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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
The epidemiology and severity of scorpion envenoming in South Africa as managed by the Tygerberg Poisons Information Centre over a 10 year period </text>
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                <text>Scorpion sting&#13;
Scorpionism&#13;
Envenomation&#13;
Epidemiology&#13;
Poisons centre&#13;
South Africa</text>
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                <text>Introduction: South Africa has a wide distribution of scorpion species, yet limited data are available regarding&#13;
the incidence and severity of scorpion envenomation. The aim of this study was to analyse South African epidemiological&#13;
data of scorpion stings and envenomation as reported to the Tygerberg Poisons Information Centre&#13;
(TPIC).&#13;
Methods: A retrospective analysis was conducted of scorpion-related telephonic consultations to the TPIC over a&#13;
ten year period (1 January 2005 to 31 December 2014). Data were entered onto a Microsoft Excel® spreadsheet&#13;
and descriptive statistics are presented for all variables. Associations with severity of envenomation are presented&#13;
as odds ratios (OR) with 95% confidence intervals (95%CI).&#13;
Results: During the study period 52,163 consultations were processed by the TPIC of which 740 (1.4%) cases&#13;
involved scorpion stings. Of these, 146 (19.7%) cases were deemed serious envenomations. Antivenom was&#13;
recommended to be administered in 131 (90%) of these cases. Healthcare professionals made most calls (63%),&#13;
but were less likely to phone for non-serious cases (OR 0.16; 95%CI 0.09 to 0.29). The Western Cape Province&#13;
had the highest incidence of calls (6.9 scorpion-related calls/100 000 people). Adults (&gt; 20 years) were victims&#13;
in 71.4% of cases, and were more likely to experience less serious stings (OR 0.57; 95%CI 0.37 to 0.86). The TPIC&#13;
was consulted within six hours of the sting occurring in 356 (48.1%) cases with a significant association to less&#13;
severity (OR 3.51; 95%CI 1.9 to 6.3). Only 2% (15) of the scorpions were available for identification.&#13;
Conclusion: The incidence of severe scorpionism to the TPIC was low. Care should be taken when children are&#13;
involved and when calls are received more than six hours after the sting. TPIC consultants as well as healthcare&#13;
professionals working in semi-arid regions should be aware of these high risk populations.</text>
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                <text>Carine J. Marks, Gert J. Muller, Dmitrij Sachno, Helmuth Reuter, Cherylynn A. Wium, Catharina E. Du Plessis, Daniel J. Van Hoving</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>AFEM</text>
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                <text>19 December 2018</text>
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                <text>PERI IRAWAN</text>
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        <name>Jurnal Internasional Keperawatan</name>
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        <name>Scorpion sting Scorpionism Envenomation Epidemiology Poisons centre South Africa</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Procedural sedation and analgesia practices in the emergency centre</text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
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                <text>Procedural sedation&#13;
Analgesia&#13;
Anesthesia&#13;
Sedation&#13;
Emergency department</text>
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                <text>Introduction: Procedural sedation and analgesia allows the clinician to safely and efficiently administer sedation,&#13;
analgesia, anxiolysis and sometimes amnesia to facilitate the performance of various procedures in the emergency&#13;
centre. The aim of this study is to determine current sedation practices, common indications and major&#13;
obstacles in selected emergency centres across Southern Gauteng, South Africa, with a view to improving future&#13;
standards and practices.&#13;
Methods: This was a prospective, questionnaire based, cross-sectional interview of emergency centre managers&#13;
or their designee of selected private-sector and public-sector hospitals in Southern Gauteng.&#13;
Results: Overall, 17 hospitals completed the interview, nine (53%) public-sector and eight (47%) private-sector&#13;
hospitals, with 36% of hospitals being aligned to an academic institute. All hospitals performed procedural&#13;
sedation in their emergency centre. Forty seven percent of managers had between ten and 19 years of clinical&#13;
experience post internship. Although eleven (64.7%) managers achieved a postgraduate qualification in emergency&#13;
medicine, only seven (41%) were accredited with a Fellowship of the College of Emergency Medicine&#13;
(FCEM) qualification and only three (17.7%) centres employed three or more specialists. The majority of centres&#13;
(52.3%) performed between ten and 30 procedures per month requiring sedation. Staff training in the practice of&#13;
procedural sedation was mostly obtained internally (52.9%), from in-house seniors. Essential drugs, procedure&#13;
