for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Elsevier   (Total: 3031 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Showing 1 - 200 of 3031 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 302, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 195, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 119, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 33, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 303, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 389, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 3, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 7, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 173, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 152, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 141, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover African Journal of Emergency Medicine
  [SJR: 0.344]   [H-I: 6]   [4 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 2211-419X
   Published by Elsevier Homepage  [3031 journals]
  • Uchunguzi (Journal Watch/ Montre de Journal)

    • Authors: Benjamin W. Wachira
      Pages: 38 - 39
      Abstract: Publication date: March 2017
      Source:African Journal of Emergency Medicine, Volume 7, Issue 1
      Author(s): Benjamin W. Wachira


      PubDate: 2017-03-08T08:14:05Z
      DOI: 10.1016/j.afjem.2017.02.001
       
  • Poor adherence to Tranexamic acid guidelines for adult, injured patients
           presenting to a district, public, South African hospital

    • Authors: Jacobus G.G. Wiese; Daniël J. van Hoving; Luke Hunter; Sa'ad Lahri; Stevan R. Bruijns
      Abstract: Publication date: Available online 19 April 2017
      Source:African Journal of Emergency Medicine
      Author(s): Jacobus G.G. Wiese, Daniël J. van Hoving, Luke Hunter, Sa'ad Lahri, Stevan R. Bruijns
      Introduction In South Africa’s high injury prevalent setting, it is imperative that injury mortality is kept to a minimum. The CRASH-2 trial showed that Tranexamic acid (TXA) in severe injury reduces mortality. Implementation of this into injury protocols has been slow despite the evidence. The 2013 Western Cape Emergency Medicine Guidelines adopted the use of TXA. This study aims to describe compliance. Methods A retrospective study of TXA use in adult injury patients presenting to Khayelitsha Hospital was done. A sample of 301 patients was randomly selected from Khayelitsha’s resuscitation database and data were supplemented through chart review. The primary endpoint was compliance with local guidance: systolic blood pressure <90 or heart rate >110 or a significant risk of haemorrhage. Injury Severity Score (ISS) was used as a proxy for the latter. ISS >16 was interpreted as high risk of haemorrhage and ISS <8 as low risk. Linear regression and Fischer’s Exact test were used to explore assumptions. Results Overall compliance was 58% (172 of 295). For those without an indication, this was 96% (172 of 180). Of the 115 patients who had an indication, only eight (18%) received the first dose of TXA and none received a follow-up infusion. Compliance with the protocol was significantly better if an indication for TXA did not exist, compared to when one did (p<0.001). Increased TXA use was associated only with ISS >15 (p<0.001). Discussion TXA is not used in accordance with local guidelines. It was as likely not to be used when indicated than when not indicated. Reasons for this are multifactorial and likely include stock levels, lack of administration equipment, time to reach definitive care, poor documentation and hesitancy to use. Further investigation is needed to understand the barriers to administration.

      PubDate: 2017-04-19T20:18:48Z
      DOI: 10.1016/j.afjem.2017.04.006
       
  • Percutaneous coronary intervention still not accessible for many South
           Africans

    • Authors: Willem Stassen; Lee Wallis; Craig Lambert; Maaret Castren; Lisa Kurland
      Abstract: Publication date: Available online 19 April 2017
      Source:African Journal of Emergency Medicine
      Author(s): Willem Stassen, Lee Wallis, Craig Lambert, Maaret Castren, Lisa Kurland
      Introduction The incidence of myocardial infarction is rising in Sub-Saharan Africa. In order to reduce mortality, timely reperfusion by percutaneous coronary intervention (PCI) or thrombolysis followed by PCI is required. South Africa has historically been characterised by inequities in healthcare access based on geographic and socioeconomic status. We aimed to determine the coverage of PCI-facilities in South Africa and relate this to access based on population and socio-economic status. Methods This cross-sectional study obtained data from literature, directories, organisational databases and correspondence with Departments of Health and hospital groups. Data was analysed descriptively while Spearman’s Rho sought correlations between PCI-facility resources, population, poverty and medical insurance status. Results South Africa has 62 PCI-facilities. Gauteng has the most PCI-facilities (n=28) while the Northern Cape has none. Most PCI-facilities (n=48; 77%) are owned by the private sector. A disparity exists between the number of private and state-owned PCI-facilities when compared to the poverty (r=0.01; p=0.17) and insurance status of individuals (r=−0.4; p=0.27). Conclusion For many South Africans, access to PCI-facilities and primary PCI is still impossible given their socio-economic status or geographical locale. Research is needed to determine the specific PCI-facility needs based on geographic and epidemiological aspects, and to develop a contextualised solution for South Africans suffering a myocardial infarction.

      PubDate: 2017-04-19T20:18:48Z
      DOI: 10.1016/j.afjem.2017.04.009
       
  • Student paramedic rapid sequence intubation in Johannesburg, South Africa:
           A case series

    • Authors: Christopher Stein
      Abstract: Publication date: Available online 7 March 2017
      Source:African Journal of Emergency Medicine
      Author(s): Christopher Stein
      Introduction Pre-hospital rapid sequence intubation was introduced within paramedic scope of practice in South Africa seven years ago. Since then, little data has been published on this high-risk intervention as practiced operationally or by students learning rapid sequence intubation in the pre-hospital environment. The objective of this study was to describe a series of pre-hospital rapid sequence intubation cases, including those that South African University paramedic students had participated in. Methods A University clinical learning database was searched for all endotracheal intubation cases involving the use of neuromuscular blockers between 1 January 2011 and 31 December 2015. Data from selected cases were extracted and analysed descriptively. Results Data indicated that most patients were young adult trauma victims with a dominant injury mechanism of vehicle-related accidents. The majority of cases utilised ketamine and suxamethonium, with a low rate of additional paralytic medication administration. 63% and 72% of patients received post-intubation sedation and analgesia, respectively. The overall intubation success rate from complete records was 99.6%, with a first pass success rate of 87.9%. Students were successful in 92.4% of attempts with a first-pass success rate of 85.2%. Five percent of patients experienced cardiac arrest between rapid sequence intubation and hospital arrival. Discussion Students demonstrated a good intubation success and first pass-success rate. However, newly qualified paramedics require strict protocols, clinical governance, and support to gain experience and perform pre-hospital rapid sequence intubation at an acceptable level in operational practice. More research is needed to understand the low rate of post-intubation paralysis, along with non-uniform administration of post-intubation sedation and analgesia, and the 5% prevalence of cardiac arrest.

