Emergency Medicine

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Assessment of Knowledge and Interpretation Skill on Arterial Blood Gas and its Associated Factors among Emergency and Critical Care Medicine Residents at Selected Ethiopian University Hospitals
(Addis Ababa University, 2024-12-13) Ephrem Basazinew; Merahi Kefyalew
Arterial Blood Gas analysis is a critical tool in the assessment and management of critically ill patients. It provides information about the patient's acid-base status, oxygenation, and ventilation. Correct interpretation of Arterial Blood Gas results is essential for making appropriate clinical decisions. Studies have shown that residents often have difficulty interpreting Arterial Blood Gas results. This can lead to misdiagnosis and inappropriate treatment. In Ethiopia, it is not currently known how accurately emergency and Critical care medicine residents interpret arterial blood gases. The present study explores this question
“Hospital-acquired infections (HAIs)” pose a considerable obstacle in healthcare settings, particularly in emergency departments where patient turnover is high and conditions may be chaotic. This sought to investigate “the risk factors associated with HAIs among patients admitted to Tikur Anbesa Specialized Hospital for more than 48 hours”.
(Addis Ababa University, 2024-12-21) Besufekad Tesfu; Merahi Kefyalew
Risk Factors and Outcomes of Non Traumatic Chest Pain Patients in A Tertiary Hospital in Addis Ababa, Ethiopia : A Retrospective Cohort Study in ED
(Addis Ababa University, 2024-12-27) Elias Amsalu; Merahi Kefyalew
Chest pain is of the most common presenting complaints globally, including in low and middle-income countries like Ethiopia, and is associated with challenging diagnostic problems in emergency rooms with increased mortality and morbidity. However, there is limited research focusing on understanding the risk factors and clinical outcomes of patients presenting with non-traumatic chest pain in the emergency departments of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia.
Prevalence, Management and Associated Factors of Severe and/or Symptomatic Hyponatremia using Hourly-Based, Locally Made, 3 % Enteral Table Salt Solution In Resource Limited Settings
(Addis Ababa University, 2024-12-05) Gadissa Birhanu; Demelash Gezahegne
Treatment of severe and acute hyponatremia is challenging in emergency departments of resource-limited setup
Assessment of Knowledge, Attitude and Associaed Factors Towards Advanced Cardiac Life Support Among Health Care Professionals Practicing in Seleceted Referal Hospitals In Addis Ababa, Ethiopia
(Addis Ababa University, 2024-10-19) Hiwot Shewangizaw; Yohannes Feleke
Cardiac arrest is the abrupt loss of heart function in a person who may or may not have been diagnosed with heart disease which is the most frequent causes of death in the world. Advanced cardiac life support (ACLS) encompasses a comprehensive array of protocols and techniques designed to promptly address life-threatening conditions leading to cardiac arrest. It is possible to reduce the high mortality rate associated with cardiac emergencies by ensuring adequate knowledge and practice of basic life support (BLS) and advanced cardiac life support (ACLS) skills (2,3).
Severity of Dehydration and Associated Factors of Patients Admitted to Cholera Treatment Centers in two Selected Government Hospitals, Addis Ababa, Ethiopia
(Addis Ababa University, 2024-12-19) Kokeb Getahun; Yohannes Feleke
Cholera is an acute illness caused by gram-negative bacteria, V. cholerae. Water is the main source of contamination. It's transmitted via the faecal-oral route. It’s characterized by acute severe diarrhea and vomiting, which leads to dehydration. If dehydration is not addressed immediately, it can lead to complications such as shock, renal failure, and death. By investigating the severity of dehydration, this research could potentially identify risk factors that may affect patient outcomes. The objective of this study is to assess the severity of dehydration and associated factors among cholera patients admitted to Tikur Anbessa and Zewditu Memorial Hospital.
