African Journal of Emergency Medicine最新文献

{"title":"Characteristics and outcomes of geriatric injuries presenting to an urban emergency department in Ghana","authors":"Hussein A Yakubu ,&nbsp;Jonathan Boakye-Yiadom ,&nbsp;Richmond O Marfo ,&nbsp;Rockefeller Oteng ,&nbsp;George Oduro","doi":"10.1016/j.afjem.2025.05.007","DOIUrl":"10.1016/j.afjem.2025.05.007","url":null,"abstract":"<div><h3>Introduction</h3><div>The elderly population is rapidly increasing in sub-Saharan Africa. Yet, their trauma care needs are often overlooked, and the epidemiology of their injuries remains poorly understood. This study aimed to describe the characteristics and outcomes of injuries in elderly patients treated at an urban emergency department (ED) in Ghana. Additionally, it aimed to identify the predictors of mortality that require focused attention.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional survey of patients ≥ 60 years presenting with traumatic injuries between November 2021 and March 2022 was conducted at the ED of Komfo Anokye Teaching Hospital (KATH), Ghana’s second-largest hospital. Eligible patients were identified upon arrival in triage. Following initial resuscitation, trained research assistants obtained informed consent and collected patient data, including sociodemographic information, comorbidities, injury characteristics, and in-patient complications.</div></div><div><h3>Results</h3><div>Of the 2242 ED patients evaluated, 101 (4.7 %) were included. The median age was 69 years and sex distribution was even. Hypertension (48.5 %) was the most prevalent comorbidity. Falls (52.5 %) and motor vehicle collisions (40.6 %) were the predominant injury mechanisms, and isolated lower extremity injuries (39.6 %) were the most common. The majority of injuries were mild (65.4 % had an Injury Severity Score &lt; 9). Venous thromboembolism was the most common in-patient complication. Median length of stay was 6 days, but patients with complications stayed longer. The overall hospital mortality rate was 11.9 %. Predictors of mortality were triage score, admission Glasgow Coma Score, admission pulse rate and Kampala Trauma Score.</div></div><div><h3>Conclusion</h3><div>Geriatric injuries constitute a small fraction of trauma admissions in this hospital. Triage score, Glasgow Coma Scale, pulse rate and Kampala Trauma Score predicted mortality and could form the basis for a simple screening protocol in low-resource EDs.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100883"},"PeriodicalIF":1.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253738","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":"Differences in quality indicators of emergency care between on- and off-hours at Ghanaian district hospitals","authors":"Paa Forson ,&nbsp;Richard Owusu ,&nbsp;George Oduro ,&nbsp;Peter Donkor ,&nbsp;Charles Mock","doi":"10.1016/j.afjem.2025.05.004","DOIUrl":"10.1016/j.afjem.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Quality of off-hours care (nights, weekends) for many emergency conditions frequently proves inadequate. Most studies on this topic are from high-income countries. Given existing resource restrictions in low- and middle-income countries, it is especially relevant to know how care is impacted during off-hours, when resources are usually less. We assessed differences in quality indicators of emergency care between on- and off-hours at two district hospitals.</div></div><div><h3>Methods</h3><div>In this prospective cohort study conducted from June 2021 to May 2023, patients presenting to the emergency unit between 8 AM and 8 PM on weekdays were categorized as presenting during on-hours. Those presenting between 8 PM and 8 AM or anytime on weekends were considered off-hours. Completion of 16 quality indicators was compared between patients who received care during on- and off-hours.</div></div><div><h3>Results</h3><div>Data were gathered on 7831 patients: 5019 (64.1 %) presenting during on-hours and 2812 (35.9 %) during off-hours. Overall achievement of quality indicators ranged from 27.1 % (recording GCS) to 98.3 % (documentation of diagnosis). Twelve indicators were performed in &lt;80 % of patients. Four indicators were performed more often during on-hours: primary survey for trauma patients; blood glucose; documentation of diagnosis; and Glasgow Coma Scale. Three indicators were performed more often during off-hours: splinting of long-bone fractures; analgesics given to patients reporting pain; and recording of complete initial vital signs. Although there were significant differences in seven indicators, differences were small (&lt;10 %) in six.