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                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Strengthening emergency care by developing data collection systems in low- and middle-income countries</text>
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                <text>Data collection systems&#13;
Emergency department&#13;
Epidemiology studies&#13;
Electronic health record&#13;
HER</text>
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                <text>Emergency care surveillance as well as registries of emergency care are largely absent in most LMICs. Improper&#13;
data systems in Emergency Department create an important gap in our understanding about the health of large&#13;
portions of the population. Clinical data systems in LMICs and lower-resource settings will foster research and&#13;
generation of contextualized evidence</text>
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                <text>Aaditya Katyal, Akshay Kumar , Preethy Rajesh, Roshan Mathew, Sanjeev Bhoi</text>
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                <text>4 September 2020</text>
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        <name>Data collection systems Emergency department Epidemiology studies Electronic health record HER</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis </text>
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                <text>Ethylene glycol poisoning&#13;
Toxic alcohols&#13;
High anion gap metabolic acidosis&#13;
Status epilepticus&#13;
Case report</text>
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                <text>South Africa, several cases of toxic alcohol ingestion presented to our emergency unit. Many of these patients&#13;
admitted to making home brews of alcohol while others simply use industrial toxic alcohols. The diagnosis of&#13;
these poisonings is challenging as direct assays are not available in our setting.&#13;
Case report: We present a case of presumed ethylene glycol poisoning that presented with persistent seizures and&#13;
a high anion gap metabolic acidosis (HAGMA).&#13;
Discussion: A high index of suspicion for toxic alcohol poisoning should be maintained in patients presenting with&#13;
an altered mental status, seizures and a HAGMA. Indirect markers such as clinical features and laboratory results&#13;
can lead to the diagnosis when direct assays are unavailable.</text>
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                <text>Almien Smit , Vidya Lalloo, Andreas Engelbrecht</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>22 October 2020</text>
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                <text>PERI IRAWAN</text>
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        <name>Ethylene glycol poisoning Toxic alcohols High anion gap metabolic acidosis Status epilepticus Case report</name>
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        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Evaluation of the clinical outcome of captopril use for hypertensive urgency in Khartoum State’s emergency centres</text>
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                <text>Captopril&#13;
Hypertensive urgency&#13;
Sudan&#13;
Blood pressure&#13;
Clinical outcome</text>
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                <text>Background: Captopril is an important drug and is used to control hypertensive urgency world-wide. But there is&#13;
very little data available regarding the evaluation of its outcomes in hypertensive urgency among African patients.&#13;
This study aimed to evaluate the clinical outcomes of captopril use for hypertensive urgency at a selection&#13;
of Sudanese emergency centres.&#13;
Methods: This was a cross-sectional study, conducted between 15 to 30 November 2015. A total of 50 patients,&#13;
attending a selection of Khartoum State hospital emergency centres, with a clinical diagnosis of hypertensive&#13;
urgency were approached by investigators for the study. Dose regimen, prognosis, and reduction in systolic and&#13;
diastolic blood pressure were collected alongside a questionaire to patients regarding their care (compliance,&#13;
etc.). Data were analysed using the Chi-square Test to compare the mean differences for various results. Differences&#13;
were considered to be significant at P &lt; 0.05.&#13;
Results: Around two-thirds (60%) of participants were female, and 28% were non-compliant with treatment. A&#13;
25mg dose of captopril was the most frequently used dose. Most of the patients (66%) did not have pre-existing&#13;
disease. The majority of patients showed an improved blood pressure: both systolic and diastolic blood pressures&#13;
were reduced by 16-25% and 5-15%, respectively.&#13;
Conclusion: The study concluded that the dose of 25 mg of captopril is effective in managing hypertensive urgency&#13;
and controlling the blood pressure. We also recommend that patients receiving captopril must be observed&#13;
in the emergency centre for further evaluation.</text>
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                <text>Amgad H.H. Obied , Aimun A.E. Ahmed</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>11 October 2020</text>