monitors, resuscitation equipment and protocols were all available in 70.6% of centres.&#13;
Conclusion: Although the safe practice and awareness of procedural sedation and analgesia in both public-sector&#13;
and private-sector emergency centres in Southern Gauteng appears to be on the increase, there is still a need to&#13;
enhance practitioner training and promote awareness of current local and international trends, protocols and&#13;
recommendations.</text>
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            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="23937">
                <text>Delecia K. Wood-Thompson, Callistus O.A. Enyuma, Abdullah E. Laher</text>
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            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="23938">
                <text>www.elsevier.com/locate/afjem</text>
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                <text>14 September 2018</text>
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            <description>An entity responsible for making contributions to the resource</description>
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                <text>PERI IRAWAN</text>
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                <text>ENGLISH</text>
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        <name>Jurnal Internasional Keperawatan</name>
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        <name>Procedural sedation Analgesia Anesthesia Sedation Emergency department</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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            <description>A name given to the resource</description>
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                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Modified Delphi study to determine optimal data elements for inclusion in a pilot violence and injury observatory in Cape Town, South Africa </text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="23924">
                <text>Delphi study&#13;
Optimal data elements&#13;
Violence surveillance systems&#13;
Violence observatories</text>
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          <element elementId="41">
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            <description>An account of the resource</description>
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                <text>Introduction: Violence and injury observatories (VIOs) are primarily a tool to aid safety and security stakeholders&#13;
within both governments and non-governmental organisations to develop interventions focused on violence&#13;
prevention and related to citizen safety issues. VIOs are centres that focus on collating and integrating violencerelated&#13;
injury data sources to monitor, evaluate, and study the progression of violence and crime in a targeted&#13;
region. In preparation for implementing a pilot VIO in Cape Town, we sought to determine the optimal indicators,&#13;
datasets and research priorities for inclusion.&#13;
Methods: The study employed a two-round Delphi study conducted via email. The Delphi panel constituted 21&#13;
participants. This included, but was not limited, to senior members of staff in the Provincial Health Services in&#13;
Emergency Medicine and Disaster Medicine, representatives from relevant data stakeholders and non-government&#13;
actors working in violence reduction.&#13;
Results: Fourteen violence-related indicators and 12 violence-related datasets reached consensus. Additionally,&#13;
research priorities were identified within 16 research themes across five different types of violence: elder abuse,&#13;
youth violence, intimate partner violence, sexual violence, and armed violence. Finally, four data-sharing&#13;
questions raised by panellists after round one were answered by the Delphi panel following the second round.&#13;
Discussion: This study provides a research priority framework for violence and injury prevention work within&#13;
South Africa. These expert-identified violence and injury indicators and datasets are context-appropriate and&#13;
may serve to guide the development of additional VIOs within the region</text>
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              <elementText elementTextId="23926">
                <text>Ardil Jabar, Shane Bjorkman, Richard Matzopoulos</text>
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            <description>A related resource from which the described resource is derived</description>
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                <text>www.elsevier.com/locate/afjem</text>
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            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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                <text>13 November 2018</text>
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                <text>PERI IRAWAN</text>
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        <name>Delphi study Optimal data elements Violence surveillance systems Violence observatories</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Implementation and evaluation of an innovative leadership and teacher training program for non-physician emergency medicine practitioners in Uganda </text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