Emergency and Critical Care Post Graduate Year three Resident at Tikur Anbessa Specialized Hospital
(Addis Ababa University, 2024-12-13) Meron Habte; Tigist worku
Survivors of sepsis utilize healthcare at higher rates that are out of proportion to those of survivors of non-sepsis hospitalizations, yet most readmissions within 30 days are preventable. Unfortunately, very little is known about the prevalence of readmission in sepsis survivors in developing countries and may contribute to substantial health cost and mortality
Association Between Lengthy Emergency Department Stay and Intensive Care Unit Mortality in Critically Ill Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2024-05-15) Nardos Belayneh; Lemlem Beza
Patients with prolonged emergency length of stay (EDLOS) who are critically ill and awaiting ICU admission constitute a significant number in TASH Emergency unit. Due to several reasons, these patients frequently experience extended stays in the emergency unit. Such delays could impede timely interventions essential for improving patient outcomes, leading to increased mortality rates and longer hospital stays
Prevalence of Physical Restraint and Associated Factors Among Intensive Care Unit Patients in Addis Ababa Hospitals, Ethiopia: a Dual-Center Cross-Sectional Study
(Addis Ababa University, 2024-12-13) Rediet Alemayehu; Temesgen Beyene
Introduction: Research done in most parts of the world demonstrates the high prevalence of physical restraint use in the intensive care unit. Though clinical use of physical restraint in Ethiopia is widely practiced evidence lacks to show its magnitude. Knowing the prevalence of physical restraint added a reference to the associated factors that might be used in the future formulation of policy and guidelines regarding the use of physical restraint in the intensive care unit. Objective: To assess the prevalence of physical restraint and associated factors among intensive care unit patients in two selected hospitals in Addis Ababa, Ethiopia from August- September 2024 Method: Institution-based cross-sectional study design was implemented in the two selected hospitals in Addis Ababa. A total of 120 patients were enrolled in the study. Data was collected using an interviewer-administered structured questionnaire and Physical Restraint Evaluation Survey observational survey tool for 2 consecutive months. One nurse from each hospital was collecting the data. Questioners were coded and data was cleaned then exported to SPSS version 27 for analysis. Descriptive analysis was used to characterize selected variables. A bivariate logistic regression was conducted and a variable with a P value of <0.25 was analyzed by multivariable logistic regression. After multivariable logistic regression, a P value of <0.05 was used to declare statistical significance. Result: The prevalence of physical restraint use was found to be 40.9%. Factors associated with the use of physical restraint were mechanical ventilator, age, and
Assessment of Level of Satisfaction and Associated Factors Among Final Year Undergraduate Medical Students of Addis Ababa University During Emergency Department Rotation At Teaching Tertiary Hospital, Addis Ababa, ETHIOPIA – Mixed Study
(Addis Ababa University, 2024-12-23) Tesfaye Alemnew; Merahi Kefyalew
Continuous evaluation of academic systems and identification of factors affecting quality are very essential after designing and implementing programs. Based on the evaluation findings, policymakers can make necessary interventions. Four years ago, the Emergency Medicine department introduced a five-week undergraduate program for final-year medical students
Appropriateness of Antimicrobial Therapy and Associated factors at Zewditu Memorial Hospital Inpatient setting: Retrospective cross-sectional study
(Addis Ababa University, 2024-12-23) Tsion Tinsae; Bitania D
Misuse and unnecessary antimicrobial therapy is becoming more widespread and results in antimicrobial resistance all over the world. Despite this, antibiotics are being used inappropriately specially in the inpatient setting.
First-Attempt Success and Associated Factors Among Emergency Tracheal Intubations in Two Government Hospitals of Addis Ababa, Ethiopia
(Addis Ababa University, 2024-12-19) Tsion Kindie; Merahi K.
First-pass success in endotracheal intubations is essential as it affects further potential complications and patient outcomes. Though there are many studies done on the topic outside our country information about the topic in our country is scarce
Knowledge and Attitude towards Nutritional Support among Emergency and Critical care Medicine Residents at adult intensive care unit, Addis Ababa, Ethiopia
(Addis Ababa University, 2024-12-15) Wolderufael Kassa; Birhanu T
Nutritional support is a crucial component of care for critically ill patients in the intensive care unit (ICU). It can improve clinical outcomes, reduce complications, and shorten hospital stays. However, studies suggest gaps exist in knowledge and attitude regarding nutritional support among healthcare professionals
Post Resuscitation Debriefing Practice and Associated Factors Among Health Professionals in Emergency Departement in Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2024-12) Yibeltal Seyid; Aklilu Azazh
The practice of post resuscitation debriefing following critical events emerged from the philosophy of understanding and learning from one’s mistakes. It is a reflective and guided method of discussion that promotes positive coping, provides peer support, evaluate team performance and identify factors that facilitate and hinder quality of resuscitative procedure. Despite recommendations from the American Heart Association to practice debriefing after critical events, only few emergency departments actually practice it.