</div></div><div><h3>Conclusion</h3><div>There were limited differences in performance of quality indicators between on- and off-hours, indicating a general consistency of quality of care across daily and weekly cycles. However, most indicators were performed in &lt;80 % of patients. Monitoring of quality indicators of emergency care should be done more consistently as a way to standardise care and improve patient outcomes.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100880"},"PeriodicalIF":1.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204916","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":"Perceptions, availability and use of vasopressors for septic shock in emergency care settings in Tanzania","authors":"Said Kilindimo ,&nbsp;Forrest Turner ,&nbsp;Raya Musa ,&nbsp;Collin Russell ,&nbsp;Adeline Dozois ,&nbsp;Hendry Sawe","doi":"10.1016/j.afjem.2025.05.003","DOIUrl":"10.1016/j.afjem.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis carries a disproportionately high mortality in Sub-Saharan Africa. Current international guidelines for management of septic shock advocate for initial fluid resuscitation followed by vasopressors if there is ongoing concern for hypoperfusion. Emerging data suggest patients in sub-Saharan Africa who receives large fluid boluses may have increased mortality and thus earlier initiation of vasopressors may have clinical benefit. Little data exists on the perceptions, availability and use of vasopressors in Tanzania, which may impact the feasibility of this strategy. We aimed to describe the perception, availability and use of vasopressor in Tanzanian emergency care settings, including its barriers.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional web-based survey among clinicians and nurses from 19 different hospitals throughout Tanzania (national, zonal, regional and district hospitals). Collected data was kept by the principal investigator on a password encrypted computer whereby descriptive statistics were used to summarize the results.</div></div><div><h3>Results</h3><div>Sixty-five healthcare providers completed the survey of whom the majority 53 (81.5 %), work in the emergency medicine department and 50 (76.9 %) reported treating at least one patient with septic shock per week. However, three quarters of respondents from district hospitals and nearly half of those from regional hospitals had access to vasopressors in &lt;50 % of the time. The most common reported barriers to vasopressor use were lack of availability (50.8 %), and lack of comfort or knowledge (43.1 %). Overall, most respondents perceived that vasopressor use is generally safe and helpful for treating septic shock.</div></div><div><h3>Conclusions</h3><div>Nearly all Tanzanian healthcare providers in emergency care settings reported that they had limited access to vasopressors to treat septic shock, as it was not consistently available. In addition to unavailability, lack of knowledge on vasopressor use was also reported as barrier. Our findings suggest that ensuring availability of vasopressors and education in the use thereof would improve sepsis care in Tanzanian hospitals.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100879"},"PeriodicalIF":1.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195262","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":"Time delays in emergency stroke care in a low-resource referral hospital in Ghana","authors":"Hussein A Yakubu ,&nbsp;Richmond O Marfo ,&nbsp;Jonathan Boakye-Yiadom ,&nbsp;Freda M Aidoo ,&nbsp;Fred S Sarfo ,&nbsp;Rockefeller A Oteng","doi":"10.1016/j.afjem.2025.05.006","DOIUrl":"10.1016/j.afjem.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Patients in sub-Saharan Africa face significant delays in receiving appropriate stroke care, which negatively impacts outcomes. This study aimed to quantify the time delays in acute stroke care at the Komfo Anokye Teaching Hospital (KATH) and determine the effect on mortality.