RT Journal Article
SR Electronic
T1 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
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e019024
DO 10.1136/bmjopen-2017-019024
VO 8
IS 2
A1 Bitter, Cindy Carol
A1 Rice, Brian
A1 Periyanayagam, Usha
A1 Dreifuss, Bradley
A1 Hammerstedt, Heather
A1 Nelson, Sara W
A1 Bisanzo, Mark
A1 Maling, Samuel
A1 Chamberlain, Stacey
YR 2018
UL http://bmjopen.bmj.com/content/8/2/e019024.abstract
AB 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.