Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 5 Articles
Objectives: The objectives of this work were to calculate the frequency of obstetrical\nemergencies, to describe the socio-demographic profile of women\nadmitted for obstetric emergencies, to identify the main emergencies, to describe\nthe care taking of emergencies and to establish the maternal foetal\nprognosis of obstetric emergencies. Methodology: It was a 6-month descriptive\nprospective study conducted in the Obstetrics and Gynaecology Department\nof the Donka National Hospital, CHU Conakry, Guinea. The study took\nplace from July 1st to December 31st, 2005. The data collected were entered\nand corrected using the Word and Excel 2010 software and then transferred\nto the Epi Info software version 7 for analysis. The results are presented in the\nform of tables, figures and texts using Word and Excel software, commented\non, discussed and compared to current literature data. The limitations of the\nstudy: The poor filling of the partograph has been the main problem of our\nstudy. Results: The frequency of obstetric emergencies was 19% in the Department.\nThe socio-demographic profile was that of a woman aged 15 to 24\n(46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous\n(34.3%), without prenatal follow-up (47.37%), coming from home\n(56%), evacuated (44%). The main emergencies are dominated by haemorrhage\n(34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%).\nThe therapeutic attitude was based on clinical data and was dominated by\ncaesarean section (70%). General anaesthesia was performed in 75% of cases\nand 1.6% benefited from local anaesthesia. The demand for blood was honoured\nin 19% of the cases. The maternal morbidity was dominated by anaemia\n(66.7%) and a lethality of 4%. After the 5th minute, 47% of the newborns\nhad APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion:\nTo avoid and/or reduce obstetric emergencies, it is necessary to detect\nand treat risk factors during referrals, properly monitor child labor, refurbish\nproviders of basic facilities, promptness in the management of the admission\nof emergencies and the availability of blood products....
Background: Major trauma care is complex and requires individuals and teams to perform together in time critical,\nhigh-stakes situations. Scenario-based simulation is well established as a strategy for trauma teamwork improvement, but\nits role in the relational and cultural aspects of trauma care is less well understood. Relational coordination theory offers a\nframework through which we aimed to understand the impact of an established trauma simulation programme.\nMethods: We studied simulation activities using a narrative survey of trauma providers from anaesthesia, emergency\nmedicine, medical imaging, surgery, trauma service, intensive care, and pre-hospital providers at Gold Coast University\nHospital, in conjunction with data from an ethnography. Data analysis was performed using a recursive approachâ??a\nsimultaneous deductive approach using the relational coordination framework and an inductive analysis.\nResults: Ninety-five of 480 (19.8%) staff completed free-text survey questions on simulation. Deductive analysis of data\nfrom these narrative survey results using the RC framework domains identified examples of shared goals, shared\nknowledge, communication and mutual respect. Two major themes from the inductive analysis--â??Behaviour, process\nand system changeâ? and â??Culture and relationshipsâ?---aligned closely with findings from the RC analysis, with additional\nthemes of â??Personal and team learningâ? and the â??Impact of the simulation experienceâ? identified.\nConclusions: Our findings suggest that an established trauma simulation programme can have a profound impact on\nthe relational aspects of care and the development of a collaborative culture, with perceived tangible impacts on\nteamwork behaviours and institutional systems and processes. The RC framework-shared knowledge, shared goals and\nmutual respect in the context of communication that is timely, accurate, frequent and problem-solving based-can\nprovide a common language for simulation educators to design and debrief simulation exercises that aim to have a\ntranslational impact....
