Current Issue : January-March
Volume : 2022
Issue Number : 1
Articles : 5 Articles
As emerging countries, China, Russia, and South Africa are establishing and/or improving their trauma systems.
China has recently established a trauma system named “the Chinese Regional Trauma Care System” and covered over
200 million populations. It includes paramedic-staffed pre-hospital care, in-hospital care in certified trauma centers,
trauma registry, quality assurance, continuous improvement and ongoing coverage of the entire Chinese territory.
The Russian trauma system was formed in the first decade of the twenty-first century. Pre-hospital care is regionbased,
with a regional coordination center that determines which team will go to the scene and the nearest hospital
where the victim should be transported. Physician-staffed ambulances are organized according to three levels of
trauma severity corresponding to three levels of trauma centers where in-hospital care is managed by a trauma team.
No national trauma registry exists in Russia. Improvements to the Russian trauma system have been scheduled. There
is no unified trauma system in South Africa, and trauma care is organized by public and private emergency medical
service in each province. During the pre-hospital care, paramedics provide basic or advanced life support services
and transport the patients to the nearest hospital because of the limited number of trauma centers. In-hospital care
is inclusive with a limited number of accredited trauma centers. In-hospital care is managed by emergency medicine
with multidisciplinary care by the various specialties. There is no national trauma registry in South Africa. The South
African trauma system is facing multiple challenges. An increase in financial support, training for primary emergency
trauma care, and coordination of private sector, need to be planned....
Background: Emergency laparotomy (EL) is a central, high-risk procedure in emergency surgery. Patients in need
of an EL present an acute pathology in the abdomen that must be operated on in order to save their lives. Usually,
the underlying condition produces an affected physiology. The perioperative management of this critically ill patient
group in need of high-risk surgery and anaesthesia is challenging and related to high mortality worldwide. However,
outcomes in Sweden have yet to be studied. This retrospective cohort study explores the perioperative management
and outcome after 710 ELs by investigating mortality, overall length of stay (LOS) in hospital, need for care at the
intensive care unit (ICU), surgical complications and a general review of perioperative management.
Methods: Medical records after laparotomy was retrospectively analysed for a period of 38 months (2014–2017),
the emergency cases were included. Children (< 18 years), aortic surgery, second look and other expected reoperations
were excluded. Demographic, management and outcome data were collected after an extensive analysis of the
Results: A total of 710 consecutive operations, representing 663 patients, were included in the cohort (mean age
65.6 years). Mortality (30 days/1 year) after all operations was 14.2% and 26.6% respectively. The mean LOS in hospital
was 12 days, while LOS in the ICU was five days. Of all operations, 23.8% patients were admitted at any time to the ICU
postoperatively and the 30-day mortality seen among ICU patients was 37.9%. Mortality was strongly correlated to
existing comorbidity, high ASA classification, ICU care and faecal peritonitis. The mean/median time from notification
to operate until the first incision was 3:46/3:02 h and 87% of patients had their first incision within 6 h of notification.
Conclusions: In this present Swedish study, high mortality and morbidity were observed after emergency laparotomy,
which is in agreement with other recent studies.
Trial registration: The study has been registered with ClinicalTrials.gov (NCT03549624, registered 8 June 2018)....
Introduction: Cardiovascular diseases constitute the deadliest pathology in
the world with 31% of global mortality in 2018. This is how we felt it necessary
to conduct a study on cardiovascular diseases in emergency units of
Senegal, more precisely in Dakar, in order to know epidemiological profile of
these patients. Methods: The study setting was the reception and emergency
units of the Hôpital de Pikine and Hôpital Principal de Dakar. This was an
observational, descriptive cross-sectional study with an analytical aim to
search for factors associated with the occurrence of cardiovascular disease.
The study ran from January 25th to February 5th, 2018 at the Hôpital de
Pikine and from February 25th to March 5th, 2018 at Hôpital Principal de
Dakar. The source population consisted of patients over 18 years of age and
not in a state of pregnancy, who were been received there and had given their
free and informed consent to participate in the survey. A representative sample
had drawn and a consecutive recruitment of eligible patients were been
carried out. The data collection tools were been based on the WHO STEPwise
survey questionnaire. Data collection was been carried out in accordance with
ethical rules. Results: The study involved 615 patients. The proportions of
sedentary lifestyle, low daily consumption of fruits/vegetables, overweight
and obesity were 72.4%, 96.4%, 22.7% and 17.3% respectively. This was 55.5%
of women who had a waist circumference that corresponded to a high risk of a cardiovascular event and 10.2% for men. 38.9% of patients had blood pressure
above 140/90mmhg and 32.2% said they had never controlled their
blood pressure in their life. The use of a consultation in a health structure to
control his blood pressure was by far the most frequent modality with 61.4%.
The proportion of people with cardiovascular disease was 50.1%. Hypertensive
flare-ups/hypertensive emergencies were the leading complications diagnosed
with 33.33%. Factors associated with the occurrence of cardiovascular
disease were sex, age, professional status and body mass index. Discussion
& Conclusion: The risk factors for cardiovascular disease are highly represented
in our emergency units. In addition to the available care offer, the
identification of factors associated with the occurrence of cardiovascular diseases
in patients who are been seen there will allow targeted preventive actions
within this fragile and vulnerable population. All this to help achieve
target 3.4 of the Sustainable Development Goals (SDGs) by 2030. Furthermore,
according to the associated factors identified, it appears that achieving
SDG 8 will greatly contribute to the prevention of cardiovascular disease. This
proves the urgency and interest of an integrated multi-ministerial vision in
our strategic plans for the prevention against major non-communicable diseases
and cardiovascular diseases in particular....
Introduction. Emergency medical services (EMS) personnel are exposed to stress. Job stress in EMS personnel can reduce their
resilience and have adverse effects on their clinical performance and mental health, thus reducing the quality of their work. The
present research was performed to determine the effect of psychological hotwash on resilience of emergency medical services
personnel. Methods. This study was a quasiexperimental. Sixty-four EMS personnel were randomly divided into two groups of
hotwash and control. The psychological hotwash program was performed in the intervention group for a month based on the
protocol; however, the control group continued their usual work and received no intervention. A day and six weeks after the
psychological hotwash in the intervention group, the resilience of the EMS personnel was remeasured in both groups. Results.
Before the intervention, the participants’ mean resilience score was 138.37 ± 7.04 in the intervention group and 137.34 ± 8.48 in the
control group. There was a statistically significant difference between the mean scores of resilience in the intervention and control
groups a day after the intervention (P 0.003). There was no statistically significant difference between the mean scores of
resilience in the intervention and control groups 6 weeks after the intervention (P 0.102). Conclusion. The EMS personnel’s
attendance at psychological hotwash sessions could increase their resilience. Nevertheless, the sessions should not be interrupted
because the 6-week interruption of the sessions caused the nonsignificant scores of resilience in the hotwash and control groups.
Hence, it is recommended to continue the investigation of the effects of hotwash on resilience, stress reduction, and job burnout
reduction in EMS personnel by other researchers in different settings....
In COVID-19 outbreak, such a sudden public health incident, the deficiency
of China’s department of CDC exposed, especially the disease control department’s
ability to cope with risk is low. For public health emergency department
personnel management, it is a wake-up call for disease control.
Starting from the current situation of personnel management in the disease
control department, from the perspective of human resources management,
this paper discusses how to improve the management of personnel to improve
the capacity of the disease control department to respond to public
health emergencies, and puts forward relevant suggestions and measures.
Public Policy Analysis...
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