Emergency Medicine
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Item Utilization and Associated Factors of Electronic Medical Record Systems Among Health Professionals at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia, 2025: An Institution Based Cross Sectional Study.(Addis Ababa University, 2025-06-28) Mishame Elias; Birhanu Melaku; Achamyelesh TadeleBackground: - An electronic medical record system is a digital alternative to traditional paper charts, designed to store detailed patient health information. Its' implementation has the potential to improve healthcare quality and patient safety. The successful utilization of the system largely depends on the knowledge and attitudes of health professionals and other influencing factors. Objective: - to assess utilization and associated factors of electronic medical record systems among health professionals Tikur Anbessa specialized hospital Addis Ababa, Ethiopia, 2025. Methods: -An institution-based cross-sectional study was conducted from March 10 to 30, 2025. Study participants were selected using a simple random sampling technique, with the sample size proportionally allocated based on profession. Data was collected using a pretested, structured questionnaire through the Kobo Toolbox application. Statistical analysis was performed using the Statistical Package for Social Sciences version 25. Multivariable logistic regression was employed to identify factors associated with electronic medical record system utilization, using adjusted odds ratios with 95% confidence intervals, and a significance level set at p < 0.05. Result: - A total of 410 respondents participated in the study, with a response rate of 97%. The overall utilization, good knowledge, and favorable attitude toward Electronic Medical Record System was 88%, 73.2%, and 75.4% respectively. Being male (AOR=2.254; 95%CI = 1.127, 4.509), used the system for > 2 years (AOR=3.320; 95% CI=1.594, 6.916), having part-time in private hospitals (AOR=2.308; 95%CI=1.029, 5.180), departmental enforcement (AOR=2.051; 95%CI=1.041, 4.040), favorable attitude (AOR=2.212; 95%CI= 1.046, 4.678), and good knowledge (AOR=3.255; 95%CI=1.046,10.131) were significantly associated factors with utilization of the system. Conclusion: -The utilization of Electronic Medical Record Systems was found to be high, supported by good knowledge and a favorable attitude. Strengthening ongoing training, technical support, and consistent system enforcement is recommended. These actions can enhance healthcare quality and improve patient data management efficiency.Item Knowledge, Attitudes, Practices, and Factors Affecting Artificial Intelligence Practices Among Final-Year Undergraduate Health Science Students at Addis Ababa University, Ethiopia, (Cross-Sectional Study Design)(Addis Ababa University, 2025-06-05) Bikila Bekele; Lemlem Beza; Heyria HussienBackground: Artificial Intelligence (AI) was the rapidly advancing tools that involve the development of health systems to perform tasks that typically require human intelligence, such as problem-solving, decision-making, and language processing. However, there was limited research data about it. Therefore, this study aims to bridge that gap by evaluating the level and identifying factors influencing artificial intelligence use among health science students, understand, views, and applies to make sure that they are prepared to join the benefits of this developing technology. Objective: To assess the level of knowledge, attitudes, practices, and factors affecting artificial intelligence practical usage among final-year undergraduate health science students at Addis Ababa University, Ethiopia, 2025. Method: An institutional-based cross-sectional study design was employed. Selected by census sampling method. Data was collected by self-administered structured questionnaires on the Kobo toolbox. Frequencies and proportions are summarized by descriptive statistics. Cronbach’s alpha (K-0.839, A-0.845, P-0.801.) and Chi-square tests were conducted, the Hosmer-Lemeshow test cheeked, and multi-collinearity by variance inflation factor<4.5. Simple and multiple binary logistic regressions assessing the association between independents and outcome variables. Result: Out of 421 participants the mean age was 24.33 ± 1.864 years, with a respondent rate of 96.9%, single 393(96.3%), information internet/social media 334(81.9%) lowest group midwifery departments (10). More than half had inadequate knowledge 294(72.1%), However, favorable attitudes 235(57.6%) and insufficient practices 300(73.5%), nursing students (AOR 0.388, 95%(.170-.885, p-.024)) associated with attitudes and lack of knowledge (AOR_1.905, 95% [1.173–3.09], p_.009) and limited access to technical equipment (AOR_1.739, 95% [1.066 2.837], p_.027) had association to practices. Conclusion: Due to a lack of formal training, most students had inadequate knowledge and practical skills. Nursing students show a significant association between attitude and technology, while limited knowledge and equipment accessibility affect practice. Barriers hinder adoption, underscoring the need for curriculum integration and strategic awareness campaigns. Further research was needed to address adoption challenges and overcome implementation obstacles.Item Treatment Outcome and Associated Factors of Acute Poisoning at Emergency Department of Worabe Comprehensive Specialized Hospital Ethiopia(Addis Ababa University, 2025-06-29) Kamil Ababor; Heyria Hussein; Andualem Wubetie; Lemlem BezaBackground: Acute poisoning, an adverse health effect that emerges within 24 hours of exposure to a