Clinical presentation and management outcome in acute heart failure patients at Tikur Anbessa Specialized Hospital, Ethiopia
(Addis Ababa University, 2023-06) Sintayehu,Melaku; Wubetie,Andualem (MSc); Tesfaye,Berhanu(MD)
Background: - Acute heart failure is the most common cause of emergency presentation with dyspnoea. It is one of the common causes of emergency department mortality. Acute heart failure patients commonly presented with dyspnoea, orthopnoea and paroxysmal nocturnal dyspnoea. Objective: - To assess the clinical presentation and management outcome of acute heart failure patients presented at emergency department of Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia, 2023. Methods: - A hospital-based retrospective cross-sectional study design was employed with a total of 235 patients’ chart which was selected using a systematic random sampling technique. Data were entered into Epi Data version 4.6 and exported to SPSS version 27 for analysis. Binary logistic regression was used to identify factors associated with mortality of acute heart failure patients. And variables with p value< 0.05 were considered to be statistically significant. The findings of study were presented using statements, tables, and figures. Results: A total of 235 patients’ medical record were reviewed. More than half 137(58.3%) of patients were females. The median age of the participants was 39 years (IQR 27 to 58). Emergency department mortality of AHF patients was 14% with 95% CI (9.4-18.7). Diastolic blood pressure less than 60 mmHg, paroxysmal nocturnal dyspnoea, cardiogenic shock and comorbidity were significant factors associated with emergency department mortality of acute heart failure patent at p-value<0.05 with AOR (95% CI, 4.13, 1.5- 11.2), (95% CI,3.3, 1.3- 8.5), (95%CI, 6.4, 1.12-19.3), (95% CI, 4.8,1.3-18.2) respectively. Conclusion and Recommendation: This study showed that mortality in acute heart failure patients was high. Diastolic blood pressure less than 60 mmHg, presence of comorbid conditions and cardiogenic shock were significant factors associated with mortality in acute heart failure patients. Greater emphasis is recommended to reduce emergency department mortality of acute heart failure patients. Interventions related to acute heart failure mortalityfactors is recommended.
Knowledge, attitude, practices, and associated factor of first aid services related to motorcycle accidents among motorcycle drivers in Dilla town, southern Ethiopia.
(Addis Ababa University, 2023-06) Tilahun,Mesafint; Tuli,Wagari (MSc ); Kefyalew,Merahi(MD)
Background: First aid is care provided initially to a sick or injured person using the resources available until professional medical assistance is available. As a result, the victim's suffering can be reduced until help arrives or until they can be transported to a health facility. It includes carefully chosen words of encouragement and expressions of a willingness to help. Motorcycles are used in developing countries to carry out practical tasks related to mobility, transportation, sport, and economic activity. My understanding is that there is little information about first aid knowledge, attitudes, and practices among motorcycle drivers in my study. Objective: This study aims to assess knowledge, attitude, practice and associated factors of first aid service related to motorcycle accidents among motorcycle drivers in Dilla town, southern Ethiopia, in 2023. Methods: The research was done in four randomly selected kebele in Dilla town using a community-based cross-sectional study design. The data gathered was entered into Epidata 4.6 and exported to SPSS 26 for coding, cleaning, and further analysis. Binary logistic regression was conducted to assess the association between dependent and independent variables. In bivariate analysis, variables with a p-value less than 0.25 are taken into multivariate analysis, and variables with a p-value less than 0.05 are declared statistically significant and reported by using an adjusted odd ratio with a 95% confidence interval. Results are presented through narrative texts, tables, and figures. Results: 272 respondents have participated in the study; the mean age of participants was 26.21 (SD 4.952). Respondents who scored equal and above the mean of 149 (54.8%) had good knowledge. Respondents who attended college or university were four times more knowledgeable than those who were not educated (AOR = 3.937; 95% CI: 1.175-13.194). Age is significantly associated with first aid practice. Study participants categorized in the age group >=33 were six times more likely to practice first aid than those in the age group under 17–24 (AOR=5.516:95%CI:1.756–17.325). Conclusion and Recommendation: The study found that almost half of the MC drivers have adequate knowledge of first aid. The majority of respondents believed that first aid was important, but their first aid practice was inadequate. First-aid practice was found to have a statistically significant relationship with age. First aid training should be given to all MC drivers to improve their knowledge of first aid. Although there is no licensure to drive and age is not restricted, all stakeholders promptly apply formally for licensure to drive a motorcycle as well as implement laws and precautions.
