Out of hospital emergency care in Nigeria: A narrative review

Oyedokun, Taofiq; Islam, Ejazul; Eke, N; Oladipo, Olajumoke; Akinola, Olurotimi; Salami, Olufunmilayo

doi:10.1016/j.afjem.2023.06.001

Cited by 2 publications

(4 citation statements)

References 25 publications

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“…This worrying trend was highlighted by Ibrahim et al in a retrospective review of 23,537 patients managed at a tertiary hospital in an urban area, which found that only 2.3% received formal prehospital care [ 30 ]. This gross deficiency of prehospital care is a partial reflection of the nonexistent trauma system on a national scale and the tragic failure of the emergency medical services established by the jurisdictional state governments [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…This study clearly identifies the need to improve prehospital trauma care through the development of a functional national trauma system, which has proven to ensure efficient utilization of resources and enhanced outcomes for victims of RTCs in high-income countries. Recommendations proposed by Oyedokun et al toward improving infrastructure, communication, integration of emergency services, and instituting relevant policies backed by adequate funding offer a blueprint for addressing this chronic problem [ 32 ]. Additionally, there is a need to implement strategies to make the roads safer amidst the rapidly increasing number of motorcycles on Nigerian roads through proper enforcement of appropriate motorcycle rider qualification and licensing processes, compliance with traffic rules and regulations, improvement of road infrastructure, and development of safer urban transport systems.…”

Section: Discussionmentioning

confidence: 99%

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Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Ezeme,

Oladeji,

Baiyewu

et al. 2023

Cureus

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Background: Motorcycle is a popular and growing form of intracity transportation in many Nigerian cities owing mainly to poorly developed transport systems. It contributes significantly to road traffic injuries (RTIs), which are a leading cause of death and disabilities in low- and middle-income countries. There is a lack of information on the quality of care received and the treatment outcome in patients with motorcycle RTIs in Ibadan and many cities in Nigeria. This study evaluated the characteristics of motorcycle-related RTIs, the quality of care received, and the outcome of the patients managed in a trauma reference center in Ibadan, Nigeria. Methods: This is a prospective cohort study. All patients involved in motorcycle road traffic crashes who presented to the emergency department of the University College Hospital, Ibadan, between August 2020 and May 2021, were included in the study. Data on patients’ demographics, history of the crash, injuries sustained, definitive care, and the outcome of in-hospital care were obtained from patients (and/or their carers) and the medical records. Results: A total of 156 patients were seen, out of which 74.4% were males. About 76.2% were less than 45 years with a mean age of 35.7 ± 16.3 years, and the peak age group was 18-44 years. About 37 (23.7%) patients were involved in motorcycle/motorcycle collisions, whereas 67 (42.9%) were involved in motorcycle/car collisions. Riders accounted for 59.6% (93), and although 62% (97) of the patients presented within six hours of the crash, only 10.9% (17) presented within one hour. About 48% received some form of prehospital care rendered by officials of the Federal Road Safety Corps, police officers, or passers-by, and none was attended by a dedicated emergency ambulance team. The head and the limbs were the most affected anatomical areas, while orthopedic and neurosurgical procedures were the most required emergency surgical interventions. About 66.7% were discharged home with only 21.2% of them fit to return to pre-trauma function at discharge, and the mortality rate was 17.3%. Patients who presented at 7-24 hours (AOR = 2.99; 95% CI = 1.04-8.62; p-value = 0.043) and >24 hours after the accident (AOR = 5.65; 95% CI = 1.64-19.53; p-value = 0.006) were 2.99 and 5.65 times, respectively, more likely to die from motorcycle-related accident compared to those who presented within the first six hours. Conclusion: This study identified the growing burden of disabilities and mortalities related to motorcycle RTIs. It highlights the lack of prehospital trauma care, which is a reflection of the deficiency of a national, regional, or jurisdictional trauma system and the critical need to develop a functional trauma system.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Ezeme,

Oladeji,

Baiyewu

et al. 2023

Cureus

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“…The provision of EMS in Nigeria is still nascent after different failed attempts by national and state governments at establishing a comprehensive emergency system in the country. This has resulted in inadequate and often delayed medical care for individuals with medical emergencies [ 16 – 18 ]. Challenges of EMS include a lack of infrastructure, limited resources, and inadequate training [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…This has resulted in inadequate and often delayed medical care for individuals with medical emergencies [ 16 – 18 ]. Challenges of EMS include a lack of infrastructure, limited resources, and inadequate training [ 16 ]. Although improvements in emergency care in Nigeria will involve strengthening human resources, physical resources, and organization and planning for prehospital care and care in hospitals (which are all supply-driven), there is an even greater need to ensure that the citizens are aware of and utilize these supplies when they are available, especially as communication has been noted as a major driver of an effective EMS system [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Strengthening care for emergencies: what is the level of awareness and utilization of Emergency Medical Services (EMS) in FCT, Nigeria?

Nto,

Oluwatola,

Samuel

et al. 2024

BMC Emerg Med

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Background As part of the Federal Government of Nigeria’s desire to increase medical coverage among the citizenry, the National Emergency Medical Service and Ambulance Scheme (NEMSAS) was set up and piloted in the FCT in 2022. To gauge the progress so far, this study sought to assess the level and determinants of public awareness and utilization of Emergency Medical Services (EMS) among residents of the Federal Capital Territory, Abuja. Methods A cross-sectional study was conducted in June 2023 among 1177 respondents residing in FCT Abuja at the time of the survey. Data was collected by trained research assistants using an interviewer-administered questionnaire and purposive sampling was adopted. The level of awareness and the socio-demographic determinants of the level of awareness in the FCT were assessed. Logistic regression was used to find predictors of EMS awareness and utilization. Results 57.8% of respondents are aware of EMS, while 42.2% are not. 62.7% are uncertain about the source of information for EMS with only a minority relying on word of mouth (17.7%), traditional media (11.1%), or social media (8.5%). 91.4% have not accessed or utilized EMS via the toll-free emergency line, while only 8.6% reported doing so. There are median EMS awareness and utilization differences across gender, age, location, and employment status of the respondents. Additionally, the multivariate logistic regression showed that age, location, and employment status are significant predictors of EMS awareness and utilization. Males have lower odds of awareness and utilization of EMS compared to females. Furthermore, there was a significant relationship between EMS access and utilization (Chi-square = 80.748, p < 0.001). However, awareness did not necessarily translate to utilization. Conclusion The relationship between EMS awareness and utilization and the unmasked predictors in this paper should be factored into the design of interventions to increase access and utilization of EMS in Nigeria.

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Out of hospital emergency care in Nigeria: A narrative review

Cited by 2 publications

References 25 publications

Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Strengthening care for emergencies: what is the level of awareness and utilization of Emergency Medical Services (EMS) in FCT, Nigeria?

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