      PubDate: 2017-03-08T08:14:05Z
      DOI: 10.1016/j.afjem.2017.01.005
       
  • In this issue…

    • Abstract: Publication date: March 2017
      Source:African Journal of Emergency Medicine, Volume 7, Issue 1


      PubDate: 2017-03-08T08:14:05Z
       
  • Global research highlights

    • Abstract: Publication date: March 2017
      Source:African Journal of Emergency Medicine, Volume 7, Issue 1


      PubDate: 2017-03-08T08:14:05Z
       
  • Stability of warmed and cooled intravenous fluids used in Emergency Room

    • Authors: Doudou Nzaumvila; Indiran Govender
      Abstract: Publication date: Available online 14 February 2017
      Source:African Journal of Emergency Medicine
      Author(s): Doudou Nzaumvila, Indiran Govender


      PubDate: 2017-02-16T10:39:50Z
      DOI: 10.1016/j.afjem.2017.01.008
       
  • Emergency care capabilities in the Kingdom of Swaziland, Africa

    • Authors: Erika Phindile Chowa; Janice A. Espinola; Ashley F. Sullivan; Masitsela Mhlanga; Carlos A. Camargo
      Abstract: Publication date: Available online 28 January 2017
      Source:African Journal of Emergency Medicine
      Author(s): Erika Phindile Chowa, Janice A. Espinola, Ashley F. Sullivan, Masitsela Mhlanga, Carlos A. Camargo
      Introduction Emergency care is available in many forms in Swaziland, and to our knowledge there has never been a systematic study of emergency centres (ECs) in the country. The purpose of this study was to describe the characteristics, resources and capacity of emergency centres in the Kingdom. Methods The National Emergency Department Inventory (NEDI)-International survey instrument (www.emnet-nedi.org) was used to survey all Swaziland ECs accessible to the general public 24/7. EC staff were asked about calendar year 2014. Data were entered directly into Lime Survey, a free, web-based, open-source survey application. Responses were analysed using descriptive statistics, including proportions and medians with interquartile ranges (IQR). Results Sixteen of 17 ECs participated (94% response rate). Participating ECs were either in hospitals (69%) or health centres (31%). ECs had a median of 53,399 visits per year (IQR 15,000–97,895). Fourteen (88%) ECs had a contiguous layout, and the other two (12%) were non-contiguous. Overall, eight (53%) had access to cardiac monitors and 11 (69%) had a 24/7 clinical laboratory available. Only 1 (6%) EC had a dedicated CT scanner, while 2 (13%) others had limited access through their hospital. The typical EC length-of-stay was between 1 and 6h (44%). The most commonly available specialists were general surgeons, with 9 (56%) ECs having them available for in-person consultation. No ECs had a plastic surgeon or psychiatrist available. Overall, 75% of ECs reported running at overcapacity. Discussion Swaziland ECs were predominantly contiguous and running at overcapacity, with high patient volumes and limited resources. The limited access to technology and specialists are major challenges. We believe that these data support greater resource allocation by the Swaziland government to the emergency care sector.

      PubDate: 2017-02-02T08:52:48Z
      DOI: 10.1016/j.afjem.2017.01.004
       
  • African emergency care providers’ attitudes and practices towards
           research

    • Authors: D.J. van Hoving; P. Brysiewicz
      Abstract: Publication date: Available online 28 January 2017
      Source:African Journal of Emergency Medicine
      Author(s): D.J. van Hoving, P. Brysiewicz
      Introduction Emergency care research in Africa is not on par with other world regions. The study aimed to assess the perceptions and practices towards research among current emergency care providers in Africa. Methods A survey was sent to all individual members of the African Federation of Emergency Medicine. The survey was available in English and French. Results One hundred and sixty-eight responses were analysed (invited n=540, responded n=188, 34.8%, excluded n=20). Responders’ mean age was 36.3years (SD=9.1); 122 (72.6%) were male, 104 (61.9%) were doctors, and 127 (75.6%) were African trained. Thirty-seven (22%) have never been involved in research; 33 (19.6%) have been involved in ⩾5 research projects. African related projects were mostly relevant to African audiences (n=106, 63.1%). Ninety-four (56%) participants have never published. Forty-one (24.4%) were not willing to publish in open access journals requesting a publication fee; 65 (38.7%) will consider open access journals if fees are sponsored. Eighty responders (47.6%) frequently experienced access block to original articles due to subscription charges. Lack of research funding (n=108, 64.3%), lack of research training (n=86, 51.2%), and lack of allocated research time (n=76, 45.2%) were the main barriers to research involvement. Improvement of research skills (n=118, 70.2%) and having research published (n=117, 69.6%) were the top motivational factors selected. Responders agreed that research promotes critical thinking (n=137, 81.5%) and serve as an important educational tool (n=134, 80.4%). However, 134 (79.8%) feel that emergency care workers need to be shown how to use research to improve clinical practice. Most agreed that insufficient emergency care research is being conducted in Africa (n=113, 67.3%). Discussion There is scope to increase research involvement in emergency care in Africa, but solutions need to be find to address lack of research-related funding, training and time.

      PubDate: 2017-02-02T08:52:48Z
      DOI: 10.1016/j.afjem.2017.01.003
       
  • Case mix of patients managed in the resuscitation area of a district-level
           public hospital in Cape Town

    • Authors: L.D. Hunter; S. Lahri; D.J. van Hoving
      Abstract: Publication date: Available online 28 January 2017
      Source:African Journal of Emergency Medicine
      Author(s): L.D. Hunter, S. Lahri, D.J. van Hoving


      PubDate: 2017-02-02T08:52:48Z
      DOI: 10.1016/j.afjem.2017.01.001
       
  • Cervical collars and immobilisation: A South African best practice
           recommendation

    • Authors: D. Stanton; T. Hardcastle; D. Muhlbauer; D. van Zyl
      Abstract: Publication date: Available online 28 January 2017
      Source:African Journal of Emergency Medicine
      Author(s): D. Stanton, T. Hardcastle, D. Muhlbauer, D. van Zyl
      Introduction The consequences of spinal injury as a result of trauma can be devastating. Spinal immobilisation using hard trauma boards and rigid cervical collars has traditionally been the standard response to suspected spinal injury patients even though the risk may be extremely low. Recently, adverse events due to the method of immobilisation have challenged the need for motion restriction in all trauma patients. International guidelines have been published for protection of the spine during transport and this article brings those guidelines into the South African context. Recommendations Trauma patients need to be properly assessed using both an approved list of high and low risk factors, as well as a thorough examination. They should then be managed accordingly. Internationally validated assessment strategies have been developed, and should be used as part of the patient assessment. The method of motion restriction should be selected to suit the situation. The use of a vacuum mattress is the preferable technique, with the use of a trauma board being the least desirable. Conclusion The need for motion restriction in suspected spinal injury should be properly evaluated and appropriate action taken. Not all trauma patients require spinal motion restriction.

