An analysis of the clinical practice of emergency medicine in public emergency departments in Kenya

Type Journal Article - Emergency Medicine Journal
Title An analysis of the clinical practice of emergency medicine in public emergency departments in Kenya
Author(s)
Volume 29
Issue 6
Publication (Day/Month/Year) 2011
Page numbers 473-476
URL http://globalhealth.uic.edu/wp-content/uploads/2014/04/journal-club-3.pdf
Abstract
Objectives To describe the case mix, interventions,
procedures and management of patients in public
emergency departments (ED) in Kenya.
Methods An observational study over 24 h, of patients
who presented to 15 public ED during the 3-month
period from 1 October to 31 December 2010. The study
was conducted across Kenya in two national referral
hospitals, five secondary level hospitals and eight
primary level hospitals. All patients presenting alive to
the ED during the 24-h study period that were seen by
a doctor or clinical officer were included in the study. A
data collection form was completed by the primary
investigator at the time of the initial ED consultation
documenting patient demographics, presenting
complaints, investigations ordered, procedures done,
initial diagnosis and outcome of ED consultation.
Results Data on 1887 patient presentations were
described. Adults ($13 years) accounted for the
majority (70%) of patients. Two peak age groups, 0e9
and 20e29 years, accounted for 27% and 25% of
patients, respectively. Respiratory and trauma
presentations each accounted for 21% of presentations,
with a wide spread of other presentations. Over half
(58%) of the patients were investigated in the
department. 385 patients received immediate treatment
in the ED before discharge. Fewer than one in three
patients admitted or transferred to specialist units
received any therapy in the ED.
Conclusions ED in Kenya provide care to an
undifferentiated patient population yet most of the
immediate therapy is provided only to patients with
minor conditions who are subsequently discharged.
Sicker patients have to await transfer to wards or
specialist units to start receiving treatment.

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