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of prospectively collected data on patients ≥ 18 years with Computed Tomography (CT) scan-confirmed stroke treated at KATH’s adult emergency department (ED) from November 2021 to March 2022. Patients were initially enrolled in a pilot stroke registry by trained research assistants, who documented relevant time points in their care. Patient outcome (dead or alive) was determined at time of hospital discharge and three months post-discharge. Data was analyzed using STATA™ version 16. The median times from stroke onset to ED arrival, physician evaluation, CT scan imaging, and treatment were measured and the relationship with mortality determined.</div></div><div><h3>Results</h3><div>Eighty-six patients with confirmed stroke were analyzed, comprising 40 males and 46 females. Ages ranged between 29 and 86 years, with mean of 57.4 years (SD 14.3). The median time from stroke onset to arrival at KATH ED was 35.3 h (IQR: 12.3–79.5). The median time from ED arrival to first physician evaluation was 1.3 h (IQR: 0.5–2.6); to CT imaging was 14.1 h (IQR: 4.3–40.8); and to antiplatelet treatment (for ischemic stroke) was 31.1 h (IQR: 16.1–42.5). The cumulative mortality rates at three months post-discharge were 8.7 % for patients who arrived at KATH’s ED within 4 h of symptom onset, 43.5 % for those arriving between 4 and 24 h, and 47.8 % for those arriving after 24 h, <em>p</em> = 0.036.</div></div><div><h3>Conclusion</h3><div>Significant delays occurred in all stages of stroke care at KATH’s ED. Improving stroke education and implementing contextually appropriate stroke codes can enable early patient presentations, improve intervention times, and reduce mortality rates.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100882"},"PeriodicalIF":1.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189686","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":"Presentation and management of snakebite envenomation at a District Hospital in the north-east of South Africa","authors":"Matamba Jean Benoit Kabeya ,&nbsp;Darryl Wood ,&nbsp;Peter Hodkinson","doi":"10.1016/j.afjem.2025.05.002","DOIUrl":"10.1016/j.afjem.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Snakebites have been recognised as a neglected tropical disease by the World Health Organization and remain a potentially preventable cause of morbidity around the world, particularly in Africa. South Africa (SA) has a well-documented prevalence of snakebites, and there has been a recent surge in attention on snakebite due to dwindling antivenom stocks. uMkhanyakude District in the far northeast of SA has one of the highest incidences of snakebite and uses more antivenom than elsewhere in SA, and the impact of antivenom shortages and the high prevalence of disease has not been assessed recently.</div></div><div><h3>Methods</h3><div>A descriptive, retrospective, observational study was undertaken to describe victims of snakebites presenting from 1 September 2019 to 31 August 2022 to a district hospital, Mosvold Hospital. Data were manually extracted from patients’ medical records. Information about demographics, clinical presentations, treatments and outcomes was collected and analysed.</div></div><div><h3>Results</h3><div>A total of 155 snakebite cases presented, with an incidence rate of 58 snakebite cases per 100 000 people per year. Most patients were young, with a median age of 19 years (range 0–94 years), and most bites occurred outdoors (75/155, 48.4 %). Patients were most often bitten on the lower limbs (107/155, 69.0 %), and most presented with minimal swelling (117/155, 75.5 %). Antivenom was administered to 33 patients (33/155, 21.3 %), and 24 (24/33, 72.7 %) of those who received antivenom experienced some form of post-antivenom reaction. Three patients died during their hospital stay, resulting in a mortality rate of 1.2 deaths per 100 000 people per year. Antivenom shortages contributed to the outcomes of several patients.</div></div><div><h3>Conclusion</h3><div>Cytotoxic snakebites are a not infrequent presentation, many requiring admission, antivenom and subsequent management. Emergency personnel need to be familiar with local protocols for snakebite management, and have the resources to manage severe envenomation, including access to antivenom. Expanding knowledge and education about snakebites provided to community members might also improve outcomes and prevent bites.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100878"},"PeriodicalIF":1.