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                <text>Human capacity development&#13;
Training and education&#13;
Faculty development&#13;
Emergency medicine&#13;
Low-resource settings&#13;
Kirkpatrick</text>
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                <text>Introduction: Leadership and teaching skills are essential, but not often emphasized, components of medical&#13;
training. As emergency care develops as a specialty in Uganda, two cadres of providers are being trained:&#13;
physicians and non-physician clinicians (NPCs). Building formal leadership and educator training into these&#13;
curricula is essential.&#13;
Methods: A week long continuing education (CE) course on leadership and teaching is described and evaluated&#13;
for effectiveness using Kirkpatrick’s framework for learner-centred outcomes. The emergency care trained NPCs&#13;
participated in a week-long course consisting of lectures, role-playing, and small group discussions, as well as a&#13;
personality self-assessment. The evaluation process consisted of: 1) an immediate post-course survey to measure&#13;
learner satisfaction, 2) a retrospective, pre/post self-assessment with a Likert-type scoring tool to measure&#13;
knowledge gains, and 3) a three-month follow up survey and structured interviews to measure knowledge retention&#13;
and behaviour change in practice.&#13;
Results: All 15 NPCs participated in the evaluation process. Learner satisfaction was high with an average score&#13;
of 9.3 (on a 1–10 scale) for course content, amount learned, and use of time. Participants reported gains in&#13;
knowledge for each of the 24 competencies measured, with an average difference in pre- and post-course Likert&#13;
scores of 1.11 (on a scale of 1–5). Lastly, all 15 participants shared detailed examples of using course content in&#13;
practice three months after the course finished. The most frequently mentioned themes were “giving and receiving&#13;
feedback,” “delegating and assigning tasks,” and “communication.”&#13;
Conclusion: This course was a successful CE intervention in this setting as measured by Kirkpatrick’s framework.&#13;
The most frequently mentioned concepts used in practice point to the NPCs ability to take on leadership roles in&#13;
this setting. Further research and evaluation methods should focus on the influence of culture and personalities&#13;
on leadership education and translation into practice in an EM setting</text>
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                <text>Mariel Colell, Mark Bisanzo, Carey Farquhar, Rashidah Nambaziira, Elizabeth Carter, Sarah Gimbel, Gabrielle O'Malley</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>4 December 2018</text>
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        <name>Human capacity development Training and education Faculty development Emergency medicine Low-resource settings Kirkpatrick</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Impact of emergency medicine training implementation on mortality outcomes in Kigali, Rwanda: An interrupted time-series study </text>
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                <text>Emergency medicine&#13;
Training&#13;
Mortality&#13;
Rwanda&#13;
Africa</text>
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                <text>Introduction: Although emergency medicine (EM) training programmes have begun to be introduced in low- and&#13;
middle-income countries (LMICs), minimal data exist on their effects on patient-centered outcomes in such&#13;
settings. This study evaluated the impact of EM training and associated systems implementation on mortality&#13;
among patients treated at the University Teaching Hospital-Kigali (UTH-K).&#13;
Methods: At UTH-K an EM post-graduate diploma programme was initiated in October 2013, followed by a&#13;
residency-training programme in August 2015. Prior to October 2013, care was provided exclusively by general&#13;
practice physicians (GPs); subsequently, care has been provided through mutually exclusive shifts allocated&#13;
between GPs and EM trainees. Patients seeking Emergency Centre (EC) care during November 2012–October&#13;
2013 (pre-training) and August 2015–July 2016 (post-training) were eligible for inclusion. Data were abstracted&#13;
from a random sample of records using a structured protocol. The primary outcomes were EC and overall&#13;
hospital mortality. Mortality prevalence and risk differences (RD) were compared pre- and post-training.&#13;
Magnitudes of effects were quantified using regression models to yield adjusted odds ratios (aOR) with 95%&#13;
confidence intervals (CI).&#13;
Results: From 43,213 encounters, 3609 cases were assessed. The median age was 32 years with a male predominance&#13;
(60.7%). Pre-training EC mortality was 6.3% (95% CI 5.3–7.5%), while post-training EC mortality&#13;
was 1.2% (95% CI 0.7–1.8%), constituting a significant decrease in adjusted analysis (aOR=0.07, 95% CI&#13;
0.03–0.17; p &lt; 0.001). Pre-training overall hospital mortality was 12.2% (95% CI 10.9–13.8%). Post-training&#13;