toxic substance, is a significant public health problem worldwide. Its impact is particularly severe in low- and middle-income countries, including Ethiopia. However, the full extent and severity of this problem in Ethiopia remains largely unexplored, highlighting the crucial need for further research and understanding in this area. Objective: To assess treatment outcome and associated factors of acute poisoning cases at the Emergency Department of Worabe Comprehensive Specialized Hospital, 2025 Methods: A hospital-based retrospective cross-sectional study was conducted for acute poisoning patients treated from February 1, 2022 to January 31, 2025 and data was collected from 20 March to 24 April 2025. All acutely poisoned patients meeting inclusion criteria during the three-year window were selected by census. Medical record numbers were retrieved from ED logbook and a total of 206 completed charts were reviewed using a pre-tested checklist. Collected data were entered in Epi-Data 4.6 and analyzed with SPSS 26. Binary logistic and multivariate model were used to asses factors associated with treatment outcome. Variables associated at p< 0.05 were taken as significantly associated. Result: Total of 206 patient‟s record was reviewed, and the mean age was 25. Majority 113(54.9 %) were females and 131(63.6%) resided in rural areas. Intentional ingestion of pesticides accounted for 117(56.8%) of cases. Fewer than half 94(45.6%) reached the hospital within one hour. Overall survival rate was 182(88.3%), and mortality rate 24(11.7%). Delayed presentation (>1 h) (AOR=4.693(1.349–18.558), p = 0.020), and male (AOR =3.77 (1.34–10.57), p = 0.012), were significantly associated with outcomes of acute poisoning. Conclusion: Acute poisoning at WCSH predominantly affects young females from rural. Intentional ingestion of pesticides was commonly involved. While most patients recover, mortality remains concerning in male patients and those patients who were arrived after 1hour of exposure. These findings highlight the need for targeted public health strategies to enhance early access to emergency care is key in reducing incidence and severity of poisoningItem Treatment Outcomes and Associated Factors of Acute Bacterial Meningitis Among Children Admitted to Pediatric Emergencies of Selected Public Hospitals in Addis Ababa, Ethiopia.(Addis Ababa University, 2025-06-24) Mekrez Tadesse; Wagari Tuli; Birhanu MelakuBackground: Acute bacterial meningitis remains a major health challenge among children under five in sub-Saharan Africa, including Ethiopia, where mortality ranges from 15% to 32.65%. Despite expanded immunization programs, delayed treatment, limited diagnostic capacity, and resource constraints contribute to poor outcomes. This study assessed treatment outcomes and associated factors of acute bacterial meningitis among children in public hospitals in Addis Ababa, highlighting gaps in treatment protocols and resource allocation. Objective: Evaluate treatment outcomes and associated factors of acute bacterial meningitis among children admitted to pediatric emergencies in selected public hospitals in Addis Ababa from January 1, 2024, to December 31, 2024. Methods: A multicenter retrospective study was conducted across five public hospitals. All children aged 0–12 years diagnosed with ABM during the study period were eligible. A total of 303 patient charts were selected through simple random sampling. Data on demographics, clinical presentation, treatment, and outcomes were collected using a structured questionnaire. Used SPSS 30 to do logistic regression to identify factors associated with treatment outcomes, with findings summarized in tables and figures. Results: Of the 303 children with Acute bacterial meningitis, 71% had good outcome, while 29% had poor outcomes: 11% mortality, 14% complications, and 4% self-discharge. Significant factors associated with poor outcomes included rural residence (AOR = 5.61; 95% CI: 1.60 19.67), seizures (AOR = 0.17; 95% CI: 0.04–0.73), altered consciousness (AOR = 0.02; 95% CI: 0.003–0.10), delayed hospital presentation ≥72 hours (AOR = 0.05; 95% CI: 0.01–0.21), comorbidities (AOR = 0.19; 95% CI: 0.05–0.66), and hospital stay <7 days (AOR = 12.75; 95% CI: 1.00–162.42). Diagnostic limitations were noted: CSF analysis was performed in 56% of cases, CSF culture in 33% (8% positive). Ceftriaxone was the most prescribed antibiotic (51%), and corticosteroids were used in only 31% of cases. Conclusions: Most patients had good outcomes, but a considerable amount experienced poor outcomes, including death, complications, or leaving the hospital before completing treatment. The findings of this study suggest the need to improve early access to care, especially for rural patients, enhance diagnostic practices, and ensure consistent use of evidence-based treatments to improve outcomes for children with bacterial meningitis.Item Knowledge about Transfusion safety practices and associated factors amongst nurses at Tikur Anbessa Specialized Hospital, Ethiopia(Addis Ababa Universtity, 2025) Natnael Nebro; Meron Tesfaye; Sophia KebedeBlood transfusion is a lifesaving therapy included on the World Health Organization list of essential medications. It is well established that nurses are leading actors of the clinical service in managing patients with blood transfusion requirement and safe transfusion practices are essential in reducing transfusion related reactions. Objective: To assess the knowledge about Transfusion safety practices and identify associated factors amongst nurses at Tikur Anbessa Specialized Hospital, Ethiopia Methodology: A facility-based, cross-sectional study conducted at Tikur Anbessa specialized Hospital. Data collected from 189 nurses by using a Pretested and structured self-administered questionnaire via web link after being prepared by kobotools.org. Data was entered and analyzed using SPSS version 26. Descriptive analysis is used to produce frequencies, mean and standard deviations for statistical analysis. Bivariate and multivariate logistic regression analysis were employed to determine factors associated with knowledge of blood transfusion p-value <0.25 is considered significant. Tables and figures are used to present the results. Result: One hundred and eighty nine nurses completed the study, with 90% response rate. The Overall knowledge scores of nurses was low with a mean knowledge score of 52.4, range of 17.8- 78.5.Data analysis revealed poor knowledge regarding basic blood transfusion safety principles. There were statistically significant relationships between nurse’s knowledge, level of education and sex of respondents but no significant association with age, year of experience, number of transfusions and specific department. Conclusion and Recommendation: This study has shown knowledge deficits whichhave potential implication on patient safety and reduce effective delivery of safe blood transfusion. This places patients to serious risks which can be prevented and ends with patients receiving incorrect transfusions and acquiring bacterial infections. We recommend more research to improve the studies limitations and the ongoing need on the training of the nursing staff on transfusion safety practices.Item Clinical Profile and Outcome of Patients With Out Attendant Admitted At Emergency(Addis Ababa Universtity, 2025) Solomon Tegene; Merahi Kefyalew; Finot DebebEmergency Department provides timely intervention for patients with life threatening emergency medical and surgical conditions. This is possible through the support and involvement of families or caregivers during clinical evaluation and management. However, there are scenarios where patients present to emergency department might be attended to solely by the patient or by other agents, such as police or passersby, where their presence during the patient’s emergency stay is impractical. Understanding the clinical characteristics and outcomes of patients managed without attendants is important for optimizing emergency care delivery and informing health care planning. Objective: This study determines the prevalence, clinical profile, and outcome of patients without attendants in selected governmental hospitals of Addis Ababa. Methods: A prospective cross-sectional study was conducted from August 1/2025, to November 1/2025, in a selected governmental hospital of Addis Ababa. After obtaining ethical clearance, data were collected by trained personnel from patients, using a data extraction tool and a questionnaire from patient documents/EMR. Data was cleaned and then exported using SPSS version 26. Descriptive statistics, including frequency and percentage, were generated for the prevalence, some clinical profiles, and outcomes of patients without attendant emergency department admissions. Considering p-value <0.05 with 95% confidence interval, a logistic regression model was conducted to see the strength of association between major outcomes and clinical profile of patients without attendants. Result: One hundred thirty-three (79.2%) participants were male. The median age was 35 years (IQR:25-46). The prevalence of patients without attendants was 2.57%. The median length of stay is 11.2days (IQR:5.6-19.7), which looks quite exaggerated. 34(19.6%) of patients died. Male sex and high acuity patients (triaged as red and orange) were found to be significantly associated with patient mortality. Conclusion: The length of stay and mortality rates in patients without attendants are higher than ED standards. Mortality is significantly associated with male sex and high acuity triage category.Item Predictors of 24hr adult emergency department mortality and its magnitude at a tertiary hospital Addis Ababa Ethiopia: Mixed method study(Addis Ababa Universtity, 2025) Endalamaw Wondimagegn; Merahi KefyalewThe definition of early emergency department mortality differs for different countries. In Ethiopia, the ministry of health define as death within 24 hours of emergency admission, excluding a dead body on arrival. The 2016 transformation guideline targets to decrease the emergency department mortality < 0.6%(1). Objective: The study aims to assess the magnitude of emergency department mortality and its predictors within 24 hour of admission at the adult Tikur Anbessa Specialised Hospital emergency department. Methodology: the study was mixed method study. Initially cross- sectional study, conducted within the study period of October 1, 2024, to September 30, 2025, at the Tikur Anbessa Specialised Hospital adult Emergency department. After the initial quantitative analysis was conducted, and showed that sepsis (54.1%) was the major contributor to deaths, a focused group discussion was conducted with the emergency and critical care postgraduate students on four open ended questions, and the results triangulated with the initial quantitative analysis to elaborate the main findings and suggest solutions. For the quantitative analysis, mean, median, and frequency were used for descriptive analysis. Multivariable logistic regression was conducted to assess the significance of the association. Results: The magnitudes of adult emergency department mortality at Tikur Anbessa Specialised Hospital within 24 hours of