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 |
Journal | BMJ Open |
Volume | 8 |
Issue | 2 |
Pagination | e019024 |
Date Published | 2018 02 24 |
ISSN Number | 2044-6055 |
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 |
Abstract | 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. |
DOI | 10.1136/bmjopen-2017-019024 |
Alternate Journal | BMJ Open |
PubMed ID | 29478017 |
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.
Faculty Reference:
Bradley A. Dreifuss, MD
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