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169700","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":"Vehicle extrication in road traffic crashes: a descriptive analysis of an advanced medical rescue service in South Africa","authors":"Naseef Abdullah ,&nbsp;Jaydon Rose ,&nbsp;Egnall Brown ,&nbsp;Heike Geduld","doi":"10.1016/j.afjem.2025.04.003","DOIUrl":"10.1016/j.afjem.2025.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Road Traffic Crashes (RTCs) represent a significant global health challenge, with a disproportionate burden on low- and middle-income countries. Vehicle extrication is a critical Emergency Medical Service (EMS) intervention enabling early assessment and treatment of entrapped patients but remains understudied in resource-limited settings despite its potential impact on patient outcomes. This study describes the RTC extrication burden managed by a public sector EMS in the Western Cape, South Africa.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of Computer-Aided-Dispatch (CAD) and a paper-based rescue case record data related to the extrication practises of 97 Advanced Medical Rescuers stationed across 25 rescue stations throughout the Western Cape of South Africa. Standard descriptive statistical procedures were applied to all variables.</div></div><div><h3>Results</h3><div>Of 2,587,979 EMS activations during the study period, 23,899 (0.9 %) required specialised medical rescue activations, and 11,699 (0.5 %) were for transport-related emergencies. Of these, 719 (6.1 %) cases necessitated vehicle extrication. Light motor vehicles accounted for most extrications (78.2 %, <em>n</em> = 562), while heavy motor vehicles showed higher proportional extrication rates (127.5 vs. 75.8 extrications per 1,000 RTCs). Peak rescue activations occurred between 08h00 and 20h00 (11.9 %, <em>n</em> = 1,388). The predominant extrication techniques were vehicle stabilisation (24.9 %, <em>n</em> = 501), third-door conversion (23.9 %, <em>n</em> = 482 ), and dashboard lift (13.9 %, <em>n</em> = 282). Most patients (83.1 %, <em>n</em> = 24,588) presented with routine (green) or non-urgent (yellow) acuity, though rural areas exhibited a higher proportion of high-acuity cases</div></div><div><h3>Conclusion</h3><div>This first comprehensive analysis of the RTC extrication burden in a South African province reveals significant spatial and temporal variations in rescue needs and techniques. Our findings provide valuable extrication-related data to inform targeted training programs, standardised extrication protocols, and strategic resource allocation to enhance EMS capabilities in resource-limited settings. These insights provide a foundation for workforce planning and specialised training to improve outcomes for entrapped RTC patients in similar contexts.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 621-627"},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912895","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 associated with mortality among patients with penetrating non-compressible torso hemorrhage in South Africa: A retrospective cohort study","authors":"Smitha Bhaumik ,&nbsp;Adane F. Wogu ,&nbsp;Lani Finck ,&nbsp;Maria Jamison ,&nbsp;Mengli Xiao ,&nbsp;Julia Finn ,&nbsp;Hendrick Lategan ,&nbsp;Janette Verster ,&nbsp;Shaheem de Vries ,&nbsp;Craig Wylie ,&nbsp;Lesley Hodson ,&nbsp;Mohammet Mayet ,&nbsp;Leigh Wagner ,&nbsp;L'Oreal Snyders ,&nbsp;Karlien Doubell ,&nbsp;Elaine Erasmus ,&nbsp;George Oosthuizen ,&nbsp;Christiaan Rees ,&nbsp;Steven G Schauer ,&nbsp;Julia Dixon ,&nbsp;Nee-Kofi Mould-Millman","doi":"10.1016/j.afjem.2025.02.002","DOIUrl":"10.1016/j.afjem.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-compressible torso haemorrhage (NCTH), resulting from penetrating trauma to the chest, abdomen, or pelvis, places patients at high risk of death. The objectives of this study are to characterize the injury profile of patients with penetrating NCTH who receive care within a tiered public trauma system in South Africa and to identify factors associated with mortality.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of clinical data collected from Sept-2021 through Dec-2023 across 6 hospitals, 4 ambulance bases, and 2 mortuaries in the Western Cape Province that form a cohesive trauma referral pathway. The study included patients age ≥18 years with penetrating NCTH who arrived at the hospital within 3 h and received blood products within 6 h of injury. NCTH was defined as Abbreviated Injury Scale (AIS) ≥ 2 to chest, abdomen or pelvis, with a systolic blood pressure ≤ 100 mm Hg. Data were analysed using multivariable logistic regression and Cox proportional hazards modelling.