Background: Disparities in the management of pain are associated with factors that include social status, age and\nrace. As there is limited data regarding the influence of race on analgesia provided by paramedics this study\ninvestigated associations between patient race and student paramedic management of pain.\nMethods: Retrospective study of student paramedic records entered in the FISDAP Skill Tracker database between\n1 January 2014 to 31 December 2015. Cases were extracted if aged 16 to 100 years, the patient was alert and the\nprimary or secondary impression was trauma. The primary outcome of interest was the association between patient\nrace and student paramedic administration of any analgesia. The adjusted odds of patients receiving any analgesic\nwas tested with logistic regression using a stepped modelling approach.\nResults: 59,915 cases were available for analysis; median age was 50 years (IQR 39 years), 50.1% were female (n =\n30,040). Fall was the most common case type 43% (n = 26,009) of cases. 14.1% of patients received any analgesia (n\n= 8424). Caucasian patients have significantly higher odds of receiving analgesia than non-Caucasian patients (p < 0.\n001). When analgesic administration is adjusted for gender, age category and injury cause, African Americans have\nthe lowest logged odds of receiving any analgesia when compared to Caucasian patients (OR 0.60, p < 0.001).\nConclusion: The results indicate inequality in the provision of analgesia by student paramedics based on patient\nrace. This suggests a need for interventions to reduce disparities in care based on race....
The management of craniocerebral trauma begins at the site of the accident.\nThis is one of the diseases for which pre-hospital care is well codified. The\nobjective of this study is to report the experience of the Emergency Aid Medical\nService (EMAS) of BENIN in the pre-hospital management of craniocerebral\ntrauma. 146 head injuries were cared for. 116 were male. The mean age\nwas 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients\nwas a public road accident. And the request for the use of the EMAS\nwas made by highway users for 41% of the injuries. About 5.5% were severe\ncranio-brain injuries, more than 75% of which had died in intensive care. In\n77% of the EMAS interventions, there was an intensive care physician in the\nteam. 34 wounded had been transported in a vacuum mattress. The rigid cervical\ncollar was used in 8 major traumas. All the wounded were transported\nby ambulance. The duration of hospitalization varied from a few hours in the\nemergency department to 90 days in the hospital ward. 9 patients died. One\nof them, who died in an ambulance, was a woman. The prehospital medical\ncare of head trauma in BENIN is still progressing....
Background: The substantial increase in cardiovascular diseases (CVD) in China over the last three decades\nwarrants comprehensive preventive primary and secondary strategies. Prolonged prehospital delay (PHD) has been\nidentified as a substantial barrier to timely therapeutic interventions for acute myocardial infarction (AMI). Despite\nworldwide efforts to decrease the patientâ??s decision-making time, minimal change has been achieved so far. Here,\nwe aim to describe the conceptual framework and methods and outline key data of the MEDEA FAR-EAST Study,\nwhich aimed to elucidate in-depth barriers contributing to delay in Chinese AMI-patients.\nMethods: Data sources of this multicenter cross-sectional observational study are a standardized bedside interview,\na self-administered tailored questionnaire tool and the patient chart. PHD was defined as the main outcome and\ntriangulated at bedside. Standard operation procedures ensured uniform data collection by trained study personnel.\nThe study was ethically approved by Tongji-Hospital and applied to all participating hospitals.\nResults: Among 379 consecutively screened patients, 296 (78.1%) fulfilled eligibility criteria. A total of 241 (81.4%) AMIpatients\nwere male and 55 (18.6%) female. Mean age was 62.9 years. Prehospital delay time was assessed for 294 (99.3%)\npatients. Overall median PHD was 151 min with no significant sex difference. Symptom mismatch was present in 200 (69.\n7%) patients and 106 (39.0%) patients did not attribute their symptoms to cardiac origin. A total of 33 (12.4%) patients\nsuffered from depression, 31 (11.7%) from anxiety and 141 (53.2%) patients employed denial as their major coping style.\nConclusion: This is the first study on prehospital delay with emphasis on psychological variables in Chinese AMI-patients. A\ncomprehensive assessment tool to measure clinical and psychological factors was successfully implemented. Sociodemographic\nkey data proved a good fit into preexisting Chinese literature. Potential barriers including cardiac denial and\nsymptom-mismatch were assessed for the first time in Chinese AMI-patients. The pretested selection of instruments allows\nfuture in depth investigations into barriers to delay of Chinese AMI-patients and enables inter-cultural comparisons....
Loading....