Factors affecting prehospital time delay of the injured patients arriving at the Emergency Department of Beni-Suef University Hospital in Egypt: A cross-sectional study

Challenges to the development of the trauma system in Egypt

Trauma is a hidden disease in Egypt, and its significance on public health has been underestimated for decades. Road traffic accidents are the leading cause of injuries presented to hospitals in Egypt. Trauma systems in developed countries effectively reduced the morbidity and mortality associated with injuries in crowded cities. Developing a trauma system in Egypt is mandatory with the exploding population growth, increasing incidence of injuries, and the vast expansion of the infrastructures in the road network. However, the implementation of the trauma system in Egypt will not be devoid of challenges, including a lack of mandatory healthcare infrastructures such as adequate pre-hospital care, poor quality of data, and a shortage of adequately trained emergency physicians across the country.

Clinical factors associated with delayed emergency department visit in intracranial traumatic brain injury: from a multicenter injury surveillance registry

INTRODUCTION

Early diagnosis and intervention by visiting the emergency department (ED) are important for traumatic brain injury (TBI). We evaluate the factors associated with delayed ED visits in patients with intracranial TBI.

METHODS

A retrospective multicenter observational study using the ED-based injury in-depth surveillance database (EDIIS) was designed. Patients with intracranial TBI with an alert mentality at ED presentation from 2014 to 2019 were enrolled. Patients were categorized into four groups according to ED visit time after injury (<1 h, 1-3 h, 3-12 h, and >12 h). ED visits after 12 h were defined as delayed ED visits. The factors associated with delayed ED visits were identified using multivariable logistic regression analysis.

RESULTS

Among 15,620 patients with TBI enrolled in the final analysis, 2,190 (14.0%) visited the ED 12 h after injury. Multivariable analysis identified the following factors as independent predictors for delayed ED visit such as unintentionally struck by or against an object or unintentional fall as a trauma mechanism, injury during ordinary activities, indoor injury, injury during nighttime, winter season, combined subdural hemorrhage and epidural hemorrhage.

CONCLUSION

In patients with intracranial TBI with an alert mentality, multiple factors related to patient demographics and injury characteristics were associated with the time interval from injury to ED visit.

Barriers and opportunities of establishing an integrated prehospital emergency response system in North West Ethiopia: a qualitative study

Background

Prehospital emergency care helps to reduce mortality and morbidity from time-sensitive conditions. In this study, we summarised the perspectives of various stakeholders on the establishment of a prehospital integrated emergency response system.

Methods

We conducted a qualitative study using a key informant interview. We used a purposive sampling technique to select participants from the sector offices based on their proximity to the problem under consideration. We took verbal informed consent from each participant before the interviews. We conducted a thematic content analysis.

Results

Twenty-three study participants, working at six sector offices (the zonal health office, University of Gondar, traffic office, fire extinguisher office, the Amhara regional health bureau and the Ethiopian red cross association), were included in this study. Five major themes have emerged. The themes that emerged include participants’ views on the importance of prehospital service, barriers and opportunities for establishing the system, and how to start and sustain the system.

Conclusion and recommendation

Lack of resources is not the main reason for the lack of prehospital emergency care in the study area rather; lack of commitment, ownership and high turnover of decision-makers were the main reasons for the absence of prehospital care, as viewed by respondents. On the other side, the availability of professionals, training institutions and the fact that emergency care is a shared agenda by different stakeholders were stated as an opportunity to establish the system. With the growing number of injuries and non-communicable diseases, emergency management should get due attention.

Violence against healthcare workers during the COVID-19 pandemic: a cross-sectional study from Egypt

Workplace violence (WPV) is a serious endemic phenomenon in healthcare settings, and it has been escalating during the COVID-19 pandemic. In this cross-sectional study, healthcare workers (HCWs) (105 physicians and 104 nurses) working at two public hospitals accepting patients with COVID-19 in Egypt were included. Using a self-administered questionnaire distributed in January 2021, data about HCWs' sociodemographic and occupational characteristics and their exposure to psychological and physical WPV during the past six months were collected. The results showed that the prevalence of psychological and physical WPV was 42.6% and 9.6%, respectively. Relatives of patients were the perpetrators in most WPV incidents. HCWs did not report 57.3% of psychological and 10.0% of physical WPV incidents. Female sex, having physical contact with patients, and working rotational shifts were associated with the increased exposure to psychological and physical WPV. In conclusion, this study showed a high prevalence of WPV against HCWs in Egyptian public hospitals during the COVID-19 pandemic.