</div></div><div><h3>Results</h3><div>There were 202 patients with penetrating NCTH; median age was 29 years, 94 % male, injured by stab wounds (66 %) and gunshot wounds (31 %). Most patients (85 %) sustained injuries to the chest, 33 % to the abdomen, and 1.5 % to the bony pelvis. In a multivariable logistic regression model, elevated Triage Early Warning Score (TEWS ≥7) (OR 4.45, 95 % CI 1.58–13.90), elevated New Injury Severity Score (NISS &gt;25) (OR 4.35, 95 % CI 1.45–16.30), anatomic injury to the abdomen/pelvis (OR 2.76, 95 % CI 1.03–7.74), and receipt of acute airway intervention (OR 4.97, 95 % CI 1.94–13.20) were significantly associated with 7-day in-hospital mortality.</div></div><div><h3>Conclusion</h3><div>Among patients with penetrating injuries to the torso, high triage scores, high injury severity, early airway interventions, and penetrating abdominal trauma were associated with elevated mortality risk.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 613-620"},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900330","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":"Knowledge, attitude, practice, and associated factors of physicians towards cardiopulmonary resuscitation at a tertiary hospital in Ethiopia","authors":"Natan Mulubrhan Alemseged ,&nbsp;Gobena Tesfaye ,&nbsp;Abera Admas","doi":"10.1016/j.afjem.2025.04.002","DOIUrl":"10.1016/j.afjem.2025.04.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiopulmonary resuscitation (CPR) is performed on victims of cardiac arrest. It is important for health professionals to successfully perform these lifesaving skills. This study aimed to assess the CPR knowledge, attitude, practice, and associated factors of physicians working at Hiwot Fana Comprehensive Specialized Hospital Eastern Ethiopia.</div></div><div><h3>Methods</h3><div>An institutional-based cross-sectional study was implemented. A stratified random sampling technique was used. A self-administered questionnaire and a manikin was used to assess CPR skills. The results are presented in the text, tables, and graphs. Multivariate logistic regression was used to identify factors associated with levels of competency. The adjusted odds ratio with the corresponding 95 % confidence interval was calculated to show the strength of the association.</div></div><div><h3>Results</h3><div>This study revealed that 63.7 % [95 % CI 57 % -71 %] of the physicians had good knowledge, and their overall competency in CPR was found to be 63 % [95 % CI 54 % - 72 %]. They have a positive attitude regarding the importance of CPR and a willingness to provide CPR. Physicians who took resuscitation training (adjusted odds ratio 11.8 [4.29–32.42]) and a specialist (adjusted odds ratio 7.99 [1.87–34.27]) were more competent than their counterparts.</div></div><div><h3>Discussion</h3><div>The results demonstrate suboptimal CPR competency among physicians’ representatives at a tertiary hospital in Eastern Ethiopia. Taking CPR training and being a specialist were found to have an effect on being competent in CPR. Participants reported positive attitudes toward doing CPR. A system of regular, updated refresher training for physicians should be implemented to maintain CPR competencies. Hospitals should also be equipped with materials and drugs needed for CPR.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 607-612"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892374","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":"The evolving role of paramedicine educators: A scoping review","authors":"Judy Sheahan ,&nbsp;Richelle Duffy ,&nbsp;Charmaine Cunningham","doi":"10.1016/j.afjem.2025.04.001","DOIUrl":"10.1016/j.afjem.2025.04.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Growing responsibility and changes to paramedicine and prehospital care have led to rapid developments in paramedicine education. Despite educational requirements at increasingly advanced levels, it remains unclear how academia has responded to these changes and if they're developing the requisite skills and knowledge.