      PubDate: 2017-02-02T08:52:48Z
      DOI: 10.1016/j.afjem.2017.01.007
       
  • A description of pharmacological analgesia administration by public sector
           advanced life support paramedics in the City of Cape Town

    • Authors: Ryan Matthews; Michael McCaul; Wayne Smith
      Abstract: Publication date: Available online 28 January 2017
      Source:African Journal of Emergency Medicine
      Author(s): Ryan Matthews, Michael McCaul, Wayne Smith
      Introduction Emergency Medical Services are ideally placed to provide relief of acute pain and discomfort. The objectives of this study were to describe pre-hospital pain management practices by Emergency Medical Services in the Western Cape, South Africa. Methods A retrospective, descriptive survey was undertaken of analgesic drug administration by advanced life support paramedics. Patient care records generated in the City of Cape Town during an 11-month period containing administrations of morphine, ketamine, nitrates and 50% nitrous oxide/oxygen were randomly sampled. Variables studied were drug dose, dose frequency, and route of administration, patient age, gender, disorder and call type as well as qualification and experience level of the provider. Results A total of 530 patient care records were included (n=530). Morphine was administered in 371 (70%, 95% CI 66–74) cases, nitrates in 197 (37%, 95% CI 33–41) and ketamine in 9 (1.7%, 95% CI 1–3) cases. A total of 5mg or less of morphine was administered in 278 (75%, 95% CI 70–79) cases, with the median dose being 4mg (IQR 3–6). Single doses were administered to 268 (72.2%, 95% CI 67–77) morphine administrations, five (56%, 95% CI 21–86) ketamine administrations and 161 (82%, 95% CI 76–87) of nitrate administrations. Chest pain was the reason for pain management in 226 (43%) cases. Advanced Life Support Providers had a median experience level of two years (IQR 2–4). Discussion Pre-hospital acute pain management in the Western Cape does not appear to conform to best practice as Advanced Life Support providers in the Western Cape use low doses of morphine. Chest pain is an important reason for drug administration in acute pre-hospital pain. Multimodal analgesia is not a feature of care in this pre-hospital service. The development of a Clinical Practice Guideline for and training in pre-hospital pain should be viewed as imperative.

      PubDate: 2017-02-02T08:52:48Z
      DOI: 10.1016/j.afjem.2017.01.002
       
  • A systematic review of burn injuries in low- and middle-income countries:
           Epidemiology in the WHO-defined African Region

    • Authors: Megan M. Rybarczyk; Jesse M. Schafer; Courtney M. Elm; Shashank Sarvepalli; Pavan A. Vaswani; Kamna S. Balhara; Lucas C. Carlson; Gabrielle A. Jacquet
      Abstract: Publication date: Available online 28 January 2017
      Source:African Journal of Emergency Medicine
      Author(s): Megan M. Rybarczyk, Jesse M. Schafer, Courtney M. Elm, Shashank Sarvepalli, Pavan A. Vaswani, Kamna S. Balhara, Lucas C. Carlson, Gabrielle A. Jacquet
      Introduction According to the World Health Organization (WHO), burns result in the loss of approximately 18 million disability adjusted life years (DALYs) and more than 250,000 deaths each year, more than 90% of which are in low- and middle-income countries (LMICs). The epidemiology of these injuries, especially in the WHO-defined African Region, has yet to be adequately defined. Methods We performed a systematic review of the literature regarding the epidemiology of thermal, chemical, and electrical burns in the WHO-defined African Region. All articles indexed in PubMed, EMBASE, Web of Science, Global Health, and the Cochrane Library databases as of October 2015 were included. Results The search resulted in 12,568 potential abstracts. Through multiple rounds of screening using criteria determined a priori, 81 manuscripts with hospital-based epidemiology as well as eleven manuscripts that included population-based epidemiology were identified. Although the studies varied in methodology, several trends were noted: young children appear to be at most risk; most individuals were burned at home; and hot liquids and flame are the most common aetiologies. Discussion While more population-based research is essential to identifying specific risk factors for targeted prevention strategies, our review identifies consistent trends for initial efforts at eliminating these often devastating and avoidable injuries.

      PubDate: 2017-02-02T08:52:48Z
      DOI: 10.1016/j.afjem.2017.01.006
       
  • Bedside ultrasound as a simple non-invasive method of assessing
           intracranial pressure in limited resource setting

    • Authors: Ayalew Zewdie; Haymanot Tesema; Abenezer Tirsit Aklilu; Tsegazeab Laeke Teklemariam; Tigist Zewdu; Yordanos Ashagre; Yemsrach Bizuneh; Aklilu Azazh; Getaw Worku Hassen
      Abstract: Publication date: Available online 22 July 2016
      Source:African Journal of Emergency Medicine
      Author(s): Ayalew Zewdie, Haymanot Tesema, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Tigist Zewdu, Yordanos Ashagre, Yemsrach Bizuneh, Aklilu Azazh, Getaw Worku Hassen
      Introduction Increased intracranial pressure is usually measured with invasive methods that are not practical in resource-limited countries. However, bedside ultrasound, a non-invasive method, measures the optic nerve sheath diameter and could be a safe and accurate alternative to measure intracranial pressure, even in children. Case report We report a case of a 15-year old patient who presented with severe headache, projectile vomiting, and neck pain for two months. The bedside ultrasound showed a 10mm optic nerve sheath diameter and a Computed Tomography scan of her brain revealed obstructive hydrocephalus secondary to a mass in the fourth ventricle. After intervening, we were able to monitor the decrease in her optic nerve sheath diameter with ultrasound. Conclusion Performing invasive procedures continues to be a challenge in the resource limited setting. However, bedside ultrasound can be a useful tool in emergency centres for early detection and monitoring of intracranial pressure.

      PubDate: 2016-07-26T00:41:59Z
      DOI: 10.1016/j.afjem.2016.06.002
       
  • South African pre-hospital guidelines: Report on progress and way forward

    • Authors: Michael McCaul; Ben de Waal; Peter Hodkinson; Karen Grimmer
      Pages: 113 - 115
      Abstract: Publication date: Available online 20 August 2016
      Source:African Journal of Emergency Medicine
      Author(s): Michael McCaul, Ben de Waal, Peter Hodkinson, Karen Grimmer


      PubDate: 2016-08-25T11:09:38Z
      DOI: 10.1016/j.afjem.2016.08.004
       
  • Developing metrics for emergency care research in low- and middle-income
           countries

    • Authors: Samer Abujaber; Cindy Y. Chang; Teri A. Reynolds; Hani Mowafi; Ziad Obermeyer
      Pages: 116 - 124
      Abstract: Publication date: Available online 12 August 2016
      Source:African Journal of Emergency Medicine
      Author(s): Samer Abujaber, Cindy Y. Chang, Teri A. Reynolds, Hani Mowafi, Ziad Obermeyer
      Introduction There is little research on emergency care delivery in low- and middle-income countries (LMICs). To facilitate future research, we aimed to assess the set of key metrics currently used by researchers in these settings and to propose a set of standard metrics to facilitate future research. Methods Systematic literature review of 43,109 published reports on general emergency care from 139 LMICs. Studies describing care for subsets of emergency conditions, subsets of populations, and data aggregated across multiple facilities were excluded. All facility- and patient-level statistics reported in these studies were recorded and the most commonly used metrics were identified. Results We identified 195 studies on emergency care delivery in LMICs. There was little uniformity in either patient- or facility-level metrics reported. Patient demographics were inconsistently reported: only 33% noted average age and 63% the gender breakdown. The upper age boundary used for paediatric data varied widely, from 5 to 20years of age. Emergency centre capacity was reported using a variety of metrics including annual patient volume (n =175, 90%); bed count (n =60, 31%), number of rooms (n =48, 25%); frequently none of these metrics were reported (n =16, 8%). Many characteristics essential to describe capabilities and performance of emergency care were not reported, including use and type of triage; level of provider training; admission rate; time to evaluation; and length of EC stay. Conclusion We found considerable heterogeneity in reporting practices for studies of emergency care in LMICs. Standardised metrics could facilitate future analysis and interpretation of such studies, and expand the ability to generalise and compare findings across emergency care settings.

