The practice of medicine at a district hospital emergency room: Middelburg Hospital, Mpumalanga Province

Nkombua, Lushiku

doi:10.1080/20786204.2008.10873671

Cited by 6 publications

(7 citation statements)

References 1 publication

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“…Within our study, 23% of diagnoses were categorised as trauma related, which is marginally lower than in other South African series, reported at between 23% and 48%. 4 , 5 , 7 It is, however, important to note that although trauma constituted the most common category at Zithulele, 78% of presentations are necessarily non-trauma related if a binary classification is used.…”

Section: Discussionmentioning

confidence: 99%

“…Patient load of on average 1334 patients per month was lower than other described patient loads in South African hospitals (a range of 1528 to 3399 patients per month). 4 , 5 , 7 This lower number of presenting patients may reflect issues with access or the presence of doctor outreaches to local clinics.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies conducted have been in the Western Cape, assessing the case mix in Community Health Centres in the Cape Town metropole, 5 an urban district hospital, 6 and an urban provincial hospital. 7 There were two other studies conducted in urban district EDs in Middelburg 8 and Bloemfontein. 9 We could not find any studies published on the case mix in respect of rural district hospital EDs in South Africa.…”

Section: Introductionmentioning

confidence: 99%

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What presents to a rural district emergency department: A case mix

Meyer

Gaunt

2020

African Journal of Primary Health Care & Family Medicine

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Background: There is little information available on the range of conditions presenting to generalist run rural district hospital emergency departments (EDs) which are the first point of acute care for many South Africans.Aim: This study aims to assess the range of acute presentations as well as the types of procedures required by patients in a rural district hospital context.Setting: Zithulele is a 147-bed district hospital in rural Eastern Cape.Methods: This is a cross-sectional study assessing all patients presenting to the Zithulele hospital emergency department from 01 October 2015 to 31 December 2015. Data collected included the triage acuity using the South African Triage Scale system, patient demographics, diagnosis, outcome and procedures performed. Diagnoses were coded retrospectively according to the international statistical classification of diseases and related health problems version 10 (ICD 10).Results: Of the 4 002 patients presenting to the ED during the study period, 2% were triaged as emergencies and 45% as non-urgent. The most common diagnostic categories were injuries, infections and respiratory illnesses respectively. Diagnoses from all broad categories of the ICD-10 were represented. 67% of patients required no procedure. Diagnostic procedures (n = 877) were more prevalent than therapeutic procedures (n = 377). Only 2.4% of patients were transferred to a referral centre acutely.Conclusion: Patients with conditions from all categories of the ICD-10 present for management at rural district hospitals. Healthcare professionals working in this setting need to independently diagnose and manage a wide range of ED presentations and execute an assortment of procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What presents to a rural district emergency department: A case mix

Meyer

Gaunt

2020

African Journal of Primary Health Care & Family Medicine

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“…Moreover aging has been associated with depression of body immunity and is known to enhance susceptibility to infection [ 2 ]. The elderly subjects as compared with young and middle aged population are also highly susceptible to acute lower respiratory infection [ 4 , 9 ]. Dominici and colleagues in the year 2006 reported that short-term exposure to fine particle air pollution are dangerous, and significantly increases the risk for cardiovascular and respiratory disease among people over the age of 65 years [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…In most developing countries and resource poor nation adequate provisions of good medical are not widely available and the burdens of respiratory diseases are not well known. Some studies have been carried out in Nigeria and other African on pattern of medical cases admitted as an emergency, but none on the pattern of respiratory diseases presenting as an emergency among adult patients in sub-Saharan Africa [ 7 – 9 ]. This study was conducted to determine the pattern of respiratory diseases seen among adults in an emergency room (ER) and their mortality within twenty- four hours in a health facility in Nigeria.…”

Section: Introductionmentioning

confidence: 99%

Pattern of respiratory diseases seen among adults in an emergency room in a resource-poor nation health facility

Desalu¹,

Ojo²,

Busari³

et al. 2011

Pan Afr Med Jrnl

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IntroductionThere is a paucity of information on utilisation of emergency medical services in Nigeria. This study was conducted to determine the pattern of respiratory diseases seen among adults in an emergency room(ER) and their mortality within twenty- four hours in a health facility in Nigeria.MethodsWe carried out a retrospective study on adult patients that presented with respiratory condition from November 2004 to December 2010 at the emergency room of Federal Medical Centre Ido-Ekiti, south western, Nigeria.ResultsA total of 3671 cases were seen, 368 were respiratory cases accounting for 10.2 % of the total emergency room visitations. The male to female patients ratio was 1.2:1 and their mean was 49 9 ± 20.3 years. Pneumonia (34.5%) was the most common cases seen in the ER, followed PTB (29.4%), acute asthma (24.5%) , acute exacerbation of COPD (10.3%), upper airway tract obstruction and malignant pleural effusion were 0.5% respectively. Fourteen of the PTB cases (3.8%) were complicated by cor-pulmonale, 9(2.5%) by pleural effusion, 4(1.1%) by massive haemoptysis and 2(0.5%) by pneumothorax. Twenty-four hours mortality was 7.4% and 44.4% of the death was due to PTB, 37.0% was due to pneumonia and 14.8% due to acute asthma attack. The overall mortalities also had a bimodal age group distribution as the highest death was recorded in ages 30-39 and ≥70 years.ConclusionPneumonia and PTB were the leading respiratory diseases among adults causing of emergency room visit and early mortality in this health facility in Nigeria.

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