admission were 161 out of the 14,276 emergency admissions making the mortality rate 1.128%. Medical causes were the major contributors of the emergency department mortality, and sepsis covers 54.1% of the deaths within 24 hours of admission. Different factors contributed for the increase in mortality of patients with sepsis. Duration of symptoms before ED arrival, <12 hours, and >24hr- 1 week; main diagnosis at admission with cardiovascular and renal were significantly associated for very early mortality. The protective variables in this study were oxygen saturation >90% and being placed in the red or orange. Conclusion and Recommendation: The magnitude of Tikur Anbessa Specialized Hospital was still high, and medical causes, mainly sepsis is the most common cause of death due to different factors. In conclusion TASH should give training on sepsis management and recognition, involve the infectious disease physicians in the daily round and equip the emergency department with material and human resource.Item Clinical profile and outcome of patients without attendants admitted at the Emergency Department(Addis Ababa Universtity, 2025) Solomon Tegen; Merahi Kefyalew; Finot DebebeEmergency Department provides timely intervention for patients with life threatening emergency medical and surgical conditions. This is possible through the support and involvement of families or caregivers during clinical evaluation and management. However, there are scenarios where patients present to emergency department might be attended to solely by the patient or by other agents, such as police or passersby, where their presence during the patient’s emergency stay is impractical. Understanding the clinical characteristics and outcomes of patients managed without attendants is important for optimizing emergency care delivery and informing health care planning. Objective: This study determines the prevalence, clinical profile, and outcome of patients without attendants in selected governmental hospitals of Addis Ababa. Methods: A prospective cross-sectional study was conducted from August 1/2025, to November 1/2025, in a selected governmental hospital of Addis Ababa. After obtaining ethical clearance, data were collected by trained personnel from patients, using a data extraction tool and a questionnaire from patient documents/EMR. Data was cleaned and then exported using SPSS version 26. Descriptive statistics, including frequency and percentage, were generated for the prevalence, some clinical profiles, and outcomes of patients without attendant emergency department admissions. Considering p-value <0.05 with 95% confidence interval, a logistic regression model was conducted to see the strength of association between major outcomes and clinical profile of patients without attendants. Result: One hundred thirty-three (79.2%) participants were male. The median age was 35 years (IQR:25-46). The prevalence of patients without attendants was 2.57%. The median length of stay is 11.2days (IQR:5.6-19.7), which looks quite exaggerated. 34(19.6%) of patients died. Male sex and high acuity patients (triaged as red and orange) were found to be significantly associated with patient mortality. Conclusion: The length of stay and mortality rates in patients without attendants are higher than ED standards. Mortality is significantly associated with male sex and high acuity triage categoryItem Assessment of the magnitude of mortality from sepsis and septic shock and associated factors among patients admitted to adult Emergency departments(Addis Ababa Universtity, 2025) Assefa Petros; Temesgen Beyene; Tigist ZewduSepsis and septic shock remain major causes of morbidity and mortality worldwide, with disproportionately high burden in low and middle-income countries. Evidence on early mortality and its determinants in Ethiopian Emergency departments is limited. This study aimed to determine the magnitude of mortality from sepsis and septic shock and associated factors among adult patients admitted to the emergency departments of Addis Ababa teaching tertiary hospitals. Methods: An institutional based retrospective chart review was conducted between October 2023 to October 2025 among the total of 141 eligible medical records of patients with sepsis or septic shock that admitted to the EDs at Tikur Anbessa Specialized Hospital and St. Paul Hospital Millenium Medical College. Multivariable logistic regression was conducted and adjusted odds ratios (AOR) with a 95% confidence interval (CI) were reported, and statistical significance was set at a p value of less than 0.05. Results: Among 141 patients, majority 57% were females and 42.6% were males, with median age range was 40-59years and about half, 47.5% of the had qSOFA score ≥ 2. The 24-hour emergency departments’ mortality among patients with sepsis and septic shock was 31.9% (95% CI: 24.2%–40.3%). Respiratory infections accounted for 49.6% of admissions, followed by gastrointestinal (38.3%) and central nervous system infection (4.3%). Mortality was significantly associated with multiorgan failure 2.9(1.1_7.4), length of EDs stay 12 hours 4.99(2.046_12.21), malignancy 2.6(1.1_6.2), qSOFA score ≥2 3.49(1.5_7.8) and comorbidities 3.3(1.125_ 9.84). Conclusion: Overall, the magnitude of ED mortality rate among patients with sepsis or septic shock admitted to EDs of Addis Ababa teaching hospitals was high. Respiratory and gastrointestinal infections were leading causes of death, emphasizing the need for targeted interventions. Clinical indicators such as altered mentation, hypotension, multiorgan failure, comorbidity, and prolonged ED significantly