      PubDate: 2016-08-15T10:01:39Z
      DOI: 10.1016/j.afjem.2016.06.003
       
  • Bedside ultrasound training at Muhimbili National Hospital in Dar es
           Salaam, Tanzania and Hospital San Carlos in Chiapas, Mexico

    • Authors: Teri A. Reynolds; Jeanne Noble; Gehres Paschal; Hendry Robert Sawe; Aparajita Sohoni; Sachita Shah; Bret Nicks; Victor Mwafongo; John Stein
      Pages: 125 - 131
      Abstract: Publication date: Available online 7 April 2016
      Source:African Journal of Emergency Medicine
      Author(s): Teri A. Reynolds, Jeanne Noble, Gehres Paschal, Hendry Robert Sawe, Aparajita Sohoni, Sachita Shah, Bret Nicks, Victor Mwafongo, John Stein
      Introduction In resource-rich settings, bedside ultrasound has rapidly evolved to be a crucial part of emergency centre practice and a growing part of critical care practice. This portable and affordable technology may be even more valuable in resource-limited environments where other imaging modalities are inaccessible, but the optimal amount of training required to achieve competency in bedside ultrasound is largely unknown. We sought to evaluate the feasibility of implementation of a mixed-modality bedside ultrasound training course for emergency and generalist acute care physicians in limited resource settings, and to provide a description of our core course components, including specific performance goals, to facilitate implementation of similar initiatives. Methods We conducted a standardised training course at two distinct sites—one large, urban tertiary hospital in Tanzania with a dedicated Emergency Centre, and one small, rural, hospital in southern Mexico with a general, acute intake area. We report on pre-training ultrasound use at both sites, as well as pre- and post-training views on most useful indications. Results Overall, participants were very satisfied with the course, although approximately one-third of the providers at both sites would have preferred more hands-on training. All participants passed a standardised exam requiring image acquisition and interpretation. Discussion Introducing bedside ultrasound training in two distinct resource-limited settings was feasible and well-received. After a brief intensive period of training, participants successfully passed a comprehensive examination, including demonstration of standardised image acquisition and accurate interpretation of normal and abnormal studies.

      PubDate: 2016-04-08T23:57:06Z
      DOI: 10.1016/j.afjem.2016.03.001
       
  • A pilot training program for point-of-care ultrasound in Kenya

    • Authors: Greg Bell; Benjamin Wachira; Gerene Denning
      Pages: 132 - 137
      Abstract: Publication date: Available online 6 April 2016
      Source:African Journal of Emergency Medicine
      Author(s): Greg Bell, Benjamin Wachira, Gerene Denning
      Introduction Ultrasound is an effective and affordable clinical diagnostic tool highly attractive for use in low and middle income countries (LMICs), but access to training programs in these countries is limited. The objective of our study was to develop and pilot a program for healthcare providers in Kenya in the use of point-of-care ultrasound. Methods Trainees were recruited in district hospitals for participation in three all-day workshops held every 3–5months from September 2013 through November 2014. Prior to the initial workshop, trainees were asked to study a training manual, and a knowledge test was administered. Ultrasound-credentialed emergency physicians provided brief didactic lessons then hands-on training for eFAST and obstetric training. This was followed by an observed assessment of scanning image quality (IM) and diagnostic interpretation (IN). Results Eighty-one trainees enrolled in four initial training sessions and 30 attended at least one refresher session. Among those trainees who attended refresher sessions, there was an increase in the proportion passing both the knowledge and practical tests at the follow-up, as compared to the initial session. Overall, mean practical skill scores also trended toward an increase over time, with a significantly higher mean score in November (2.64+0.38, p =0.02) as compared to March (2.26+0.54), p <0.05. Pre-workshop preparation evolved over time with the goal of maximizing trainee readiness for the hands-on course. A strong correlation was observed between knowledge and practical skill scores illustrating the importance of pre-workshop training. Conclusions Our pilot workshop showed promise in promoting knowledge and practical skills among participants, as well as increasing use in patient care. Results also suggest that refresher training may provide additional benefits for some participants. These findings provide a strong rationale for expanding the training program and for measuring its clinical impact.

      PubDate: 2016-04-07T23:52:35Z
      DOI: 10.1016/j.afjem.2016.03.002
       
  • Added value of graded compression ultrasound to the Alvarado score in
           cases of right iliac fossa pain

    • Authors: Mohamed Samir; Mohamed Hefzy; Mohamed Gaber; Khaled Moghazy
      Pages: 138 - 143
      Abstract: Publication date: Available online 7 April 2016
      Source:African Journal of Emergency Medicine
      Author(s): Mohamed Samir, Mohamed Hefzy, Mohamed Gaber, Khaled Moghazy
      Introduction Acute appendicitis is one of the most common emergencies treated by the general surgeon. Simple appendicitis can progress to perforation, which is associated with a much higher morbidity and mortality, and surgeons have therefore been inclined to operate when the diagnosis is probable rather than wait until it is certain. The aim of this study was to evaluate the sensitivity and specificity of the Alvarado score combined with ultrasounds of the abdomen and pelvis in cases of right iliac fossa pain with suspected acute appendicitis. Methods 100 patients admitted to the Department of Surgery at Alexandria Main University Hospital in 2013 complaining of right iliac fossa pain with suspected acute appendicitis were studied prospectively. The demographic information, histopathology, physical examination, laboratory data, Alvarado score, sonography report and histopathological reports of these patients were gathered. The treating surgeon made decisions for surgery or conservative management without any intervention from the research team. Results A combination of methods showed that Alvarado alone was 100% sensitive in excluding appendicitis at scores below five and was highly specific at scores above eight (91.9%) with no added value when combining it with ultrasound in those scores. On the other hand, ultrasound was beneficial only in patients with Alvarado scores between five and eight for detecting appendicitis and not excluding it (increasing specificity to 100% and not affecting sensitivity). Conclusion Ultrasound is a good adjuvant examination in cases with Alvarado scores between five and eight in order to diagnose appendicitis. Negative ultrasound results do not exclude appendicitis and further assessment by other modalities should be performed.

