED has consequences for patient outcomes and the quality of healthcare provided. Based on the findings of this study, strategies to improve patient flow are essential in facilitating timeous discharge from wards and to prioritise the forward flow of patients waiting in ED.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100896"},"PeriodicalIF":1.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908580","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":"Barriers and facilitators to providing facility-based emergency care in Addis Ababa, Ethiopia: A mixed methods study","authors":"Demelash Ataro Ambushe ,&nbsp;Lee A Wallis ,&nbsp;Willem Stassen","doi":"10.1016/j.afjem.2025.100894","DOIUrl":"10.1016/j.afjem.2025.100894","url":null,"abstract":"<div><h3>Background</h3><div>Illness and injury that may be impacted by emergency care account for over half of all deaths in low- and middle-income countries. However, studies show that Emergency Units in these countries face numerous barriers to facility-based emergency care. Yet, data on the barriers to facility-based emergency care in Ethiopia and some reasons for these barriers have not been established, and this study aimed to bridge this gap.</div></div><div><h3>Methods</h3><div>The study followed an explanatory, sequential mixed-methods design. In phase one, a cross-sectional evaluation of five hospitals was done using WHO's Hospital Emergency Unit Assessment Tool (HEAT). A purposive sampling technique was used to select the hospitals, and a convenience sampling technique was used to determine the participants. Quantitative data were analysed descriptively. In phase two, in-depth key informant interviews were done. Qualitative data were analysed using content analysis. Finally, the integration of the results from the two phases was done.</div></div><div><h3>Results</h3><div>We surveyed 38 participants in phase one and interviewed 15 in phase two. The most apparent findings to emerge from the quantitative phase of the study were the participants from across the hospitals reported the absence of equipment (<em>n</em> = 119) and stock out of supplies (<em>n</em> = 47) as the two most common barriers. Similarly, the most common reasons reported for not performing diagnostic services across all facilities were absent equipment (<em>n</em> = 128) and stock out of supplies (<em>n</em> = 99). The most important barriers identified from the qualitative phase of the study included a shortage or lack of resources, and inadequate management of resources. The facilitators identified for the procedures they could perform were the availability of essential resources, including trained human resources, good management practices, and coordination among the staff.</div></div><div><h3>Conclusion</h3><div>Overall, the tertiary hospitals in Addis Ababa reported they could perform the majority of the diagnostic and therapeutic procedures in the emergency units despite the interruption of some of the services. Some of the services' complete absence or interruptions were due to several barriers. Both existing literature and the findings of this study indicate the EUs of Ethiopian hospitals need further investment to improve resource availability and proper management of available resources.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100894"},"PeriodicalIF":1.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827125","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}