At a Nigerian university hospital, none of the motorcyclists who presented over a 12 month period had been wearing a helmet, and of the eight patients who died, seven had head injuries. Of the five collision types described, the rate of motorcycle-other vehicle collisions was highest at 40.6%, while the motorcycle-pedestrian rate was 23.4%. Measures to prevent these collisions might reduce overall crashes by 64%; in addition, helmet law should be enforced.
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Inadequacies were found in clinical documentation, especially gross underutilization of discharge summary forms. However, some forms were properly documented, suggesting that hospital healthcare providers possess the necessary skills for quality clinical documentation but lack the will. There is a need to institute a clinical documentation improvement program and promote quality clinical documentation among staff.
Background and Objectives: Data on trauma in Nigeria requires updating just as trauma care needs coordination and organization. This study was done to examine the clinical spectrum of trauma and to propose measures for organization of trauma care. Patients and Methods: A 2-year prospective report of an ongoing trauma research is presented. Data obtained from include name, age, sex, presenting diagnosis at the accident and emergency (A and E) unit, injury-arrival time, mode of transportation of patients to the hospital, and the outcome of care. Results: Trauma patients comprised 2,913 of the 4,164 (70.0%) surgical patients seen in the A and E but 129 of 171 deaths (75.4%). Types of trauma were lacerations (585 patients, 20.1%), fractures (542, 18.7%), head injury (250, 8.6%), multiple injuries (249, 8.6%), burns (159, 5.5%), and others. Road traffic accidents (RTA) occurred in 1,816 patients (62.3%), falls in 308, assaults in 258, burns in 159, home accidents in 122, gunshot injuries in 107, industrial accidents in 73, and foreign body injuries in 70. There was no pre-hospital care. Transport to the A and E was done by relations, the police and a few Good Samaritans. Most of the patients reached the hospital in < 6 h. Common mortalities were from head injury (37 patients, 28.7%), multiple injuries (35, 27.1%), fractures (12, 9.3%), and burns (9, 7.0%). Of 106 deaths with timed records, 22 (20.7%), 56 (53.0%) and 28 (26.3%) occurred in 0-1 h, > 1-24 h and > 24 h, respectively. Conclusions: The spectrum of trauma is predominantly RTA-related, hence, trauma care organization would include prevention of RTA, organization of pre-hospital care aimed at transport time of < 2 h, training volunteers from the populace and the police as emergency medical services technicians for resuscitation during transport and getting patients to hospital in optimal state, and an enhanced in-hospital care by designation and categorization of hospitals. These strategies, including continuous trauma research and funding, would go a long way in reducing mortalities from trauma, especially from RTA.
Background and purpose Childhood injury is of great significance globally and epidemiological data on the subject in most developing countries are inadequate. Informed demographics can help direct resources toward research and programs most likely to reduce the burden.Methods A survey to determine the prevalence, mechanism of injury, and intervention measures was conducted using pretested questionnaires distributed to consented parents/guardians of children 15 years and younger who presented at six selected hospitals (representing public and private and low or high income clientele hospitals) for healthcare needs for any reason. Results were analyzed using Epi Info (6.04) and SPSS software (version 15).Results There were 1088 respondents comprising parents (96.5%) and guardians (3.5%). Most were 21-40 years old (86.2%) and 51.9% of them had more than three children living with them. Over 50% had witnessed injuries of their wards within the previous 12 months and about a quarter admitted that a child was injured more than once. The risk of injury was twice in the male child mainly in the 1-4 years age group. Most injuries (65.2%) occurred at home, with 98% being unintentional from falls (62.6%) and 71.9% of the times the parents witnessed the injury as it occurred. The intentional injuries (2%) followed assaults during fights among peers. Treatment was provided at home in 58.5% of children by the parents, whereas only 27.5% took their wards to the hospital; 12.6% received treatment at patent medicine stores and 1.3% from the herbal/ traditional bone setters' home. Two deaths resulted from the injuries from fall, whereas six children had residual deformity as a result of home injury. Three-quarter (74.8%) of the respondents believed childhood injuries were preventable.Conclusion Childhood injuries are not uncommon in the community. The significant proportions of respondents using inappropriate means of treatment and who believed that injuries are not preventable represent targets for health education and counseling in the community. Ann
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