increased the risk of mortality. Enhancing early identification, optimizing resuscitation within the golden hours, and improving timely interventions are critical to reducing sepsis related mortality.Item Exploring the perspective of emergency and critical care medicine(Addis Ababa Universtity, 2025) Tamrat Kifle; Merahi kefyalew; Demmelash GezahegnThe rapid global advancement of Artificial Intelligence (AI) presents a transformative potential for healthcare The integration of Artificial Intelligence (AI) , particularly in high burden, time-sensitive disciplines such as Emergency and Critical Care Medicine (ECCM) holds significant potential to enhance diagnostics, decision-making and minimize workload burden However, its adoption in low-resource settings remain uncertain, with limited understanding of the perspectives and readiness of frontline practitioners. This study explores the perspective of ECCM residents in Addis Ababa, Ethiopia regarding AI’s integration in clinical practice. Objective: The objective of this study is to explore the perspectives of Emergency and Critical Care Medicine (ECCM) residents regarding the integration of Artificial Intelligence (AI) in their clinical practice at three major teaching hospitals in Addis Ababa, Ethiopia. Methodology: A qualitative, phenomenological, multi-center study was conducted from June 1 to October 30, 2025, at three major teaching hospitals in Addis Ababa. Using purposive sampling, sixteen ECCM residents participated. One focus group discussion with eight members and eight in-depth interviews were conducted. Data were collected from ECCM residents through audio recordings in the Amharic language, then transcribed and translated by the principal investigator. After familiarization with the data, initial open coding was generated, followed by axial coding. Five themes with three subthemes for each theme were developed, each theme and subtheme were defined and supported by verbatim quotes. thematic analysis was conducted manually. Results: Five major themes emerged (1) a foundational Knowledge gap alongside conceptual understanding of AI (2) strong belief in AI’s potential clinical Benefits for decision support, diagnostic accuracy, and burnout mitigation (3) profound systemic Barriers including financial constraints, lack of formal training, infrastructure limitations and lack of data governance (4) Attitudes of cautious optimism coupled with ethical concerns about accountability and skill erosion and (5) clear prerequisites of AI Implementation requiring AI literacy training, national policy, and infrastructure investment. Conclusion and Recommendations: ECCM residents' positive attitude towards AI as a supportive tool rather than a replacement for clinical judgment and its perceived utility in mitigating burnout whereas key barriers include a lack of formal training and practical AI exposure, inadequate digital infrastructure, absence of regulatory frameworks, and fears regarding clinical autonomy and liability. We recommend formal AI training for the health professionals and conducting further research on perceptions of stakeholder at medical curricula to develop national AI integration policies.Item Practice of Informed Consent and Associated Factors Influencing its Application in Emergency Department Among, Residents and Nurse(Addis Ababa Universtity, 2025) Wondim Aboye; Gedefaw Tigabu; Finot DebebeInformed consent is a basic principle for the ethical and legal conduct of healthcare that protects the autonomy of the patient. At present, its practice in the emergency departments (EDs) is hindered by time pressure, lack of patient education, patient ignorance, and emotional distress, notably in low middle income states, such as Ethiopia. Objective: The study aims to is to assess informed consent practice and associated factors influencing its application in emergency departments among residents and nurses of selected governmental hospitals in Addis Ababa Methods: A cross-sectional institutional study was conducted on nurses and residents from three tertiary hospitals, namely Tikur Anbessa Specialized Hospital (TASH), Saint Paul’s Hospital Millenium Medical College (SPHMMC) and Yekatit 12 Medical College. Data were collected on self-administered Google Form, and analyzed using SPSS 27. For multivariate analysis, variables with binary logistic regression (p < 0.25) were used, accounting for potentially confounding factors. Results: Among 157 residents and nurses, 144 were included in this study and 51.8% have good informed consent practice. Residents and nurses with good knowledge about informed consent [AOR: 7.17 (95%CI: 2.267-22.682)], regular supervision from administration [AOR: 4.72 (95%CI: 1.706-13.06)], consideration of patients' cultural norms [AOR: 2.911 (95% CI: 1.024-8.278)] and patients’ incapacity to make decisions [AOR: 0.242 (95% CI: 0.089-0.657)] were significantly associated with informed consent practices. Conclusion: Good informed consent, driven by professional knowledge, administrative oversight, and cultural norms yet challenged by patients’ incapacity to make decisions, can be enhanced through continuous education, robust administrative support, cultural competency training, and clear protocols.Item Clinical Profile and Outcome of Adult Hiv-Positve Patients Presenting to the Emergency(Addis Ababa Uinverstiy, 2025) Ayenew Genet; Bitania Debalkew; Aklilu Azazh: HIV has been a global health problem since its identification. Despite a decline in new infections, many patients still present to emergency departments with advanced disease and critical systemic infections