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                <text>PERI IRAWAN</text>
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        <name>Captopril Hypertensive urgency Sudan Blood pressure Clinical outcome</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
A mandatory Emergency Medicine clerkship influences students’ career choices in a developing system</text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
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                <text>Medical student&#13;
Emergency medicine&#13;
Career&#13;
Perception</text>
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                <text>Background: Attracting medical students for a front-line specialty, Emergency Medicine, is challenging in many&#13;
countries. The available literature is scarce and bounded to the mature emergency care and education systems. In&#13;
the countries where emergency medicine is a new specialty and has different contextual needs, the perception of&#13;
the students and their career interest in emergency medicine specialty is an unanswered question.&#13;
Objective: We aimed to study the effects of a mandatory Emergency Medicine (EM) clerkship on students’ perceptions&#13;
and their future career choice to be emergency physicians.&#13;
Methods: A voluntary de-identified survey was prospectively collected before and after the EM clerkship to&#13;
capture students’ perceptions in four domains (EM clerkship, EM physicians, EM patients, and EM specialty as a&#13;
career choice). The survey included 24 statements having five-point Likert scale for each statement. Nonparametric&#13;
Wilcoxon signed rank test was used for statistical analysis.&#13;
Results: Sixty-seven students responded to both surveys (response rate of 85%). Students’ perceptions have&#13;
significantly improved on the EM physicians, and their job after attending the clerkship (p &lt; 0.001). They found&#13;
EM a respected (p = 0.038), flexible (p &lt; 0.001), secure (p &lt; 0.001), satisfying, and prestigious (p = 0.006) job.&#13;
They found EM physicians compassionate (p &lt; 0.011), have adequate patient contact (p &lt; 0.045) and control on&#13;
their time (0.004). Choosing EM as a future career has significantly increased after clerkship (p &lt; 0.001).&#13;
Conclusions: Our mandatory EM clerkship significantly improved students’ perceptions on EM specialty as a&#13;
future career choice. A well-structured and mandatory EM clerkship can attract more students to be trained in the&#13;
EM</text>
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            <description>An entity primarily responsible for making the resource</description>
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                <text>Arif Alper Cevik , Elif Dilek Cakal , Sami Shaban ,Margret El Zubeir , Fikri M. Abu-Zidan</text>
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                <text>9 August 2020</text>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Patterns of road traffic accident, nature of related injuries, and post-crash outcome determinants in western Ethiopia - a hospital based study </text>
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                <text>Road traffic accident&#13;
Severity&#13;
Patterns&#13;
Outcomes&#13;
Determinants&#13;
Western Ethiopia</text>
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            <description>An account of the resource</description>
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              <elementText elementTextId="25116">
                <text>Introduction: Ethiopia is one of the countries with the worst road traffic accident records in the world and it ranks&#13;
second among east African countries. There have not been sufficient studies that mainly reflect the post-crash&#13;
determinants of deaths and this study was therefore done to assess the overall nature of injuries and the postcrash&#13;
outcome determinants of road the traffic accident in western part of Ethiopia.&#13;
Methods: This was a hospital-based prospective study conducted from 1 January 2019 to 31 December 2019 using&#13;
an area sampling technique. Five administrative zones in west Ethiopia were initially selected as a geographical&#13;
cluster; out of which, four zones were randomly selected. Then, a total of four hospitals were conveniently&#13;
selected. Finally, 327 people injured in road traffic accidents and brought to the selected hospitals were&#13;
consecutively included.&#13;
Results: Overall, 189 (66.1%) of the casualties have sustained multiple injuries and 65 (24.0%) of them have got&#13;
severe injuries. About 38.8% and 13.6% have respectively died and discharged with permanent disabilities. A&#13;
longer distance from receiving hospital (AOR: 1.4, 95% CI [0.48–4.08]), singleness in the number of injury (AOR:&#13;
4.3, 95% CI [2.08–9.8]), and lack of receiving pre-hospital care (AOR: 4.072, 95% CI [1.197–13.85]) had statistical&#13;
associations with increased number of death. On the other hand, injured people who were taken to the&#13;
hospitals by police officers (AOR: 0.371, 95% CI [0.160–0.860]) than emergency medical technicians and those&#13;
who were transported by other vehicles (AOR: 2. 58, 95% CI [1.21–5.52]) than ambulance have ironically&#13;