      PubDate: 2016-04-07T23:52:35Z
      DOI: 10.1016/j.afjem.2016.02.004
       
  • Conservative management of gunshot oesophageal injuries: A report of two
           consecutive exceptional cases

    • Authors: Francesco Virdis; Sharfuddin Chowdhury; Andrew John Nicol; Pradeep Harkison Navsaria
      Pages: 144 - 147
      Abstract: Publication date: Available online 29 June 2016
      Source:African Journal of Emergency Medicine
      Author(s): Francesco Virdis, Sharfuddin Chowdhury, Andrew John Nicol, Pradeep Harkison Navsaria
      Introduction Oesophageal trauma carries high mortality and morbidity. For penetrating intrathoracic oesophageal injury, surgical repair has been the standard for decades to avoid its devastating consequences. Case report Both patients presented with a thoracoabdominal gunshot wound and retained intraabdominal missile. Although there were no visible signs of perforation on oesophagoscopy or contrast swallow, the presence of an intraluminal bullet highly suggested a thoracic oesophageal injury. Discussion Non-operative management of intrathoracic oesophageal perforation is controversial. Small perforations or contained leaks diagnosed within 24–48h in a stable patient with no mediastinitis or empyema can be managed non-operatively with antibiotics and nasogastric feeds. These two case reports support the notion of selective non-operative management of asymptomatic patients with penetrating injury to the oesophagus.

      PubDate: 2016-07-20T00:03:30Z
      DOI: 10.1016/j.afjem.2016.05.007
       
  • Message in a bottle. The use of chest radiography for diagnosis of
           pericardial effusion

    • Authors: James Foley; Lai Pun Tong; Navin Ramphul
      Pages: 148 - 150
      Abstract: Publication date: Available online 29 June 2016
      Source:African Journal of Emergency Medicine
      Author(s): James Foley, Lai Pun Tong, Navin Ramphul
      Introduction The diagnosis of pericardial effusion may be elusive, and only diagnosed with echocardiography. Case reports Here we report the cases of two patients who presented to the emergency centre (EC) with dyspnoea, and their chest X-rays (CXR) revealed the “water bottle sign”, which is the typical appearance of the cardiac silhouette that is present when there is a large pericardial effusion. Discussion This clinched the diagnosis of pericardial effusion, where the diagnosis may have otherwise been delayed. We discuss these cases, and the relevant literature and discuss the benefits of standard chest radiography in aiding in the diagnosis of pericardial effusion.

      PubDate: 2016-07-20T00:03:30Z
      DOI: 10.1016/j.afjem.2016.01.004
       
  • Ujuzi (Practical Pearl/Perle Pratique)

    • Authors: Kwame Ekremet; Maxwell Osei-Ampofo; Reginald Sefah Nkansah; Kwasi Owusu Offei; Kwabena Antwi-Donkor; Peggy Asiedu Ekremet
      Pages: 154 - 155
      Abstract: Publication date: September 2016
      Source:African Journal of Emergency Medicine, Volume 6, Issue 3
      Author(s): Kwame Ekremet, Maxwell Osei-Ampofo, Reginald Sefah Nkansah, Kwasi Owusu Offei, Kwabena Antwi-Donkor, Peggy Asiedu Ekremet


      PubDate: 2016-09-19T13:07:50Z
      DOI: 10.1016/j.afjem.2014.08.003
       
  • Access to out-of-hospital emergency care in Africa: Consensus conference
           recommendations

    • Authors: Christopher Stein; Nee-Kofi Mould-Millman; Shaheem De Vries; Lee Wallis
      Pages: 158 - 161
      Abstract: Publication date: Available online 6 September 2016
      Source:African Journal of Emergency Medicine
      Author(s): Christopher Stein, Nee-Kofi Mould-Millman, Shaheem De Vries, Lee Wallis
      Out-of-hospital emergency care (OHEC) should be accessible to all who require it. However, available data suggests that there are a number of barriers to such access in Africa, mainly centred around challenges in public knowledge, perception and appropriate utilisation of OHEC. Having reached consensus in 2013 on a two-tier system of African OHEC, the African Federation for Emergency Medicine (AFEM) OHEC Group sought to gain further consensus on the narrower subject of access to OHEC in Africa. The objective of this paper is to report the outputs and statements arising from the AFEM OHEC access consensus meeting held in Cape Town, South Africa in April 2015. The discussion was structured around six dimensions of access to care (i.e. awareness, availability, accessibility, accommodation, affordability and acceptability) and tackled both Tier-1 (community first responder) and Tier-2 (formal prehospital services and Emergency Medical Services) OHEC systems. In Tier-1 systems, the role of community involvement and support was emphasised, along with the importance of a first responder system acceptable to the community in which it is embedded in order to optimise access. In Tier-2 systems, the consensus group highlighted the primacy of a single toll-free emergency number, matching of Emergency Medical Services resource demand and availability through appropriate planning and the cost-free nature of Tier-2 emergency care, amongst other factors that impact accessibility. Much work is still needed in prioritising the steps and clarifying the tools and metrics that would enable the ideal of optimal access to OHEC in Africa.

      PubDate: 2016-09-09T12:06:49Z
      DOI: 10.1016/j.afjem.2016.08.008
       
  • Sub-Saharan African hospitals have a unique opportunity to address
           intentional injury to children

    • Authors: Jared R. Gallaher; Elizabeth Molyneux; Anthony G. Charles
      Pages: 59 - 60
      Abstract: Publication date: Available online 13 May 2016
      Source:African Journal of Emergency Medicine
      Author(s): Jared R. Gallaher, Elizabeth Molyneux, Anthony G. Charles


      PubDate: 2016-05-17T15:38:04Z
      DOI: 10.1016/j.afjem.2016.05.003
       
  • Pre-hospital clinical practice guidelines – Where are we now'

    • Authors: Michael McCaul; Karen Grimmer
      Pages: 61 - 63
      Abstract: Publication date: Available online 13 May 2016
      Source:African Journal of Emergency Medicine
      Author(s): Michael McCaul, Karen Grimmer


      PubDate: 2016-05-17T15:38:04Z
      DOI: 10.1016/j.afjem.2016.05.001
       
  • A promising poison information centre model for Africa

    • Authors: Carine Marks; Niel van Hoving; Nick Edwards; Christopher Kanema; David Kapindula; Tom Menge; Caesar Nyadedzor; Clare Roberts; Dexter Tagwireyi; Joanna Tempowski
      Pages: 64 - 69
      Abstract: Publication date: Available online 5 January 2016
      Source:African Journal of Emergency Medicine
      Author(s): Carine Marks, Niel van Hoving, Nick Edwards, Christopher Kanema, David Kapindula, Tom Menge, Caesar Nyadedzor, Clare Roberts, Dexter Tagwireyi, Joanna Tempowski
      Introduction The burden of poisoning exposures in Africa is a significant public health concern, yet only ten African countries have poisons information centres. The establishment of poisons centres was subsequently identified as a priority. This article focuses on workshop discussions with international multi-sector stakeholders in Eastern Africa regarding the possibility of a sub-regional poisons centre serving multiple countries. Methods The project was led by an independent consultant under the guidance of an international steering group. Steering group members provided input at international multi-stakeholder meetings and during monthly teleconferences. Results Participants of the stakeholder meetings agreed that the establishment of a sub-regional poisons centre in Eastern Africa was necessary and feasible. Virtual collaboration is possible due to recent technological developments, and the overall suggestion was for countries to establish their own poisons centres and to network and coordinate these centres through a network hub. Conclusion A number of benefits might result from such a poisons centre network hub, including: (1) Improved cooperation between countries on poisoning problems; (2) Harmonisation and strengthening of research and surveillance; (3) Common standards and best practices e.g. regulating chemicals, data management, and staff training; and (4) Greater bargaining power to secure resources. Further investigation is needed to identify the most suitable location for the network hub, the activities it should fulfil, and the availability of specialists in poisons information who could become members of the hub.

