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BackgroundAccording to the World Health Organization (WHO), injuries represent the largest cause of death among people ages 140 –and contribute to a large burden of disease worldwide. The aims of this study were to characterize the prevalence and relative mechanism of injury among children seeking emergency care and describe the demographics at time of presentation among these children to inform further research in Ghana and sub-Saharan Africa.MethodsA prospective cross-sectional survey of pediatric patients (n = 176) was conducted between 13 July 2009 and 30 July 2009 in the Accident and Emergency Center at Komfo Anoche Teaching Hospital (KATH) in Kumasi, Ghana. Participants were asked questions regarding demographics, insurance status, overall health, and chief complaint.ResultsOf the 176 patients surveyed, 66% (n = 116) presented for injuries. The mean age was 4.7 years (range 1.5 months to 17 years), and 68% (n = 120) were male. Of those presenting with injury, 43% (n = 50) had road traffic injuries (RTI). Of the RTIs, 58% (n = 29) were due to being an occupant in a car crash, 26% (n = 13) were pedestrian injuries, and 14% (n = 7) were from motorcycles. There was no significant difference in demographics, health status or indicators of socioeconomic status between injured and non-injured patients.ConclusionsAmong pediatric patients presenting for acute care at KATH during the study time frame, the majority (n = 116, 66%) presented for injuries. To date, there are no studies that characterize pediatric patients that present for acute care in Ghana. Identifying injury patterns and collecting epidemiologic data are important to guide future research and educational initiatives for Emergency Medicine.

appropriate care, such as not prescribing antibiotics in uncomplicated sinusitis. We determined the rates of following the CW guidelines for sinusitis among DTC telemedicine, Urgent Care (UC), and the emergency department (ED).Methods: Within our DTC telemedicine health records, we searched for chief complaints for the terms cough, sinusitis, upper respiratory infection, cold, sore throat, and congestion (Sept 2015 thru Feb 2016) (82 cases). We matched on date and chief complaints 82 cases from our UC and EM services (246 cases total). Two trained abstractors then used a standardized form to determine adherence to the CW recommendations.Results: Patients were 35 +/-17 years old, 57% female. Overall, the rates of antibiotic prescription were 59% for DTC telemedicine, 76% urgent care, and 65% in the ED (p<0.05). Rates of following CW guidelines for sinusitis were 73% in DTC telemedicine, 62% in urgent care, and 69% in the ED (p¼0.41).Conclusions: DTC telemedicine had the lowest rate of antibiotic prescriptions and the highest rate of Choosing Wisely guideline adherence for sinusitis.