Citation

Valles P, Van den Bergh R, van den Boogaard W, Tayler-Smith K, Gayraud O, Mammozai BA, Nasim M, Cheréstal S, Majuste A, Charles JP, Trelles M. Int. Health 2016; 8(6): 390-397.

Affiliation

Médecins Sans Frontières - Operational Centre Brussels, Medical Department, Brussels, Belgium.

Copyright

(Copyright © 2016, Oxford University Press)

DOI

10.1093/inthealth/ihw035

PMID

27810881

Abstract

BACKGROUND: Trauma is a leading cause of death and represents a major problem in developing countries where access to good quality emergency care is limited. Médecins Sans Frontières delivered a standard package of care in two trauma emergency departments (EDs) in different violence settings: Kunduz, Afghanistan, and Tabarre, Haiti. This study aims to assess whether this standard package resulted in similar performance in these very different contexts.

METHODS: A cross-sectional study using routine programme data, comparing patient characteristics and outcomes in two EDs over the course of 2014.

RESULTS: 31 158 patients presented to the EDs: 22 076 in Kunduz and 9082 in Tabarre. Patient characteristics, such as delay in presentation (29.6% over 24 h in Kunduz, compared to 8.4% in Tabarre), triage score, and morbidity pattern differed significantly between settings. Nevertheless, both EDs showed an excellent performance, demonstrating low proportions of mortality (0.1% for both settings) and left without being seen (1.3% for both settings), and acceptable triage performance. Physicians' maximum working capacity was exceeded in both centres, and mainly during rush hours.

CONCLUSIONS: This study supports for the first time the plausibility of using the same ED package in different settings. Mapping of patient attendance is essential for planning of human resources needs.

© The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Language: en