survived more.&#13;
Conclusion: This study concludes that the road traffic accidents related deaths occur largely due to the seriousness&#13;
of injuries and are exacerbated by lack of adequate pre-hospital emergency care services, costing the lives of&#13;
many Ethiopians.</text>
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              <elementText elementTextId="25117">
                <text>Ashenafi Habte Woyessa , Worku Dechasa Heyi , Nesru Hiko Ture , Burtukan Kebede Moti</text>
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              <elementText elementTextId="25118">
                <text>www.elsevier.com/locate/afjem</text>
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              <elementText elementTextId="25119">
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              <elementText elementTextId="25120">
                <text>5 September 2020</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="25121">
                <text>peri irawan</text>
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            <elementTextContainer>
              <elementText elementTextId="25123">
                <text>english</text>
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        <name>Jurnal Internasional Keperawatan</name>
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      <tag tagId="3550">
        <name>Road traffic accident Severity Patterns Outcomes Determinants Western Ethiopia</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Injured and broke: The impacts of the Ghana National Health Insurance Scheme (NHIS) on service delivery and catastrophic health expenditure among seriously injured children </text>
              </elementText>
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          </element>
          <element elementId="49">
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              <elementText elementTextId="24849">
                <text>Ghana&#13;
Financial risk protection&#13;
Universal health coverage&#13;
Trauma&#13;
Children</text>
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          <element elementId="41">
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            <description>An account of the resource</description>
            <elementTextContainer>
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                <text>Introduction: Ghana implemented a National Health Insurance Scheme (NHIS) in 2003 as a step toward universal&#13;
health coverage. We aimed to determine the effect of the NHIS on timeliness of care, mortality, and catastrophic&#13;
health expenditure (CHE) among children with serious injuries at a trauma center in Ghana.&#13;
Methods: We performed a retrospective cohort study of injured children aged &lt;18 years who required surgery (i.&#13;
e., proxy for serious injury) at Komfo Anokye Teaching Hospital from 2015 to 2016. Household income data was&#13;
obtained from the Ghana Statistical Service. CHE was defined as out-of-pocket payments to annual household&#13;
income ≥10%. Differences in insured and uninsured children were described. Multivariable regression was used&#13;
to assess the effect of NHIS on time to surgery, length of stay, in-hospital mortality, out-of-pocket expenditure&#13;
and CHE.&#13;
Results: Of the 263 children who met inclusion criteria, 70% were insured. Mechanism of injury, triage scores and&#13;
Kampala Trauma Score II were similar in both groups (all p &gt; 0.10). Uninsured children were more likely to have&#13;
a delay in care for financial reasons (17.3 vs 6.4%, p &lt; 0.001) than insured children, and the families of&#13;
uninsured children paid a median of 1.7 times more out-of-pocket costs than families with insured children (p &lt;&#13;
0.001). Eighty-six percent of families of uninsured children experienced CHE compared to 54% of families of&#13;
insured children (p &lt; 0.001); however, 64% of all families experienced CHE. Insurance was protective against&#13;
CHE (aOR 0.21, 95%CI 0.08–0.55).&#13;
Conclusions: NHIS did not improve timeliness of care, length of stay or mortality. Although NHIS did provide&#13;
some financial risk protection for families, it did not eliminate out-of-pocket payments. The families of most&#13;
seriously injured children experienced CHE, regardless of insurance status. NHIS and similar financial risk&#13;
pooling schemes could be strengthened to better provide financial risk protection and promote quality of care for&#13;
injured children</text>
              </elementText>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="24851">
                <text>Barclay T. Stewart , Adam Gyedu , Stephanie K. Goodman , Godfred Boakye ,&#13;
John W. Scott , Peter Donkor , Charles Mock</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="24852">
                <text>www.elsevier.com/locate/afjem</text>
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            <description>An entity responsible for making the resource available</description>
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              <elementText elementTextId="24853">
                <text>elsevier</text>
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                <text>21 September 2020</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="24855">