      PubDate: 2016-01-05T17:51:41Z
      DOI: 10.1016/j.afjem.2015.09.005
       
  • Tapping into a vital resource: Understanding the motivators and barriers
           to blood donation in Sub-Saharan Africa

    • Authors: Tanja Z. Zanin; Denise P. Hersey; David C. Cone; Pooja Agrawal
      Pages: 70 - 79
      Abstract: Publication date: Available online 8 April 2016
      Source:African Journal of Emergency Medicine
      Author(s): Tanja Z. Zanin, Denise P. Hersey, David C. Cone, Pooja Agrawal
      Introduction Sub-Saharan Africa (SSA) has a need for blood and blood products that exceeds current availability. This unmet demand is evidenced by persistently high mortality rates associated with potentially reversible conditions such as haemorrhage and anaemia. This study reviews current literature on blood donation in SSA to identify common local motivators and deterrents to blood donation and highlights specific interventions that have successfully increased the number of blood donors in this region. Methods The authors searched the health literature to identify original studies conducted in SSA that addressed blood donation motivators and deterrents. Data were then extracted from each study to determine how often each study identified specific motivators and deterrents. Results Pro-social motivation, such as altruism and the desire to have a positive effect on the community, is the most frequently noted reason for people in SSA countries to donate blood. Negative attitudes and misconceptions towards blood donation, in addition to perceived negative health effects caused by donation, are the two most frequently mentioned reasons that dissuade individuals from donating blood. Conclusion Due to paucity of research on this topic, our understanding of blood donor behaviour in SSA is limited. Local traditions and cultures intimately shape individuals’ proclivity towards the donation process. In order to change the attitudes and behaviours of many potential donors in SSA it is important to address the deterrents to blood donation, as many represent misconceptions or culture-specific beliefs that may be the ultimate driving force dictating donor behaviour.

      PubDate: 2016-04-08T23:57:06Z
      DOI: 10.1016/j.afjem.2016.02.003
       
  • Economic development and road traffic fatalities in two neighbouring
           African nations

    • Authors: Douglas J. Wiebe; Sunanda Ray; Titus Maswabi; Christina Kgathi; Charles C. Branas
      Pages: 80 - 86
      Abstract: Publication date: Available online 31 May 2016
      Source:African Journal of Emergency Medicine
      Author(s): Douglas J. Wiebe, Sunanda Ray, Titus Maswabi, Christina Kgathi, Charles C. Branas
      Introduction The rapid growth of Botswana’s economy since independence in 1966 has brought more tarred roads and vehicles, accompanied by an escalating road crash fatality rate. We tested the hypothesis that motor vehicle crash fatality increases resulted from, rather than just corresponded with, annual gross domestic product (GDP) increases. Data from Zambia, adjacent to Botswana, were used for comparison. Methods Annual social and economic indicators and motor vehicle crash fatality rates in Botswana and Zambia were accessed from 1960 to 2012 and analysed using vector autoregressive analysis and Granger causality tests. Results In Botswana, annual changes in per capita GDP predicted annual changes in motor vehicle crash fatality rates (p =0.042). The opposite was not observed; annual changes in motor vehicle crash fatality rates did not predict annual GDP changes. These findings suggest that GDP growth in a given year caused additional road traffic fatalities in Botswana and that, on average, every billion dollar increase in GDP produced an increase in the rate of road traffic fatalities. In Zambia, annual GDP changes predicted annual fatality rate changes three years later (p =0.029), but annual changes in road crash fatality rates also predicted annual increases in per capita GDP (p =0.026) three years later, suggesting a correlation between trends, but not a causal effect of GDP. Conclusion Road crash fatalities increased in recent decades in both Zambia and Botswana. But the rapid economic development in Botswana over this time period appears to have driven proportionate road traffic fatality increases. There are opportunities for newly emerging economies such as Zambia, Angola, and others to learn from the Botswana experience. Evidence-based investments in road safety interventions should be concomitant with economic development.

      PubDate: 2016-06-02T17:18:43Z
      DOI: 10.1016/j.afjem.2016.03.003
       
  • In this issue…

    • Abstract: Publication date: December 2016
      Source:African Journal of Emergency Medicine, Volume 6, Issue 4


      PubDate: 2016-12-10T15:04:57Z
       
  • An assessment of nurse-led triage at Connaught Hospital, Sierra Leone in
           the immediate post-Ebola period

    • Authors: Richard Lowsby; Cecilia Kamara; Michael Kamara; Hedda Nyhus; Nathaniel Williams; Michael Bradfield; Hooi-Ling Harrison
      Abstract: Publication date: Available online 12 November 2016
      Source:African Journal of Emergency Medicine
      Author(s): Richard Lowsby, Cecilia Kamara, Michael Kamara, Hedda Nyhus, Nathaniel Williams, Michael Bradfield, Hooi-Ling Harrison


      PubDate: 2016-11-13T01:46:15Z
      DOI: 10.1016/j.afjem.2016.10.003
       
  • Global research highlights

    • Abstract: Publication date: Available online 8 November 2016
      Source:African Journal of Emergency Medicine


      PubDate: 2016-11-13T01:46:15Z
       
  • Uchunguzi (Journal Watch/Montre de Journal)

    • Authors: Benjamin Wachira
      Abstract: Publication date: Available online 5 November 2016
      Source:African Journal of Emergency Medicine
      Author(s): Benjamin W. Wachira


      PubDate: 2016-11-06T01:36:49Z
       
  • Emergency care conference in the land of a thousand hills

    • Authors: Gabin Mbanjumucyo; Giles N. Cattermole
      Abstract: Publication date: Available online 5 November 2016
      Source:African Journal of Emergency Medicine
      Author(s): Gabin Mbanjumucyo, Giles N. Cattermole


      PubDate: 2016-11-06T01:36:49Z
      DOI: 10.1016/j.afjem.2016.11.002
       
  • A brave African discussion on emergency medicine

    • Authors: Jocelyn Park-Ross
      Abstract: Publication date: Available online 5 November 2016
      Source:African Journal of Emergency Medicine
      Author(s): Jocelyn Park-Ross


