|Title||What resources are used in emergency departments in rural sub-Saharan Africa? A retrospective analysis of patient care in a district-level hospital in Uganda.|
|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||Bitter CCarol, Rice B, Periyanayagam U, Dreifuss B, Hammerstedt H, Nelson SW, Bisanzo M, Maling S, Chamberlain S|
|Date Published||2018 02 24|
|Keywords||Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Drug Prescriptions, Emergency Service, Hospital, Female, Health Resources, Humans, Infant, Infant, Newborn, Longitudinal Studies, Male, Middle Aged, Point-of-Care Systems, Radiology, Retrospective Studies, Rural Population, Seasons, Uganda, Young Adult|
OBJECTIVES: To determine the most commonly used resources (provider procedural skills, medications, laboratory studies and imaging) needed to care for patients.
SETTING: A single emergency department (ED) of a district-level hospital in rural Uganda.
PARTICIPANTS: 26 710 patient visits.
RESULTS: Procedures were performed for 65.6% of patients, predominantly intravenous cannulation, wound care, bladder catheterisation and orthopaedic procedures. Medications were administered to 87.6% of patients, most often pain medications, antibiotics, intravenous fluids, antimalarials, nutritional supplements and vaccinations. Laboratory testing was used for 85% of patients, predominantly malaria smears, rapid glucose testing, HIV assays, blood counts, urinalyses and blood type. Radiology testing was performed for 17.3% of patients, including X-rays, point-of-care ultrasound and formal ultrasound.
CONCLUSION: This study describes the skills and resources needed to care for a large prospective cohort of patients seen in a district hospital ED in rural sub-Saharan Africa. It demonstrates that the vast majority of patients were treated with a small formulary of critical medications and limited access to laboratories and imaging, but providers require a broad set of decision-making and procedural skills.
|Alternate Journal||BMJ Open|
|PubMed Central ID||PMC5855402|
What resources are used in emergency departments in rural sub-Saharan Africa? A retrospective analysis of patient care in a district-level hospital in Uganda.
Bradley A. Dreifuss, MD