Knowledge, Attitude and Associated factors towards Medication Error among Nurses Working at ICU in Public Hospital, Addis Ababa, Ethiopia, 2023
(Addis Ababa University, 2023-06) Endale,Miraf; Beza,Lemlem (PHD, Ass. Prof.)
Background: Medication errors are a significant concern in healthcare and among the most prevalent types of medical errors. Medication errors can happen at any stage of the medication use process: prescribing, transcribing, dispensing, and administering, and they can jeopardize the lives of intensive care unit patients. In particular, these errors occur more frequently in intensive care unit settings due to their unique medical framework. Currently, little is known about the knowledge and attitudes of nurses working in the Ethiopian intensive care units regarding medication errors. Objective: The aim of the study was to assess knowledge, attitude and associated factors towards medication error among nurses working in intensive care unit at selected public hospital, Addis- Ababa, Ethiopia 2023 Methods: An institution-based cross-sectional study was conducted on 122 randomly selected nurses working in the ICUs of selected public hospitals in Addis Ababa from March 15 to April 15 ,2023. The data collection tool was developed by reviewing relevant literature and BSc nurses who received training were responsible for data collection. The data was input into EPI-data version 4.6 before being cleaned and analyzed with the Statistical Package for Social Science (SPSS) version 26 software. To summarizes the findings, descriptive statistics were utilized, and univariable and multivariable logistic regression analysis were used to analyze the relationship between the outcome variable and independent variables using the Odds ratio. The significance of statistical associations was tested with a 95% confidence interval (CI) and 𝑝-value (<0.05). Results were presented with text, graphs, figures, and tables. Result: The study involved 122 nurses. About 50.8% of the participants were male and the mean age was 30.16 SD± 3.455years. A significant proportion of the respondent (75.5%) didn’t have medication error reporting training before. This study showed that (n=72,59%) and (n=67,54.9) % of nurses had inadequate knowledge and positive attitude regarding medication error respectively. Training was strongly associated with adequate knowledge of the participant at p-value < 0.05 [AOR 2.688 ,95% CI (1.02,7.03)]). Sex [AOR 4.5, 95%CI (1.7,11.6)] and work experience [AOR 5.9 95%CI (2.1,16.5)] were strongly associated with the attitude of the participants at a p- value < 0.05. Conclusion and Recommendation: Nurses were shown to have inadequate knowledge and positive attitudes towards medication errors. However, there was a significant association between knowledge level and training. It is therefore recommended to provide in-service training for nurses to enhance their understanding of safe medication management and reporting of medication errors.
Knowledge, practice and associated factors towards neonatal resuscitation among midwives working in delivery room of public health centers in Addis Ababa Ethiopia
(Addis Ababa University, 2023-06) Yitayih,Tsegaye; Debebe, Finot (Asso. Prof.); Tdele,Achamyelesh (Asso. Prof.)