</div></div><div><h3>Methods</h3><div>A scoping review was undertaken to understand the present role of paramedicine educators and how they've adapted to the evolution of paramedicine education worldwide. Data searches were performed across eight electronic databases, six paramedicine journals, grey literature, and included sources reference lists.</div></div><div><h3>Results</h3><div>The four-staged search strategy revealed 1,738 sources, of which 32 remained for final synthesis. In general, there was a lack of contemporary research examining the role of the paramedicine educator despite changes to Higher Education provision and function of paramedics. Noteworthy was the absence of articles from Africa, South America, and major parts of Europe, highlighting the need for development in these regions. There is a lack of clear role descriptions or definitions for paramedicine educators. Inconsistencies were highlighted in entry criteria and progression routes across paramedicine academia globally, emphasising the importance of support for transitioning and established paramedicine educators.</div></div><div><h3>Discussion</h3><div>These findings have important implications for Higher Education. Professional demands are on the rise, creating a need to introduce clearly defined roles for paramedicine educators to provide clarity in expectations and increase confidence. The changing landscape of care provision in paramedicine from the historic emergency care focussed model to a more autonomous and inclusive sphere of out-of-hospital care, provides an ideal opportunity to progress and shape the identity of the paramedicine educator.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 595-601"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839122","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 trauma care training in undergraduate medical education programs in Uganda; A cross-sectional survey of final year medical students","authors":"Nankabirwa Victoria ,&nbsp;Guma Isaac ,&nbsp;Kabunga Jonathan ,&nbsp;Bigogo H Charles ,&nbsp;Navume Deborah Esther ,&nbsp;Mwanje T Kintu ,&nbsp;Nakiwere Elizabeth ,&nbsp;Chelimo Gerald ,&nbsp;Lemi Edward Nelson ,&nbsp;Kanyike A Marvin ,&nbsp;Francis M. Mwaka ,&nbsp;Law J Tyler ,&nbsp;Annet N. Alenyo ,&nbsp;Bulamba Fred","doi":"10.1016/j.afjem.2025.01.003","DOIUrl":"10.1016/j.afjem.2025.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma is one of the leading causes of death and long-term disability globally. In sub-Saharan Africa, the number of specialist emergency care personnel is inadequate and task shifting is common. We aimed to assess the variation in knowledge on acute trauma care, and self-perceived confidence in performing lifesaving skills amongst final year medical students in Uganda.</div></div><div><h3>Methods</h3><div>We conducted a multi-institutional, cross-sectional survey among final year medical students who had just completed their training from eight medical schools in Uganda. We assessed knowledge using a 25 standardized multiple-choice question test adopted from a previous study, and self-reported confidence in perfuming lifesaving skills, scored on a 5-Point Likert scale.</div></div><div><h3>Results</h3><div>Some 246 (88.5 %) participants responded to the survey and 241 provided complete data. The mean knowledge score was 58.9 % (SD; 12.4) with a mean variation ratio of 0.36 (SD; 0.17). The mean self-perceived confidence score of the participants was 3.8 (SD; 1.0) with relatively high scores in interpretation of radiological investigations (mean 4.2, SD; 0.9) and patient assessment (mean 4.1, SD; 0.9), and lower scores in management of different categories of trauma patients (mean 3.8, SD; 1.0) and performing life-saving procedures (mean 3.5, SD; 0.9). Only three institutions had emergency medicine physicians, with one at each institution, and 146 (60.6 %) of participants received no dedicated trauma training.</div></div><div><h3>Conclusion</h3><div>Final year medical students exiting training in Uganda had variable knowledge in acute trauma care and intermediate self-perceived confidence in performing lifesaving skills. Training programs need to standardize and strengthen acute trauma training and provide specialists and resources essential for trauma training at undergraduate level.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 602-606"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844774","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}