卢旺达基加利的院前流行病学和受伤儿童管理。

Prehospital epidemiology and management of injured children in Kigali, Rwanda.

机构信息

Thomas Jefferson University, Philadelphia, Pennsylvania, USA

Department of Emergency Medicine, University Teaching Hospital of Kigali, Kigali, Rwanda.

出版信息

Emerg Med J. 2020 Mar;37(3):146-150. doi: 10.1136/emermed-2019-208907. Epub 2020 Jan 30.

DOI:10.1136/emermed-2019-208907

PMID:32001607

Abstract

INTRODUCTION

Paediatric injuries are a major cause of mortality and disability worldwide, yet little information exists regarding its epidemiology or prehospital management in low-income and middle-income countries. We aimed to describe the paediatric injuries seen and managed by the prehospital ambulance service, Service d'Aide Medicale d'Urgence (SAMU), in Kigali, Rwanda over more than 3 years.

METHODS

A retrospective, descriptive analysis was conducted of all injured children managed by SAMU in the prehospital setting between December 2012 and April 2016.

RESULTS

SAMU responded to a total of 636 injured children, 10% of all patients seen. The incidence of paediatric injury in Kigali, Rwanda was 140 injuries per 100 000 children. 65% were male and the average age 13.5 (±5.3). Most patients were between 15 and 19 years old (56%). The most common causes of injuries were road traffic incidents (RTIs) (447, 72%), falls (70, 11%) and assaults (50, 8%). Most RTIs involved pedestrians (251, 56%), while 15% (65) involved a bicycle. Anatomical injuries included trauma to the head (330, 52%), lower limb (280, 44%) and upper limb (179, 28%). Common interventions included provision of pain medications (445, 70%), intravenous fluids (217, 34%) and stabilisation with cervical collar (190, 30%).

CONCLUSION

In Kigali, RTIs were the most frequent cause of injuries to children requiring prehospital response with most RTIs involving pedestrians. Rwanda has recently instituted several programmes to reduce the impact of paediatric injuries especially with regard to RTIs. These include changes in traffic laws and increased road safety initiatives.

摘要

简介

儿科损伤是全球范围内导致死亡和残疾的主要原因，但在低收入和中等收入国家，关于其流行病学或院前管理的信息很少。我们旨在描述 3 年多来卢旺达基加利的院前救护车服务（Service d'Aide Medicale d'Urgence，SAMU）救治的儿科损伤情况。

方法

对 2012 年 12 月至 2016 年 4 月期间 SAMU 在院前环境中救治的所有受伤儿童进行回顾性描述性分析。

结果

SAMU 共响应了 636 名受伤儿童，占所有患者的 10%。卢旺达基加利儿科损伤的发生率为每 100000 名儿童 140 例。65%为男性，平均年龄为 13.5（±5.3）岁。大多数患者年龄在 15 至 19 岁之间（56%）。受伤最常见的原因是道路交通伤害（RTIs）（447 例，占 72%）、跌倒（70 例，占 11%）和袭击（50 例，占 8%）。大多数 RTIs 涉及行人（251 例，占 56%），而 15%（65 例）涉及自行车。解剖损伤包括头部（330 例，占 52%）、下肢（280 例，占 44%）和上肢（179 例，占 28%）。常见的干预措施包括提供止痛药物（445 例，占 70%）、静脉补液（217 例，占 34%）和使用颈托稳定（190 例，占 30%）。