Emergency care of the elderly in the short-stay ward of the accident and emergency department.

BackgroundResource-limited settings are increasingly experiencing a ‘triple burden’ of disease, composed of trauma, non-communicable diseases (NCDs) and known communicable disease patterns. However, the epidemiology of acute and emergency care is not well characterised and this limits efforts to further develop emergency care capacity.ObjectiveTo define the burden of disease by describing the patient population presenting to the Accident and Emergency Department (A&E) at Kenyatta National Hospital (KNH) in Kenya.MethodsWe completed a prospective descriptive assessment of patients in KNH’s A&E obtained via systematic sampling over 3 months. Research assistants collected data directly from patients and their charts. Chief complaint and diagnosis codes were grouped for analysis. Patient demographic characteristics were described using the mean and SD for age and n and percentages for categorical variables. International Classification of Disease 10 codes were categorised by 2013 Global Burden of Disease Study methods.ResultsData were collected prospectively on 402 patients with an average age of 36 years (SD 19), and of whom, 50% were female. Patients were most likely to arrive by taxi or bus (39%), walking (28%) or ambulance (17%). Thirty-five per cent of patients were diagnosed with NCDs, 24% with injuries and 16% with communicable diseases, maternal and neonatal conditions. Overall, head injury was the single most common final diagnosis and occurred in 32 (8%) patients. The most common patient-reported mechanism for head injury was road traffic accident (39%).ConclusionThis study estimates the characteristics of the A&E population at a tertiary centre in Kenya and highlights the triple burden of disease. Our findings emphasise the need for further development of emergency care resources and training to better address patient needs in resource-limited settings, such as KNH.

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Next day telephone follow up of the elderly: a needs assessment and critical incident monitoring tool for the accident and emergency department

Emergency Medicine Journal ◽

10.1136/emj.17.5.337 ◽

2000 ◽

Vol 17 (5) ◽

pp. 337-340 ◽

Cited By ~ 31

Author(s):

H D M Poncia

Keyword(s):

Emergency Department ◽

Needs Assessment ◽

Critical Incident ◽

The Elderly ◽

Monitoring Tool ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

Incident Monitoring

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Use of an accident and emergency department observation ward in the management of head injury

British Journal of Surgery ◽

10.1002/bjs.1800800858 ◽

1993 ◽

Vol 80 (8) ◽

pp. 1079-1079 ◽

Cited By ~ 2

Author(s):

A. F. T. Brown ◽

G. J. Wilkes ◽

C. T. Myers ◽

R. E. Maclaren

Keyword(s):

Emergency Department ◽

Head Injury ◽

Accident And Emergency ◽

Accident And Emergency Department

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Hand Infections: An Audit of 160 Infections Treated in an Accident and Emergency Department

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(93)90208-w ◽

1993 ◽

Vol 18 (1) ◽

pp. 115-118 ◽

Cited By ~ 16

Author(s):

J. STEVENSON ◽

I. W. R. ANDERSON

Keyword(s):

Emergency Department ◽

Complete Resolution ◽

Wound Care ◽

Duration Of Treatment ◽

Mean Delay ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

The Mean ◽

Careful Assessment

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.

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The role of pulse oximetry in the accident and emergency department.

Emergency Medicine Journal ◽

10.1136/emj.6.3.211 ◽

1989 ◽

Vol 6 (3) ◽

pp. 211-215 ◽

Cited By ~ 19

Author(s):

M A Lambert ◽

J Crinnion

Keyword(s):

Emergency Department ◽

Pulse Oximetry ◽

Accident And Emergency ◽

Accident And Emergency Department

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Radiological features of body packers: An experience from a regional accident and emergency department in close proximity to the Hong Kong International Airport

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918770083 ◽

2018 ◽

Vol 25 (4) ◽

pp. 202-210

Author(s):

Ho Kai Patrick Tsang ◽

Cheuk Kei Kathy Wong ◽

Oi Fung Wong ◽

Wing Lun William Chan ◽

Hing Man Ma ◽

...

Keyword(s):

Emergency Department ◽

Hong Kong ◽

Body Packing ◽

Radiological Features ◽

International Airport ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

Body Packers ◽

Solid Form ◽

Hong Kong International Airport

Background: Body packing is a frequently used method for drug trafficking. Local information about the clinical and radiological features of body packing is lacking. Objectives: To evaluate the radiological features of body packers presenting to a hospital near to the Hong Kong International Airport and to compare the radiological features of solid form versus liquid cocaine. Methods: This was a retrospective cohort study. Medical notes of 269 suspected body packers, presenting to the Accident and Emergency Department of North Lantau Hospital under the detention by the law enforcement personnel from 1st January 2015 to 28th February 2017, were reviewed. The radiological features of body packing were retrospectively evaluated. Results: Sixty-nine cases were confirmed body packers radiographically. Majority of them (81%, 56/69) were cocaine packers. Powder form cocaine (67%, 49/69) was the most popular drug packed, followed by liquid cocaine (15%, 10/69). There was a trend of increasing incidence of liquid cocaine packers. The classical ‘double condom’, ‘tic tac’ and ‘halo’ signs were present in 94%, 72.5% and 42% of cases with radiologically confirmed body packing respectively. The ‘rosette’ sign was only identified in 1 case. Three new radiological signs, the ‘bag of eggs’, ‘lucent triangle’ and ‘black crescent’ sign, were suggested to aid identification of drug packets. The classical ‘tic tac’ sign was absent in all liquid cocaine packing cases (p<0.05). The liquid cocaine packets appeared irregular with indistinct border in majority of cases (p<0.05). The solid form packets were mostly opaque to faeces while liquid cocaine had variable density (p<0.05). Most solid form packets had homogeneous content which was in contrast to the heterogeneous content in liquid cocaine (p<0.05). Conclusion: Failure in detecting drug body packing may result in medicolegal consequences. Emergency physicians need to be aware of subtle radiological signs of liquid cocaine packets in the plain abdominal radiography.

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