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An analysis of the clinical practice of emergency medicine in public emergency departments in Kenya
  1. Benjamin W Wachira1,
  2. Lee A Wallis2,
  3. Heike Geduld3
  1. 1University of Cape Town, Boston, Bellville, South Africa
  2. 2Division of Emergency Medicine,University of Stellenbosch, Cape Town, South Africa
  3. 3Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
  1. Correspondence to Dr. Benjamin W. Wachira 21 Salisbury Road, Boston, Bellville 7530 South Africa; benjawambugu{at}yahoo.com

Abstract

Objectives To describe the case mix, interventions, procedures and management of patients in public emergency departments (ED) in Kenya.

Methods An observational study over 24 h, of patients who presented to 15 public ED during the 3-month period from 1 October to 31 December 2010. The study was conducted across Kenya in two national referral hospitals, five secondary level hospitals and eight primary level hospitals. All patients presenting alive to the ED during the 24-h study period that were seen by a doctor or clinical officer were included in the study. A data collection form was completed by the primary investigator at the time of the initial ED consultation documenting patient demographics, presenting complaints, investigations ordered, procedures done, initial diagnosis and outcome of ED consultation.

Results Data on 1887 patient presentations were described. Adults (≥13 years) accounted for the majority (70%) of patients. Two peak age groups, 0–9 and 20–29 years, accounted for 27% and 25% of patients, respectively. Respiratory and trauma presentations each accounted for 21% of presentations, with a wide spread of other presentations. Over half (58%) of the patients were investigated in the department. 385 patients received immediate treatment in the ED before discharge. Fewer than one in three patients admitted or transferred to specialist units received any therapy in the ED.

Conclusions ED in Kenya provide care to an undifferentiated patient population yet most of the immediate therapy is provided only to patients with minor conditions who are subsequently discharged. Sicker patients have to await transfer to wards or specialist units to start receiving treatment.

  • Case mix
  • emergency care systems
  • emergency department
  • emergency medicine
  • demographics
  • Kenya

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Footnotes

  • Funding All costs were borne by the primary investigator.

  • Competing interests None.

  • Ethics approval The study was approved by the University of Cape Town ethics committee (REC 208/2010). Patient confidentiality was maintained by secure storage of data sheets, use of an anonymous coding system and restricted access to the database.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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