                <text>peri irawan</text>
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            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="24857">
                <text>english</text>
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        <name>Ghana Financial risk protection Universal health coverage Trauma Children</name>
      </tag>
      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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              <description>A name given to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="24216">
                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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              <elementText elementTextId="26215">
                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Awareness and attitude of final year students towards the learning and practice of cardiopulmonary resuscitation at the University of Ibadan in Nigeria</text>
              </elementText>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="26216">
                <text>Awareness&#13;
Attitude&#13;
Cardiopulmonary resuscitation (CPR)&#13;
Basic life support (BLS)&#13;
Students</text>
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            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Introduction: Out-of-hospital cardiac arrest (OHCA) is a major cause of sudden cardiac death which can be&#13;
prevented by early cardiopulmonary resuscitation (CPR). International bodies recommend that basic life support&#13;
(BLS) skills be taught in schools in order to increase the rate of bystander CPR and reduce mortality from OHCA.&#13;
We are not aware of any BLS education program for non-healthcare students in Nigeria. This study was to assess&#13;
the awareness and attitude to acquiring BLS skills among university students.&#13;
Methods: We conducted a cross-sectional study among final year university undergraduates using a questionnaire&#13;
that assessed students’ sociodemographic characteristics, awareness of CPR, previous experiences, and attitude&#13;
to basic life support (BLS). Counts and proportions were compared for the demographic characteristics using Chisquared&#13;
and Fisher’s exact tests.&#13;
Results: Four hundred and seventy-five students from 15 faculties participated in this study, median age was 22.8&#13;
years (interquartile range: 21.2–24.5 years). Majority (82.5%) have heard of CPR, 29.7% have undergone CPR&#13;
training; 77.3% of those who had been trained were confident that they could perform CPR. Previous CPR&#13;
training was significantly associated with faculty, year of study and age. Eighty-nine (18.7%) students have&#13;
witnessed someone die from a trauma. Four hundred and fifty (94.7%) respondents would like to get BLS&#13;
training, 440 (92.6%) think that CPR training should be included in the school curriculum.&#13;
Conclusion: There is good awareness and positive attitude to the acquisition and practice of cardiopulmonary&#13;
resuscitation among university students in Nigeria. Few students however, have been trained to administer&#13;
bystander cardiopulmonary resuscitation. Therefore, there is a need to implement university wide BLS education&#13;
in Nigeria.</text>
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            <elementTextContainer>
              <elementText elementTextId="26218">
                <text>Boluwatife Adeleye Adewale , Daniel Ehis Aigbonoga , Abiodun David Akintayo , Peter Seyi Aremu , Oluwaseun Akinola Azeez , Suliyat Dolapo Olawuwo , Joshua Damilare Adeleke , Oluwatobi Simeon Kazeem , Eghonghon Okojie ,Richard Ayobami Oguntoye </text>
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            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="26219">
                <text>www.elsevier.com/locate/afjem</text>
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              <elementText elementTextId="26221">
                <text>23 September 2020</text>
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            <description>An entity responsible for making contributions to the resource</description>
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              <elementText elementTextId="26222">
                <text>PERI IRAWAN</text>
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                <text>ENGLISH</text>
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        <name>Awareness Attitude Cardiopulmonary resuscitation (CPR) Basic life support (BLS) Students</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 1 2021</text>
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            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="26183">
                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Association between volume resuscitation &amp; mortality among injured patients at a tertiary care hospital in Kigali, Rwanda</text>
              </elementText>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
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              <elementText elementTextId="26184">
                <text>Injury care&#13;
Resuscitation&#13;
Global health&#13;
Low- &amp; middle-income countries</text>