overall hospital mortality was 8.2% (95% CI 6.9–9.6%), resulting in a 43% reduction in mortality likelihood&#13;
(aOR=0.57, 95% CI 0.36–0.94; p=0.016).&#13;
Discussion: In the studied population, EM training and systems implementation was associated with significant&#13;
mortality reductions demonstrating the potential patient-centered benefits of EM development in resourcelimited&#13;
settings.</text>
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              <elementText elementTextId="23905">
                <text>Adam R. Aluisio, Meagan A. Barry, Kyle D. Martin, Gabin Mbanjumucyo, Zeta A. Mutabazi, Naz Karim, Rachel T. Moresky, Jeanne D'Arc Nyinawankusi, Jean Claude Byiringiro, Adam C. Levine</text>
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                <text>www.elsevier.com/locate/afjem</text>
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            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
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              <elementText elementTextId="23907">
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            <elementTextContainer>
              <elementText elementTextId="23909">
                <text>PERI IRAWAN</text>
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      <tag tagId="3980">
        <name>Emergency medicine Training Mortality Rwanda Africa</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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              <elementText elementTextId="23891">
                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Fifteen years of emergency medicine literature in Africa: A scoping review</text>
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              <elementText elementTextId="23892">
                <text>Emergency medicine&#13;
EM&#13;
Emergency medical services&#13;
EMS&#13;
Africa&#13;
Scoping review&#13;
Literature review</text>
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                <text>Introduction: Emergency medicine (EM) throughout Africa exists in various stages of development. The number&#13;
and types of scientific EM literature can serve as a proxy indicator of EM regional development and activity. The&#13;
goal of this scoping review is a preliminary assessment of potential size and scope of available African EM&#13;
literature published over 15 years.&#13;
Methods: We searched five indexed international databases as well as non-indexed grey literature from 1999-&#13;
2014 using key search terms including “Africa”, “emergency medicine”, “emergency medical services”, and&#13;
“disaster.” Two trained physician reviewers independently assessed whether each article met one or more of five&#13;
inclusion criteria, and discordant results were adjudicated by a senior reviewer. Articles were categorised by&#13;
subject and country of origin. Publication number per country was normalised by 1,000,000 population.&#13;
Results: Of 6091 identified articles, 633 (10.4%) were included. African publications increased 10-fold from&#13;
1999 to 2013 (9 to 94 articles, respectively). Western Africa had the highest number (212, 33.5%) per region.&#13;
South Africa had the largest number of articles per country (171, 27.0%) followed by Nigeria, Kenya, and Ghana.&#13;
537 (84.8%) articles pertained to facility-based EM, 188 (29.7%) to out-of-hospital emergency medicine, and&#13;
109 (17.2%) to disaster medicine. Predominant content areas were epidemiology (374, 59.1%), EM systems&#13;
(321, 50.7%) and clinical care (262, 41.4%). The most common study design was observational (479, 75.7%),&#13;
with only 28 (4.4%) interventional studies. All-comers (382, 59.9%) and children (91, 14.1%) were the most&#13;
commonly studied patient populations. Undifferentiated (313, 49.4%) and traumatic (180, 28.4%) complaints&#13;
were most common.&#13;
Conclusion: Our review revealed a considerable increase in the growth of African EM literature from 1999 to&#13;
2014. Overwhelmingly, articles were observational, studied all-comers, and focused on undifferentiated complaints.&#13;
The articles discovered in this scoping review are reflective of the relatively immature and growing state&#13;
of African EM.</text>
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                <text>Nee-Kofi Mould-Millman, Julia Dixon, Taylor W. Burkholder, Nana Sefa, Hiren Patel, Anna Q. Yaffee, Amarachukwu Osisanya, Tolulope Oyewumi, Isaac Botchey Jr. Maxwell Osei-Ampofo, Hendry Sawe, Jay Lemery, Tracy Cushing, Lee A. Wallis</text>
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                <text>www.elsevier.com/locate/afjem</text>
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              <elementText elementTextId="23898">
                <text>PERI IRAWAN</text>
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        <name>Emergency medicine EM Emergency medical services EMS Africa Scoping review Literature review</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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              <elementText elementTextId="23880">
                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Fatal Boomslang bite in the Northern Cape</text>
