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
AuthorBitter, Cindy Carol
Nelson, Sara W
AffiliationUniv Arizona, Coll Med, Dept Emergency Med
Univ Arizona, Dept Hlth Promot Sci, Mel & Enid Zuckerman Coll Publ Hlth
MetadataShow full item record
PublisherBMJ PUBLISHING GROUP
CitationBitter CC, Rice B, Periyanayagam U, et al 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. BMJ Open 2018;8:e019024. doi: 10.1136/bmjopen-2017-019024
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AbstractObjectives 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.
NoteOpen access journal.
VersionFinal published version
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