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            <description>An account of the resource</description>
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                <text>Background: Injuries cause significant morbidity and mortality in sub-Saharan African countries such as Rwanda.&#13;
These burdens may be compounded by limited access to intravenous (IV) resuscitation fluids such as crystalloids&#13;
and blood products. This study evaluates the association between emergency department (ED) intravenous&#13;
volume resuscitation and mortality outcomes in adult trauma patients treated at the University Teaching&#13;
Hospital-Kigali (UTH- K).&#13;
Methods: Data were abstracted using a structured protocol for a random sample of ED patients treated during&#13;
periods from 2012 to 2016. Patients under 15 years of age were excluded. Data collected included demographics,&#13;
clinical aspects, types of IV fluid resuscitation provided and outcomes. The primary outcome was facility-based&#13;
mortality. Descriptive statistics were used to explore characteristics of the population. Kampala Trauma Scores&#13;
(KTS) were used to control for injury severity. Magnitudes of effects were quantified using multivariable&#13;
regression models adjusted for gender, KTS, time period, clinical interventions, presence of head injury and&#13;
transfer to a tertiary care centre to yield adjusted odds ratios (aOR) with 95% confidence intervals (CI).&#13;
Results: From the random sample of 3609 cases, 991 trauma patients were analysed. The median age was 32 [IQR&#13;
26, 46] years and 74.3% were male. ED volume resuscitation was given to 50.1% of patients with 43.5%&#13;
receiving crystalloid and 6.4% receiving crystalloid and packed red blood cell (PRBC) transfusions. The median&#13;
KTS score was 13 [IQR 12, 13]. In multivariable regression, mortality likelihood was increased in those who&#13;
received crystalloid (aOR = 4.31, 95%CI 1.24, 15.05, p = 0.022) and PRBC plus crystalloid (aOR = 9.97, 95%CI&#13;
2.15,46.17, p = 0.003) as compared to trauma patients not treated with IV resuscitation fluids.&#13;
Conclusions: Injured ED patients treated with volume resuscitation had higher mortality, which may be due to&#13;
unmeasured confounding or therapies provided. Further studies on fluid resuscitation in trauma populations in&#13;
resource-limited settings are needed.</text>
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              <elementText elementTextId="26186">
                <text>Catalina Gonz´alez Marqu´es , Katelyn Moretti , Siraj Amanullah , Chantal Uwamahoro , Vincent Ndebwanimana , Stephanie Garbern , Sonya Naganathan , Kyle Martin , Joseph Niyomiza , Annie Gjesvik , Menelas Nkeshimana , Adam C. Levine , Adam R. Aluisio </text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 1 2021&#13;
African Journal of Emergency Medicine&#13;
Drop for drop: A descriptive analysis of blood product usage in a South African tertiary care setting during the Covid-19 pandemic </text>
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                <text>Background: The Covid-19 pandemic has had a drastic effect on the global community. Blood products are&#13;
precious resources especially in the African context and this has been especially compounded during the Covid-&#13;
19 pandemic. Concurrent to this during the Covid-19 level 5 lockdown in South Africa from 26 March – 30 April&#13;
2020, a decrease in trauma admissions to state hospitals was noted. The aim of this data collection was to assess&#13;
whether lowered blood product issuance was seen during the Covid-19 pandemic lockdown.&#13;
Method: Areas at Tygerberg Hospital with trauma patients were identified, namely: the A1W intensive care unit&#13;
(Surgical ICU), Trauma Front Room (Trauma Admissions), Trauma Resuscitation unit (Trauma Resus Area) and&#13;
J7(Trauma Ward). Data of blood product issuance (red blood cells and fresh frozen plasma) for these 4 areas was&#13;
provided by the Western Cape Blood Service for the period 26 March-30 April 2018, 2019 and 2020. This&#13;
included the stage 5 Covid-19 South African lockdown, as well as Easter for all three years which is traditionally&#13;
associated with raised trauma admissions. This data was quantitative.&#13;
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Tygerberg Hospital. The surgical ICU received the most products over 3 years with 183 of the product issuances.&#13;
Discussion: As expected there was a significant decrease in blood product (red blood cell and fresh frozen plasma)&#13;
issuance during the 2020 period which paralleled the lowered trauma numbers. This represented a significant&#13;
cost saving of over R150 000 despite increased yearly costs for blood products over the same period. This data&#13;
collection did not consider the reasoning for these blood transfusions or the clinical appropriateness thereof. The&#13;
author acknowledges the wide variability of transfusion thresholds and protocols within various centres around&#13;
the world, including Tygerberg and was not seeking to prove commentary on the appropriateness thereof in this&#13;
research.</text>
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African Journal of Emergency Medicine&#13;
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