      PubDate: 2016-11-06T01:36:49Z
      DOI: 10.1016/j.afjem.2016.11.001
       
  • The first Tanzanian Conference on Emergency Medicine

    • Authors: Hendry R. Sawe; Elizabeth M. Rojo; Marwa Obogo; Juma A. Mfinanga; Irene Kulola; Upendo George; Victor G. Mwafongo
      Abstract: Publication date: Available online 5 November 2016
      Source:African Journal of Emergency Medicine
      Author(s): Hendry R. Sawe, Elizabeth M. Rojo, Marwa Obogo, Juma A. Mfinanga, Irene Kulola, Upendo George, Victor G. Mwafongo


      PubDate: 2016-11-06T01:36:49Z
      DOI: 10.1016/j.afjem.2016.11.003
       
  • The role of wilderness medicine training in resource-limited settings

    • Authors: Jay Matthew
      Abstract: Publication date: Available online 5 November 2016
      Source:African Journal of Emergency Medicine
      Author(s): Jay Matthew


      PubDate: 2016-11-06T01:36:49Z
      DOI: 10.1016/j.afjem.2016.11.004
       
  • Epidemiology of injuries and outcomes among trauma patients receiving
           prehospital care at a tertiary teaching hospital in Kigali, Rwanda

    • Authors: Gabin Mbanjumucyo; Naomi George; Alexis Kearney; Naz Karim; Adam R. Aluisio; Zeta Mutabazi; Olivier Umuhire; Samuel Enumah; John W. Scott; Eric Uwitonze; Jeanne D’Arc Nyinawankusi; Jean Claude Byiringiro; Ignace Kabagema; Georges Ntakiyiruta; Sudha Jayaraman; Robert Riviello; Adam C. Levine
      Abstract: Publication date: Available online 28 October 2016
      Source:African Journal of Emergency Medicine
      Author(s): Gabin Mbanjumucyo, Naomi George, Alexis Kearney, Naz Karim, Adam R. Aluisio, Zeta Mutabazi, Olivier Umuhire, Samuel Enumah, John W. Scott, Eric Uwitonze, Jeanne D’Arc Nyinawankusi, Jean Claude Byiringiro, Ignace Kabagema, Georges Ntakiyiruta, Sudha Jayaraman, Robert Riviello, Adam C. Levine
      Introduction Injury accounts for 9.6% of the global mortality burden, disproportionately affecting those living in low- and middle-income countries. In an effort to improve trauma care in Rwanda, the Ministry of Health developed a prehospital service, Service d’Aide Médicale Urgente (SAMU), and established an emergency medicine training program. However, little is known about patients receiving prehospital and emergency trauma care or their outcomes. The objective was to develop a linked prehospital–hospital database to evaluate patient characteristics, mechanisms of injury, prehospital and hospital resource use, and outcomes among injured patients receiving acute care in Kigali, Rwanda. Methods A retrospective cohort study was conducted at University Teaching Hospital – Kigali, the primary trauma centre in Rwanda. Data was included on all injured patients transported by SAMU from December 2012 to February 2015. SAMU’s prehospital database was linked to hospital records and data were collected using standardised protocols by trained abstractors. Demographic information, injury characteristics, acute care, hospital course and outcomes were included. Results 1668 patients were transported for traumatic injury during the study period. The majority (77.7%) of patients were male. The median age was 30years. Motor vehicle collisions accounted for 75.0% of encounters of which 61.4% involved motorcycles. 48.8% of patients sustained injuries in two or more anatomical regions. 40.1% of patients were admitted to the hospital and 78.1% required surgery. The overall mortality rate was 5.5% with nearly half of hospital deaths occurring in the emergency centre. Conclusion A linked prehospital and hospital database provided critical epidemiological information describing trauma patients in a low-resource setting. Blunt trauma from motor vehicle collisions involving young males constituted the majority of traumatic injury. Among this cohort, hospital resource utilisation was high as was mortality. This data can help guide the implementation of interventions to improve trauma care in the Rwandan setting.

      PubDate: 2016-10-29T22:50:11Z
      DOI: 10.1016/j.afjem.2016.10.001
       
  • Development of a trauma and emergency database in Kigali, Rwanda

    • Authors: Alexis S. Kearney; Lise M. Kabeja; Naomi George; Naz Karim; Adam R. Aluisio; Zeta Mutabazi; Jean Eric Uwitonze; Jeanne D’Arc Nyinawankusi; Jean Claude Byiringiro; Adam C. Levine
      Abstract: Publication date: Available online 28 October 2016
      Source:African Journal of Emergency Medicine
      Author(s): Alexis S. Kearney, Lise M. Kabeja, Naomi George, Naz Karim, Adam R. Aluisio, Zeta Mutabazi, Jean Eric Uwitonze, Jeanne D’Arc Nyinawankusi, Jean Claude Byiringiro, Adam C. Levine
      Introduction Injuries account for 10% of the global burden of disease, resulting in approximately 5.8 million deaths annually. Trauma registries are an important tool in the development of a trauma system; however, limited resources in low- and middle-income countries (LMIC) make the development of high-quality trauma registries challenging. We describe the development of a LMIC trauma registry based on a robust retrospective chart review, which included data derived from prehospital, emergency centre and inpatient records. Methods This paper outlines our methods for identifying and locating patients and their medical records using pragmatic and locally appropriate record linkage techniques. A prehospital database was queried to identify patients transported to University Teaching Hospital – Kigali, Rwanda from December 2012 through February 2015. Demographic information was recorded and used to create a five-factor identification index, which was then used to search OpenClinic GA, an online open source hospital information system. The medical record number and archive number obtained from OpenClinic GA were then used to locate the physical medical record for data extraction. Results A total of 1668 trauma patients were transported during the study period. 66.7% were successfully linked to their medical record numbers and archive codes. 94% of these patients were successfully linked to their medical record numbers and archive codes were linked by four or five of the five pre-set identifiers. 945 charts were successfully located and extracted for inclusion in the trauma registry. Record linkage and chart extraction took approximately 1256h. Conclusion The process of record linkage and chart extraction was a resource-intensive process; however, our unique methodology resulted in a high linkage rate. This study suggests that it is feasible to create a retrospective trauma registry in LMICs using pragmatic and locally appropriate record linkage techniques.

