Bitter Cindy Carol, Rice Brian, Periyanayagam Usha, Dreifuss Bradley, Hammerstedt Heather, Nelson Sara W, Bisanzo Mark, Maling Samuel, Chamberlain Stacey
Division of Emergency Medicine, Department of Surgery, Saint Louis University, St. Louis, Missouri, USA.
Global Emergency Care.
BMJ Open. 2018 Feb 24;8(2):e019024. doi: 10.1136/bmjopen-2017-019024.
To determine the most commonly used resources (provider procedural skills, medications, laboratory studies and imaging) needed to care for patients.
A single emergency department (ED) of a district-level hospital in rural Uganda.
26 710 patient visits.
Procedures were performed for 65.6% of patients, predominantly intravenous cannulation, wound care, bladder catheterisation and orthopaedic procedures. Medications were administered to 87.6% of patients, most often pain medications, antibiotics, intravenous fluids, antimalarials, nutritional supplements and vaccinations. Laboratory testing was used for 85% of patients, predominantly malaria smears, rapid glucose testing, HIV assays, blood counts, urinalyses and blood type. Radiology testing was performed for 17.3% of patients, including X-rays, point-of-care ultrasound and formal ultrasound.
This study describes the skills and resources needed to care for a large prospective cohort of patients seen in a district hospital ED in rural sub-Saharan Africa. It demonstrates that the vast majority of patients were treated with a small formulary of critical medications and limited access to laboratories and imaging, but providers require a broad set of decision-making and procedural skills.
确定护理患者所需的最常用资源（医疗服务提供者的操作技能、药物、实验室检查和影像学检查）。
乌干达农村地区一家区级医院的单一急诊科。
26710例患者就诊。
65.6%的患者接受了操作，主要是静脉插管、伤口护理、膀胱插管和骨科手术。87.6%的患者接受了药物治疗，最常用的是止痛药、抗生素、静脉输液、抗疟药、营养补充剂和疫苗。85%的患者进行了实验室检查，主要是疟疾涂片、快速血糖检测、艾滋病毒检测、血细胞计数、尿液分析和血型检测。17.3%的患者进行了放射学检查，包括X光、即时超声和正规超声检查。
本研究描述了在撒哈拉以南非洲农村地区一家区级医院急诊科就诊的大量前瞻性队列患者所需的技能和资源。研究表明，绝大多数患者使用少量关键药物进行治疗，且获得实验室检查和影像学检查的机会有限，但医疗服务提供者需要具备广泛的决策和操作技能。