in Ethiopia. Objective: The main aim of this study was to assess the clinical profile and outcomes of adult HIV-positive patients presenting to the emergency department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: This study involved a retrospective cross-sectional electronic medical records review from January 1 to June 30, 2025, taking place in Tikur Anbessa Specialized Hospital adult emergency department. Data was extracted using a structured Kobo tool and then analyzed with SPSS v27. Multivariable logistic regression was applied to identify the factors associated with mortality, with a p-value of <0.05 regarded as statistically significant. Results: Out of a total of 104 HIV-positive patients included, the mean age was 45.78 ±14.25 years, and 64(61.5%) were females. The leading clinical presentations were vomiting (14.1%), diarrhea (10.5%), and fatigue (10.1%). Outcomes included ICU admission at 3.8%, and emergency department mortality at 14.2%. Advanced WHO clinical stage (AOR=6.068, 95%CI:1.273-28.880, P=0.024), high white blood cell count(AOR=1.205, 95%CI:1.015- 1.429,P=0.033), and hemoglobin (AOR=0.704, 95% CI: 0.540-0.918,P=0.009) were significant independent predictors of mortality. The majority (76.4%) stayed in the ED for ≥24 hours, with a median stay of 2 days (IQR: 1–3). Conclusion: Most HIV-positive adults presenting Tikur Anbessa Specialized Hospital emergency department had advanced diseases, high mortality, and prolonged ED stays. Advanced WHO clinical stage, high WBC, and low hemoglobin are independently associated with increased mortality. Findings underscore the need for early HIV diagnosis, proper monitoring, and optimized care.Item Clinical Profile and Outcome of Adult Hiv-Positve Patients Presenting to the Emergency(Addis Ababa Uinverstiy, 2025) Ayenew Genet; Bitania Debalkew; Aklilu AzazhHIV has been a global health problem since its identification. Despite a decline in new infections, many patients still present to emergency departments with advanced disease and critical systemic infections in Ethiopia. Objective: The main aim of this study was to assess the clinical profile and outcomes of adult HIV-positive patients presenting to the emergency department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: This study involved a retrospective cross-sectional electronic medical records review from January 1 to June 30, 2025, taking place in Tikur Anbessa Specialized Hospital adult emergency department. Data was extracted using a structured Kobo tool and then analyzed with SPSS v27. Multivariable logistic regression was applied to identify the factors associated with mortality, with a p-value of <0.05 regarded as statistically significant. Results: Out of a total of 104 HIV-positive patients included, the mean age was 45.78 ±14.25 years, and 64(61.5%) were females. The leading clinical presentations were vomiting (14.1%), diarrhea (10.5%), and fatigue (10.1%). Outcomes included ICU admission at 3.8%, and emergency department mortality at 14.2%. Advanced WHO clinical stage (AOR=6.068, 95%CI:1.273-28.880, P=0.024), high white blood cell count(AOR=1.205, 95%CI:1.015- 1.429,P=0.033), and hemoglobin (AOR=0.704, 95% CI: 0.540-0.918,P=0.009) were significant independent predictors of mortality. The majority (76.4%) stayed in the ED for ≥24 hours, with a median stay of 2 days (IQR: 1–3). Conclusion: Most HIV-positive adults presenting Tikur Anbessa Specialized Hospital emergency department had advanced diseases, high mortality, and prolonged ED stays. Advanced WHO clinical stage, high WBC, and low hemoglobin are independently associated with increased mortality. Findings underscore the need for early HIV diagnosis, proper monitoring, and optimized care.Item Knowledge and associated factors towards oxygen therapy among residents and nurses working at the adult emergency department.(Addis Ababa Uinverstiy, 2025) Hulugrigesh Derib; Bitania Debalkew; Ayenew AmareOxygen therapy is a critical intervention in the management of hypoxemia. It is used to treat respiratory distress in emergency and critical care settings. Even-though its importance, inappropriate administration and a knowledge gap among healthcare providers may compromise patient outcomes. Objective: To determine the level of knowledge and associated factors towards oxygen therapy among residents and nurses working in the adult emergency and critical care medicine department of Tikur Anbessa Specialized Hospital, Ethiopia, 2025. Methodology: A cross-sectional study was conducted among 108 participants (57 nurses and 51 residents). Data were collected using a structured self-administered questionnaire assessing sociodemographic characteristics, knowledge of oxygen therapy and related factors. Data analysis was by using SPSS version 25. Descriptive statistics were computed, and logistic regression was used to identify factors associated with satisfactory knowledge. Results: Among 108 participants, 55(50.9%) were male and 64(59.3%) were in the age range between 25-30 years. Among them, 57(52.8%) were nurses and 51(47.2%) were residents. Overall, 65(60.2 %) demonstrated satisfactory knowledge, while 43(39.8%) had unsatisfactory knowledge. Availability of oxygen therapy guidelines (AOR = 4.943, 95% CI: 1.567-15.591, p = 0.006), professional category (AOR = 3.646, 95% CI: 1.163-11.431, p = 0.027) and training on oxygen therapy (AOR=37.037, 95% CI: 10.163-134.976, p=0.001) were significantly associated with satisfactory knowledge. Conclusion: The study demonstrated that most respondents had satisfactory knowledge of oxygen therapy. But significant gaps were found, especially regarding, need of humidification, FiO₂ levels and monitoring practices. Regular training, improved guideline accessibility and ensuring adequate oxygen supply are recommended to enhance safe and effective oxygen therapyItem A Single Centered Cross Sectional Study on Assessment of Knowledge and Attitude of Emergency Department Staff Towards Future Infectious Disease Outbreak Preparedness: A Study at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.