Descriptive study of free Emergency Trauma Services and Outcomes in a Tertiary Teaching Hospital, North-Western Nigeria
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Keywords
Free emergency services, Interval to intervention, waiting time, Trauma centre , Federal Government of Nigeria
Abstract
Background: Waiting time at a trauma centre (TC) before injured patients receive treatment is critical to treatment outcomes. The study aims to find the impact of the government’s free emergency services on the waiting time before treatment is initiated.
Methodology: This was a retrospective study of the admitted emergency patients at the Trauma Centre, of Usmanu Dan fodio University Teaching Hospital (UDUTH), Sokoto, Nigeria, from November 2024 to March 2025. Patients’ presentation time was classified as less than 6 hours or more than 6 hours before admission and waiting time as less than 15 minutes or greater than 15 minutes. The outcome was either satisfactory or unsatisfactory. Chi-Square was used to analyse categorical data. The level of significance was set at P<0.05.
Results: There were 366 patients included in the study. The average waiting time before intervention (in minutes) was 10.5±0.242. Most patients (42/11.5%) had a waiting time of 7 minutes. The male-to-female ratio was 2.1 to 1. The mean age of patients was 35.87±17.20. Cases seen were fractures & dislocations (122/33.3%), gunshot wounds (62/16.9%), head injuries (43/11.7%), burns (38/10.4%), spinal cord injuries (33/9.0%), abdominal injuries (26/7.1%), urologic injuries (21/5.7%) and others (21/5.7%) include chest injuries, soft tissues, limbs gangrene etc. There were 252 (58.9%) patients who presented less than 6 hours post-injury, while 114 (31.1%) presented after 6 hours. Patients who started receiving treatment on admission <16 minutes were 298 (81.4%), and those at >15 minutes were 68 (18.6%). Associating injury duration (<6 hours vs. >6 hours) and treatment outcomes, p-value=0.0001, OR=4.90, 95% CI=2.39-10.04. At the same time, associating waiting time before treatment and treatment outcomes, the p-value=0.0001, OR=5.29, 95% CI=10.77. Following the paired sample t-test of the 2 groups between the median (10.0), the p-value was 0.0001.
Conclusion: There was an improvement in the waiting time for the initiation of treatment. This was largely influenced by the presence of free ambulance services, available free medications and surgical interventions.
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