      PubDate: 2016-10-29T22:50:11Z
      DOI: 10.1016/j.afjem.2016.10.002
       
  • Mawasiliano (Correspondence/Correspondance)

    • Abstract: Publication date: Available online 17 October 2016
      Source:African Journal of Emergency Medicine


      PubDate: 2016-10-29T22:50:11Z
       
  • In this issue…

    • Abstract: Publication date: September 2016
      Source:African Journal of Emergency Medicine, Volume 6, Issue 3


      PubDate: 2016-09-19T13:07:50Z
       
  • Focused assessment with sonography for HIV-associated tuberculosis (FASH)
           case series from a Rwandan district hospital

    • Authors: Gabin Mbanjumucyo; Patricia C. Henwood
      Abstract: Publication date: Available online 6 September 2016
      Source:African Journal of Emergency Medicine
      Author(s): Gabin Mbanjumucyo, Patricia C. Henwood
      Introduction The majority of HIV-TB co-infection worldwide is reported in Africa. The risk of developing extra-pulmonary tuberculosis (EPTB) increases as immune deficiency progresses but is difficult to diagnose. Point-of-care ultrasonography (POCUS) can be an effective adjunct to identify and treat EPTB-associated findings using the focused assessment with sonography for HIV-associated TB (FASH) protocol. Case report Three HIV-infected patients without known history of EPTB presented to a Rwandan district hospital with fever and unclear infection. Initial testing did not reveal a source. Each patient was then evaluated with the FASH protocol by a Rwandan emergency physician with POCUS training. All patients had findings suggestive of EPTB by ultrasound. Anti-TB treatment was initiated, and all subsequently demonstrated symptom improvement. Discussion This case series demonstrates the additional clinical information obtained. It describes how management was changed using POCUS and the FASH in a resource-limited setting in Rwanda and calls for further FASH protocol validation studies.

      PubDate: 2016-09-09T12:06:49Z
      DOI: 10.1016/j.afjem.2016.07.001
       
  • Ujuzi (Practical Pearl/Perle Pratique)

    • Authors: Michael Gottlieb
      Abstract: Publication date: Available online 4 September 2016
      Source:African Journal of Emergency Medicine
      Author(s): Michael Gottlieb


      PubDate: 2016-09-09T12:06:49Z
      DOI: 10.1016/j.afjem.2016.08.007
       
  • Ujuzi (Practical Pearl/Perle Pratique)

    • Authors: Michael Gottlieb
      Abstract: Publication date: Available online 3 September 2016
      Source:African Journal of Emergency Medicine
      Author(s): Michael Gottlieb


      PubDate: 2016-09-03T11:51:18Z
      DOI: 10.1016/j.afjem.2016.08.007
       
  • Global research highlights

    • Abstract: Publication date: Available online 21 August 2016
      Source:African Journal of Emergency Medicine


      PubDate: 2016-08-25T11:09:38Z
       
  • Uchunguzi (Journal Watch/Montre de Journal)

    • Authors: Benjamin Wachira
      Abstract: Publication date: Available online 21 August 2016
      Source:African Journal of Emergency Medicine
      Author(s): Benjamin W. Wachira


      PubDate: 2016-08-25T11:09:38Z
       
  • Ujuzi (Practical Pearl/Perle Pratique)

    • Authors: Emmanuel Kwasi Acheampong
      Abstract: Publication date: Available online 16 August 2016
      Source:African Journal of Emergency Medicine
      Author(s): Emmanuel Kwasi Acheampong


      PubDate: 2016-08-20T10:39:13Z
      DOI: 10.1016/j.afjem.2016.08.001
       
  • Seeking health care from a general hospital in Uganda following a fracture
           or a dislocation

    • Authors: Isaac Kajja; Cees Th. Smit Sibinga
      Abstract: Publication date: Available online 25 July 2016
      Source:African Journal of Emergency Medicine
      Author(s): Isaac Kajja, Cees Th. Smit Sibinga
      Introduction Selecting a treatment approach and a facility to get treated from, poses a challenge in musculoskeletal injuries in Africa. The study aimed at determining demographic and injury characteristics of patients with musculoskeletal injuries and how these impact the time and reason for presenting to a general hospital in Uganda. Methods An observational study was carried out at Entebbe general hospital on patients presenting with musculoskeletal injuries between 1 November 2014 and 28 February 2015. The patient demographics, injury characteristics, duration of injury to presentation for treatment and reason for seeking treatment from this hospital were noted. Results A total of 101 patients were recruited. Of these, 95 had fractures while six had dislocations. Patients took an average of 96h before presenting for care, females taking significantly longer than males (191.2 and 58.6h respectively, p =0.005). The fractured segment of bone significantly influenced the patients’ choice for care at this hospital (p =0.02). Discussion Entebbe General Hospital serves a young and unemployed population for musculoskeletal injuries. These patients present late for care, especially females. Patients base their choice for care from this hospital on the character of the injury.

      PubDate: 2016-07-26T00:41:59Z
      DOI: 10.1016/j.afjem.2016.05.008
       
  • The clinical profile and acute care of patients with traumatic spinal cord
           injury at a tertiary care emergency centre in Addis Ababa, Ethiopia

    • Authors: Finot Debebe; Assefu Woldetsadik; Adam D. Laytin; Aklilu Azazh; James Maskalyk
      Abstract: Publication date: Available online 22 July 2016
      Source:African Journal of Emergency Medicine
      Author(s): Finot Debebe, Assefu Woldetsadik, Adam D. Laytin, Aklilu Azazh, James Maskalyk
      Introduction Traumatic spinal cord injuries can have catastrophic physical, psychological, and social consequences, particularly in low resource settings. Since many of these injuries result in irreversible damages, it is essential to understand risk factors for them and focus on primary prevention strategies. The objectives of this study are to describe the demographics, injury characteristics, and management of traumatic spinal cord injury victims presenting to the Adult Emergency Centre of Tikur Anbessa Specialised Hospital in Addis Ababa, the tertiary referral centre for emergency care in Ethiopia. Methods A prospective cross sectional survey was conducted from October 2013 to March 2014 in the Adult Emergency Centre of Tikur Anbessa Specialised Hospital. Patients were identified at triage and followed through admission to discharge from the emergency centre. Results Eighty-four patients with traumatic spinal cord injuries were identified. The mean age was 33years and 86% were male. The most common mechanisms of injury were motor vehicle collisions (37%), falls (31%), and farming injuries (11%). The cervical spine (48%) was the most commonly injured region and 41% were complete spinal cord injuries. Most patients (77%) did not receive any prehospital care or medical care at other facilities prior to arrival in the Emergency Centre. Conclusion In our context, traumatic spinal cord injuries predominantly affect young men, and the majority of victims suffer severe injuries with little chance of recovery. Attention to occupational and road traffic safety is essential to mitigate the personal and societal burdens of traumatic spinal cord injuries. It is also imperative to focus on improving prehospital care and rehabilitation services for traumatic spinal cord injury victims.

      PubDate: 2016-07-26T00:41:59Z
      DOI: 10.1016/j.afjem.2016.06.001
       
  • In this issue…

    • Authors: Stevan Bruijns
      Abstract: Publication date: June 2016
      Source:African Journal of Emergency Medicine, Volume 6, Issue 2
      Author(s): Stevan R. Bruijns


      PubDate: 2016-07-20T00:03:30Z
       
  • Ujuzi (Practical Pearl/Perle Pratique)

    • Authors: Johanna Catharina Botha
      Abstract: Publication date: Available online 26 March 2016
      Source:African Journal of Emergency Medicine
      Author(s): Johanna Catharina Botha


      PubDate: 2016-03-30T23:18:34Z
      DOI: 10.1016/j.afjem.2016.02.002
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.166.186.79
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2016