(Addis Ababa University, 2025-12-01) Ekram Getahun; Merahi Kefyalew; Tigist WorkuBackground: Infectious Disease Outbreaks Pose Ongoing Challenges to Global Public Health, Particularly in Low- And Middle-Income Countries with Limited Resources. Emergency Departments (Eds) Are Critical Frontline Units for Early Detection and Management of Outbreaks. The Knowledge and Attitudes of ED Staff Are Essential for Effective Preparedness. At Tikur Anbessa Specialized Hospital (TASH) In Addis Ababa, The Recently Restructured ED Has Not Yet Been Evaluated for Outbreak Readiness. Objective: This Study Assessed the Knowledge and Attitudes of ED Staff at TASH Regarding Preparedness for Future Infectious Disease Outbreaks. Methods: A Descriptive Cross-Sectional Study Was Conducted from July to September 2025 Among Clinical Staff. Stratified Random Sampling Was Used to Include All Staff Categories. Data Were Collected Using a Structured, Self-Administered Questionnaire Adapted from WHO And CDC Guidelines and Analyzed Using Descriptive Statistics In SPSS. Result: Out Of 100 Participants, only 44 Of Them (44%) Demonstrated Good Knowledge (≥80%). 56 Participants Out Of 100 (56%) Scored Below 80%. This Indicates Poor Knowledge. High Knowledge Was Observed in Isolation Practices (93%), Outbreak Leadership (86%), And Infection Prevention (87%). While Gaps Were Identified in Recognition of Airborne Transmission (54%), Correct Use of Personal Protective Equipment (57–77%), Triage Prioritization (64%), Team Coordination, And Certain Isolation Practices (43–72%). Attitudes Toward Outbreak Preparedness Were Generally Positive, with (73%–78%) Expressing Confidence in Managing Infectious Diseases and Supporting Preventive Strategies. However, Notable Concerns Were Reported Regarding PPE Feasibility (24%), Institutional Support (64%), Triage and Isolation Readiness (47%), And Team Coordination (36%). Conclusion: Although ED Staffs at TASH Have Positive Attitudes and Good Knowledge in Some Areas, There Are Critical Gaps in Outbreak Management Skills. Focused Training and Stronger Institutional Support Are Recommended to Improve Preparedness and Ensure Effective Responses to Future Infectious Disease Outbreaks.Item A Single Center Retrospective Cohort Study on Clinical Profile and Short Term Out Come of Rheumatic Heart Disease Patients Presenting with Acute Heart Failure at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.(Addis Ababa University, 2025-12-07) Amarech Dage; Merahi Kefiyale; Ayenew AmareBackground: The Burden of Rheumatic Heart Disease (RHD) In Low- And Middle-Income Countries, Including Ethiopia, Remains Significant. Despite This, There Are Limited Retrospective Data on the Clinical Features and Outcomes of Patients with RHD Presenting with AHF In Ethiopia, Particularly at Tertiary Centers Such as Tikur Anbessa Specialized Hospital (TASH). Objectives: To Assess the Clinical Profile and Short-Term Outcomes of RHD Patients Presenting with AHF At TASH. Methods: This Hospital-Based Retrospective Cohort Study Was Conducted At TASH, Addis Ababa. Patients Diagnosed with RHD and After between October 1, 2024 to September 30, 2025 Were Randomly Selected for Enrollment. Data Collection Included Demographic Characteristics, Clinical Features at Admission, Laboratory and Echocardiographic Findings, Treatment, And Outcomes (E.G., Length of Stay, In-Hospital Mortality, And 30-Day Readmission or Death). The New York Heart Association Classification Was Used to Categorize the Functional Status of the Patients. Results: The Median Age of the Cohorts Was 31 Years (IQR 20-39), 57%Were Female, and 50.4% Were Married. 83.7% Of Patients Covered Their Healthcare Costs Out of Pocket. The Median Duration of Symptoms Before Hospital Presentation Was 7days (IQR 5-14). Dyspnea Was the Most Common Presenting Symptom; 47.4% Of Patients Presented in NYHA Class IV And the Most Common Precipitating Factor Identified Was Pneumonia (27.1%); Mitral Valve Involvement Was 97%, Nearly All Patients (99.3%) Received Diuretics. In-Hospital Complications Occurred In 52.8% Of Patients, With Electrolyte Abnormalities Being the Most Common Complication, The Median Length of Stay Was 21 Days (IQR 11-31), 76.3% Of Patients Were Discharged, and 23.7% Died. Conclusion: This Study Shows That RHD Remains a Major Cause of AHF In Young Adults, Often Presenting Late and Experiencing High Complication Rates and Mortality.Item Assessing Sedation Practice in Critically Ill Patients Among ICU In TASH, A Prospective Observational Study(Addis Ababa University, 2025-12-07) Yafet Solomon; Finot DebebeBackground: Sedation is an Essential Component of Care for Mechanically Ventilated ICU Patients, Aimed at Ensuring Comfort, and Safety. Evidence-Based Guidelines Recommend Light, Protocolized Sedation with Routine Use of Validated Assessment Tools. However, Adherence to These Practices Remains Variable in Low-Resource Settings, Contributing to Suboptimal Outcomes. Object: -This Study Evaluated Sedation Practices, Monitoring Patterns, and Associated Outcomes in an ICU Patient. Methods: A Cross-Sectional Review of ICU Patients Receiving Mechanical Ventilation Was