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                <text>Fatal Boomslang bite in the Northern Cape</text>
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                <text>bite with rapid progression of symptoms and death.&#13;
Case report: A young gentleman was bitten and rapidly decompensated before monovalent antivenom could be administered, with fatal results.&#13;
Conclusion: This case highlights the importance of having monovalent Boomslang antivenom rapidly available in all referral centres that may be involved in the&#13;
management of Boomslang bite victims</text>
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                <text>Hendrik Johannes Krüger, Franz Gustav Lemke</text>
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                <text>www.elsevier.com/locate/afjem</text>
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            <elementTextContainer>
              <elementText elementTextId="23887">
                <text>PERI IRAWAN</text>
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            <description>The file format, physical medium, or dimensions of the resource</description>
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                <text>ENGLISH</text>
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        <name>Fatal Boomslang bite in the Northern Cape</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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              <elementText elementTextId="23869">
                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Developing a South African Helicopter Emergency Medical Service Activation Screen (SAHAS): A Delphi study </text>
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          <element elementId="49">
            <name>Subject</name>
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              <elementText elementTextId="23870">
                <text>Helicopter Emergency Medical Services&#13;
Air ambulances&#13;
Prehospital care&#13;
Emergency medical dispatch</text>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Introduction: Helicopter Emergency Medical Services (HEMS) are an expensive resource that should be utilised&#13;
efficiently to optimise the cost-benefit ratio. This is especially true in resource-limited settings, such as South&#13;
Africa. This may be achieved by implementing call-out criteria that are most appropriate to the healthcare&#13;
system in which HEMS operate. Currently, there are no published evidence-based HEMS call-out criteria developed&#13;
for South Africa. By identifying patients that are most likely to benefit from HEMS, their utilisation can&#13;
be enhanced and adjusted to ensure optimal patient outcome. We aimed to systematically utilise expert opinions&#13;
to reach consensus on HEMS call-out criteria that are contextual to the South African setting.&#13;
Methods: A modified Delphi technique was used to develop call-out criteria, using current literature as the basis&#13;
of the study. Purposive, snowball sampling was employed to identify a sample of 118 participants locally and&#13;
internationally, of which 42 participated for all three rounds. Using an online survey platform, binary agreement/&#13;
disagreement with each criterion was sought. Acceptable consensus was set at 75%. Statements were sent&#13;
out in the third round ascertaining whether participants agreed with the analysis of the first two rounds.&#13;
Results: After two rounds, consensus was obtained for 63% (36/57) of criteria, while 64% of generated statements&#13;
received consensus in the third round. Results emphasised the opinion that HEMS dispatch criteria relating&#13;
to patient condition and incident locations were preferential to a comprehensive list. Through collation of&#13;
these results and international literature, we present an initial concept for a South African HEMS Activation&#13;
Screen (SAHAS), favouring inquiry on a case-by-case basis.&#13;
Discussion: The combination of existing literature and participant opinions, established that call-out criteria are&#13;
most efficient when based on clinical parameters and geographic considerations, as opposed to a specified list of&#13;
criteria. The initial concept of our SAHAS should be investigated further.</text>
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                <text>Diane Laatz, Tyson Welzel, Willem Stassen</text>
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        <name>Helicopter Emergency Medical Services Air ambulances Prehospital care Emergency medical dispatch</name>
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        <name>Jurnal Internasional Keperawatan</name>
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                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Cola therapy for oesophageal food bolus impactions a case series</text>
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                <text>Oesophagus&#13;
Constriction, pathologic&#13;
Therapeutics&#13;
Foreign body migration</text>
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                <text>Introduction: This retrospective case series describes the use of cola to immediately treat complete oesophageal&#13;
