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INITIAL INJURY CARE IN NAIROBI, KENYA: A CALL FOR TRAUMA CARE REGIONALISATION
Abstract
ABSTRACT
Objective: To describe the emergency care of injuries at a main city hospital.
Design: A prospective study.
Setting: Data were collected between February 1st, 1999 and 30th April, 1999 from the
records of the 2000 bed Kenyatta National Hospital (KNH) in Nairobi, Kenya.
Subjects: Two hundred and forty injury patients admitted at KNH were analysed.
Methods: All patients were analysed for demographics, environment of injury hospital
arrival and Emergency Department times. The effects of injury severity, place of injury
and time of day on these time intervals were analysed statistically.
Results: Road injury admissions formed 31% of all injury admissions. The mean age
was 30 years. Males comprised 84.6% of all patients. The proportions of patients under
20 years of age was 20% with a peak age of 20-29 years. Majority (43.3%) of the
injured resided in deprived neighbourhood of East Nairobi. The mean pre-hospital time
was 2.56 hours. The Emergency Department disposition time was 3.36 hours. Injuries
of all severities, as determined by the Injury Severity Score (ISS), were treated. The
pace of care did not match severity of the injuries. Only 17.5% reached their areas
of definitive care within sixty minutes.
Conclusion: Injuries following road traffic accidents (RTAs) are common in Nairobi.
The response to injury is slow and haphazard. The insitution of a care incorporating
the city’s health centers and pre-hospital triage may optimise care.
Objective: To describe the emergency care of injuries at a main city hospital.
Design: A prospective study.
Setting: Data were collected between February 1st, 1999 and 30th April, 1999 from the
records of the 2000 bed Kenyatta National Hospital (KNH) in Nairobi, Kenya.
Subjects: Two hundred and forty injury patients admitted at KNH were analysed.
Methods: All patients were analysed for demographics, environment of injury hospital
arrival and Emergency Department times. The effects of injury severity, place of injury
and time of day on these time intervals were analysed statistically.
Results: Road injury admissions formed 31% of all injury admissions. The mean age
was 30 years. Males comprised 84.6% of all patients. The proportions of patients under
20 years of age was 20% with a peak age of 20-29 years. Majority (43.3%) of the
injured resided in deprived neighbourhood of East Nairobi. The mean pre-hospital time
was 2.56 hours. The Emergency Department disposition time was 3.36 hours. Injuries
of all severities, as determined by the Injury Severity Score (ISS), were treated. The
pace of care did not match severity of the injuries. Only 17.5% reached their areas
of definitive care within sixty minutes.
Conclusion: Injuries following road traffic accidents (RTAs) are common in Nairobi.
The response to injury is slow and haphazard. The insitution of a care incorporating
the city’s health centers and pre-hospital triage may optimise care.
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