Background: Neonatal resuscitation is simple and life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Worldwide, four million neonate deaths happen annually, and birth asphyxia accounts for one million deaths. Increasing providers’ knowledge of neonatal resuscitation and improving its practice is critical for delivering quality care and for morbidity and mortality reduction. Objective: To assess knowledge, practice and associated factors towards neonatal resuscitation among midwives working in delivery room of public health centers at Addis Ababa city, Ethiopia 2023. Methods: Institutional based cross-sectional study design was employed among 141 study population selected by simple random sampling method. Self-administered questionnaire and interview guide were used to collect data. Data was entered to Epidata 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. The association between the dependent variable and independent variables were analyzed using binary logistic regression. Adjusted odds ratio with 95% CI was computed and variables with p-value ≤ 0.05 were considered as statistically significant. Result: A total of 134 participants were included in the study with a response rate of 95%. Only 42.5% and 26.9 % of the participants had the appropriate level of knowledge and practice towards neonatal resuscitation respectively. Lack of training (AOD=2.47, 95% CI: 1.086-5.640, P-value=0.031), unavailability of guidelines (AOD=4.34, 95% CI: 1.78-10.59, P-value=0.001) and absence of supportive supervision (AOD=3.27, 95% CI: 1.38-7.74, P-value= 0.007) were significantly associated with poor knowledge. While educational level (AOD=3.34, 95% CI: 1- 11, P-value= 0.048), lack of training (AOD=3.32, 95% CI: 1.17-9.4, P-value= 0.024) and unavailability of guidelines (AOD=4.57, 95% CI: 1.47-14.12, P-value= 0.009) were significantly associated with poor practice. Conclusion and Recommendation: Overall knowledge and practice of midwives were inadequate. Strengthening training and supportive supervision needs to improve knowledge and practice of midwives
Burnout and Associated Factors Among Nurses Working in Intensive Care Units of Selected Public Hospitals of Addis Ababa,Ethiopia, 2023.
(Addis Ababa University, 2023-06) Hailu,Yealemsew; Tuli,Wagari (BSc, MSc); Kebede,Sofia(MD)
Introduction: Nurse burnout is a public health problem, with global prevalence estimates ranging from 15-60%. Intensive care unit nurses are exposed to much pressure from varying stressors in their environment. It is important to gain a greater understanding of burnout, since it may lead to poor patient care, poor communication with relatives, and high staff turnover. Despite this fact, there is a scarce of literature in developing countries, including Ethiopia. Objective: The objective of the study is to asses burnout and associated factors among nurses working in the intensive care unit of selected public hospitals in Addis Aaba, Ethiopia, 2023. Method: Institutional-based mixed methods were employed. All nurses who fillfiled the inclusion criteria and worked in the Intensive Care Unit of selected public hospitals were included in the study. The quantitative data was collected at randomly selected public hospitals and entered in to Epi data version 4.6, and analyzed using SPSS version 26.0. the qualitative data were collected by using in-depth nterviews and thematic analysis done manually to supplimet the quantitative results. Result: The mean age the respondents was 29.66±5.2 years. More than half 118(56.2%) of the study participants had worked in Intensive care unit for less than 2 years. The greater part 198(94.3%) of the study participants reported they had work overload in their working unit. 49 (23.3%) of the participants were found to have burnout syndrome. Among those, 33(15.7%) had high emotional exhaustion, 116(56.2%) experienced depersonalization and 56(26.7 %) of them had low personal achievements. Marital status(AOR 2.23; 95% CI, 1.03-4.80) and perceived quality of life( AOR, 3.34; 95% CI, 1.09-10.24) were independatly associated with burnout. Conclusion: Approximately one-quarter of Intensive care unit nurses have experienced burnout syndrome. The intention to leave Intensive care unit is also high. Marital status and perceived quality of life were found to be independently associated with the level of burnout. It is crucial to invest in burnout prevention actions and health promotion in critical care context.
Perceived Nurse - Resident Communication in Patient Care and Associated Factors in Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia: Cross-Sectional Study
(Addis Ababa University, 2024-01-12) Ayalew Abiy; Merahi Kefyalew
Effective communication between nursing staff and physicians/residents is essential in providing safe and effective care. Even if high-quality patient care is the goal of medicine and nursing, patients are dying and experiencing preventable complications because of poor nurse-physician communication

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