food bolus obstructions in the emergency centre. Short of emergent endoscopy – which is invasive, expensive,&#13;
not without adverse events, and often unavailable in low-resource settings – no other proven therapies exist to&#13;
relieve oesophageal food impactions.&#13;
Methods: We performed a chart review of adults with complete oesophageal food bolus obstructions presenting&#13;
to two Dutch emergency centres. Our primary outcome was cola’s success rate in resolving the obstruction. Our&#13;
secondary outcome was adverse event occurrence.&#13;
Results: We identified 22 cola interventions in 19 patients, the majority of whom (77.3%) were male. The&#13;
median age was 59 years (IQR 29–73). All presentations were due to meat impaction. Endoscopy revealed relevant&#13;
upper gastrointestinal pathology in 54.5%. When initiated in the emergency centre, cola successfully&#13;
resolved 59% of complete oesophageal obstructions. No adverse events were reported in patients successfully&#13;
treated with cola.&#13;
Discussion: While keenly aware of our retrospective study’s limitations, we found a promising success rate for&#13;
cola as an acute intervention for oesophageal food bolus impactions. We registered no adverse events attributable&#13;
to cola. Also, given that cola is cheap, widely available and seemingly safe we believe it can be considered&#13;
in patients with oesophageal obstructions due to food, either as pre-endoscopy treatment or in case endoscopy is&#13;
not available at all. We think our findings provide an impetus for prospective research on this intervention</text>
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                <text>Eva P. Baerends, Tom Boeije, Anna Van Capelle, Nieke E. Mullaart-Jansen,&#13;
Michael D. Burg, Albert J. Bredenoord</text>
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                <text>www.elsevier.com/locate/afjem</text>
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              <elementText elementTextId="23865">
                <text>PERI IRAWAN</text>
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                <text>PDF</text>
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            <description>A language of the resource</description>
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                <text>ENGLISH</text>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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        <name>Oesophagus Constriction, pathologic Therapeutics Foreign body migration</name>
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                  <text>Jurnal Internasional Afrika vol. 9 issue 1 2019</text>
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                <text>Jurnal Internasional Afrika vol. 9 issue 1 2019&#13;
African Journal of Emergency Medicine&#13;
Are “virtual” paediatric weight estimation studies valid?</text>
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                <text>Broselow tape&#13;
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Paediatric weight estimation</text>
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                <text>Introduction: “Virtual” studies account for nearly one-third of all published weight estimation articles, but the&#13;
validity of these virtual studies has never been evaluated. It is important to establish this validity in order to&#13;
decide whether the results of these studies can be applied to real-world usage. The objectives of this study were&#13;
to evaluate the accuracy of virtual weight estimates using the Broselow and PAWPER tapes and compare these to&#13;
actual real-life estimates from the tapes.&#13;
Methods: Virtual weights were generated for the Broselow and PAWPER tapes using anthropometric data from a&#13;
sample of 1385 children for whom actual Broselow and PAWPER tape weights were available. The accuracy of&#13;
the virtual and real-life estimates was compared against each child’s actual weight. The agreement of the virtual&#13;
and real estimates was also evaluated.&#13;
Results: The percentage of weight estimates within 10% of actual weight were 57.9% and 59.3% for the real and&#13;
virtual Broselow tapes respectively and 76.6% and 78.4% for the real and virtual PAWPER tapes respectively.&#13;
The Cohen’s kappa for the real and virtual Broselow and PAWPER tapes was 0.65 and 0.64 respectively, which&#13;
indicated substantial agreement.&#13;
Conclusions: The virtual and real weight estimates had very similar accuracy outcomes for both tapes in this&#13;
study. However, if virtual studies are used, they should be followed by real-life studies in order to assess the&#13;
impact of human and patient factor errors on the accuracy of the weight estimation systems.</text>
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                <text>Mike Wells, Lara Goldstein</text>
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                <text>www.elsevier.com/locate/afjem</text>
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              <elementText elementTextId="23852">
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                <text>10 January 2019</text>
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