A descriptive study of the use of cardiac point of care ultrasound (PoCUS) in public emergency centres in Cape Town.

Introduction: The indications for cardiac point of care ultrasound (PoCUS) vary somewhat in different parts of the world, and training programs may also differ. We set out to describe the self-reported cardiac PoCUS indications and imaging windows used at a selection of secondary-level, public hospital emergency centres in Cape Town.

Methods: A descriptive study with prospective data collected from emergency centres of Mitchells Plain District, Victoria and New Somerset Hospitals in Cape Town were used.

Effect of hospital interventions to improve patient flow on emergency department clinical quality indicators.

Introduction: The Royal College of Emergency Medicine highlights poor flow through hospitals as a major challenge to improving emergency department flow. We describe the effect of several hospital-wide flow interventions on Yeovil District Hospital's emergency department flow.

Methods: During 2016, a design science research study addressed several areas disproportionally contributing to exit block within Yeovil District Hospital.

Global health and the Royal College of Emergency Medicine: a cross-sectional survey of members and fellows.

Background: There is growing interest in global health participation among emergency care doctors in the UK. The aim of this paper was to describe the demographics of members and fellows of the Royal College of Emergency Medicine involved in global health, the work they are involved in, as well as the benefits and barriers of this work.

Methods: We conducted a survey to include members and fellows of the Royal College of Emergency Medicine describing the context of their global health work, funding arrangements for global health work and perceived barriers to, and benefits of, global health work.

Strengthening prehospital clinical practice guideline implementation in South Africa: a qualitative case study.

Background: Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, research into alternative methods of CPG development using existing CPG documents (CPG adaptation) - a specific issue for guideline development groups in low- and middle-income countries - is sparse. There are only a few examples showcasing the pragmatic application of such alternative approaches in settings with time and budget constraints, especially in the prehospital setting.

An international, interprofessional investigation of the self-reported podcast listening habits of emergency clinicians: A METRIQ Study.

Objectives: Podcasts are increasingly being used for medical education. A deeper understanding of usage patterns would inform both producers and researchers of medical podcasts. We aimed to determine how and why podcasts are used by emergency medicine and critical care clinicians.

Disparity in conference registration cost for delegates from low- and middle-income backgrounds.

Background: Better access for clinicians from low- and middle-income countries to international conferences can improve collaborative opportunities and subsequently address the knowledge gap between the weaker and stronger knowledge economies. A better understanding of the cost of international conferences may help conference organisers improve access to their conferences. This study aimed to describe the expense-associated barriers to a selection of international emergency medicine and critical care conferences, in terms of registration cost and out-of-pocket expense.

A cross-sectional description of open access publication costs, policies and impact in emergency medicine and critical care journals.

Introduction: Finding journal open access information alongside its global impact requires access to multiple databases. We describe a single, searchable database of all emergency medicine and critical care journals that include their open access policies, publication costs, and impact metrics.

Methods: A list of emergency medicine and critical care journals (including citation metrics) was created using Scopus (Citescore) and the Web of Science (Impact Factor).

Utilisation of emergency blood in a cohort of South African emergency centres with no direct access to a blood bank.

Introduction: The transfusion of emergency blood is an essential part of haemostatic resuscitation. Locally, where direct access to a blood bank is limited, emergency blood is stored within emergency centres. It was previously suggested that stored blood provides inadequate volumes compared to what is needed.

Access to acute care resources in various income settings to treat new-onset stroke: A survey of acute care providers.

Introduction: Stroke affects 15 million people annually and is responsible for 5 million deaths per annum globally. In contrast to the trend in low- and middle-income countries (LMICs), stroke mortality is on the decline in high-income countries (HICs). Even though the availability of resources varies considerably by geographic region and across LMICs and HICs, evidence suggests that material resources in LMICs to implement recommendations from international guidelines are largely unmet.

Dissemination patterns of scientific abstracts presented at the first and second African Conference of Emergency Medicine.

Introduction: Evidence based medicine is the standard of modern health care practices. Ongoing biomedical research is needed to expand existing knowledge and improve quality of care, but it needs to reach clinicians to drive change. Journal articles and conference presentations are dissemination tools.

The variables perceived to be important during patient handover by South African prehospital care providers.

Introduction: High-acuity patients are typically transported directly to the emergency centre via ambulance by trained prehospital care providers. As such, the emergency centre becomes the first of many physical transition points for patients, where a change of care provider (or handover) takes place. The aim of this study was to describe the variables perceived to be important during patient handover by a cohort of South African prehospital care providers.

Access to Top-Cited Emergency Care Articles (Published Between 2012 and 2016) Without Subscription.

Introduction: Unrestricted access to journal publications speeds research progress, productivity, and knowledge translation, which in turn develops and promotes the efficient dissemination of content. We describe access to the 500 most-cited emergency medicine (EM) articles (published between 2012 and 2016) in terms of publisher-based access (open access or subscription), alternate access routes (self-archived or author provided), and relative cost of access.

Methods: We used the Scopus database to identify the 500 most-cited EM articles published between 2012 and 2016.

Poor access to acute care resources to treat major trauma in low- and middle-income settings: A self-reported survey of acute care providers.

Introduction: Injury and violence are neglected global health concerns, despite being largely predictable and therefor preventable. We conducted a small study to indirectly describe and compare the perception of availability of resources to manage major trauma in high-income, and low- and middle-income countries using evidence-based guidance (as per the 2016 National Institute of Clinical Excellence guidelines), as self-reported by delegates attending the 2016 International Conference on Emergency Medicine held in South Africa.

Methods: A survey was distributed to delegates at the International Conference on Emergency Medicine 2016.

Global emergency care clinical practice guidelines: A landscape analysis.

Introduction: An adaptive guideline development method, as opposed to a guideline development, is dependent on access to existing high-quality up-to-date clinical practice guidelines (CPGs). We described the characteristics and quality of CPGs relevant to prehospital care worldwide, in order to strengthen guideline development in low-resource settings for emergency care.

Methods: We conducted a descriptive study of a database of international CPGs relevant to emergency care produced by the African Federation for Emergency Medicine (AFEM) CPG project in 2016.

Estimated injury-associated blood loss versus availability of emergency blood products at a district-level public hospital in Cape Town, South Africa.

Introduction: International guidance suggests that injury-associated haemorrhagic shock should be resuscitated using blood products. However, in low- and middle-income countries resuscitation emphasises the use of crystalloids - mainly due to poor access to blood products. This study aimed to estimate the amount of blood loss from serious injury in relation to available emergency blood products at a secondary-level, public Cape Town hospital.

The case for a regional approach to publication impact.

Healthcare-related research is largely regional. Put simply, this is because disease burdens differ between world regions. Even global burdens, such as ischaemic heart disease and cancer, display distinctive characteristics in certain regions that are not seen in others.

Poor Access for African Researchers to African Emergency Care Publications: A Cross-sectional Study.

Introduction: Based on relative population size and burden of disease, emergency care publication outputs from low- and middle-income regions are disproportionately lower than those of high-income regions. Ironically, outputs from regions with higher publication rates are often less relevant in the African context. As a result, the dissemination of and access to local research is essential to local researchers, but the cost of this access (actual and cost-wise) remains unknown.

Describing the categories of people that contribute to an Emergency Centre crowd at Khayelitsha hospital, Western Cape, South Africa.

Introduction: Emergency Centre (EC) crowding has globally been recognised to adversely affect patients, staff and visitors. Anecdotally, local ECs are perceived to be fairly crowded, however, not much is known about the size of this crowd and what constitutes it. Although more reliable, resource restrictions render more detailed flow studies less achievable.