Conducted. Demographic Characteristics, Sedative Agents Used, Sedation Monitoring Methods, And Sedation-Related Outcomes were Analyzed. Findings were Interpreted in Relation to International Guidelines and Recent Literature on Protocolized Sedation Strategies. Results: The ICU Cohort Consisted Predominantly of Young to Middle-Aged Adults (14–45 Years: 61.2%) and Males (63.9%). Respiratory Failure, ARDS, and Neurological Conditions were the Most Common Reasons for ICU Admission. Ketamine was the Most Frequently Used Sedative Agent (25%), Followed by Propofol (16.7%) And Ketofol (13.9%), with Doses Within Accepted Therapeutic Ranges. Continuous Infusions were Used in 36.1% of Cases, and Light Sedation Targets (RASS –2 To 0) Were Applied in 30.6% of patients. However, Substantial Gaps in Monitoring were Identified: Only 40.3% Had Documented Sedation Scale Assessments, and Daily Sedation Interruption Was Performed in Just 6.9%. Prolonged Mechanical Ventilation (≥3 Days in 86.1%), Extended ICU Stays, and High 30-Day Mortality (55.6%) were Observed. Delirium and Sedation-Related Complications were Rarely Documented, Likely Reflecting Under Assessment. Conclusion: Sedation Practices in This ICU Setting Are Characterized by Acceptable Choice of Sedative Agents but Significant Deficiencies in Monitoring, Documentation, and Protocol Adherence. Limited use of Sedation Scales and Daily Interruption May Contribute to Prolonged Ventilation and poor Outcomes.Item Determinants of Early Mortality for Critically Ill Patients Awaiting Intensive Care in Ethiopian Emergency Department at Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia, 2025: A Prospective Observational Study(Addis Ababa University, 2025-12-01) Kalkidan Philipos; Aklilu Azazh; Tigist WorkuBackground: Broadly, Critical Illness Constitutes a State of Illness Involving Vital Organ Dysfunction, A High Risk of Imminent Death If Care Is Not Provided, And Potential for Reversibility with Appropriate Intervention. This Condition Manifests as Acute Impairment of One Or More Vital Organ Systems, Such As the Central Nervous System, Cardiovascular, Or Respiratory Systems, Resulting in a High Risk of Life-Threatening Deterioration. In Clinical Practice, Such Patients Necessitate Intensive Monitoring, High-Complexity Decision-Making, And Organ Support to Prevent Further Decompensation (1). The Intensive Care Unit (ICU) Plays A Vital Role in Managing Patients with Life-Threatening Conditions Requiring Advanced Organ Support. Over The Past Decades Advances in Ventilatory Support, Hemodynamic Monitoring, And Renal Replacement Therapy Have Improved Survival Rates Among Critically Ill Patients (2). However, The Demand for ICU Care Is Still High. It Continues to Rise Due To Aging Populations, Increasing Chronic Disease Burdens, And Frequent Infectious Outbreaks (3). Critically Ill Patients Thus Require Prompt Assessment and Aggressive Management to Improve Survival and Reduce Complications. The Transition from the Emergency Department (ED) To the ICU Is a Vital Step in the Continuum of Care. Delays In This Process Often Associated with Poorer Clinical Outcomes (4,5). Globally, Prolonged Waiting Times Before ICU Admission Have Been Linked to Increased Mortality, Extended Hospital Stays, And Increased Resource Utilization. This Emphasize That the Importance of Timely Transfer for the Best Outcomes (6–8). High Income Countries Typically Maintain 10–25 ICU Beds Per 100,000 Population. This Is Supported by Favorable Nurse to Patient Ratios and Policy Driven Expansions to Address Rising Demand. In Contrast, Low- and Middle-Income Countries (Lmics), Including Ethiopia, Average Just 0.3 ICU Beds Per 100,000 Population, With Ethiopia's 51 Public Icus Providing Only 324 Beds Nationwide (9). These Stark Disparities Can Result in Differing ED Boarding Time Alongside Short- and Long-Term Outcomes. Despite Existing Evidence, Prospective Studies in Ethiopia Directly Linking ED To ICU Admission Delays to Specific Patient Outcomes Remain Scarce. Most Of the Research Limited To 1 Retrospective Audits or Descriptive Analyses. This Study Aimed to Address That Gap Through a Prospective Observational Design. It Examines How Prolonged Boarding Times in the ED Influence Early Prognosis at Tikur Anbessa Specialized Hospital (TASH) And Zewditu Memorial Hospital (ZMH) In Addis Ababa, Ethiopia. Hoping It Will Outline the Bottlenecks and Guiding Targeted Interventions For Better Critical Care Pathway.Item Assessment of clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit at two selected public hospitals: A retrospective study.(Addis Ababa Uinverstiy, 2025) Bezawit Hailu; Lemlem Beza; Bitaniya DebalkewBackground: Obstetric complications remain a leading cause of maternal morbidity and mortality globally, particularly in low-resource settings such as Ethiopia. Despite improvements in antenatal care and delivery services, severe obstetric complications requiring intensive care unit (ICU) admission continue to pose major challenges, causing feto-maternal morbidity and mortality. Objective: To assess the prevalence, clinical profiles, and outcomes of obstetric complications among ICU admissions and identify factors associated with maternal mortality in ICU settings. Methods: A retrospective cross-sectional study was conducted on all obstetric patients admitted to the ICUs of ALERT and Zewditu Memorial Hospitals from July 1, 2023, to July 1, 2025. Data were extracted from medical records using a structured questionnaire. Descriptive statistics summarized patient demographics, obstetric complications, and clinical profile. Bivariable and multivariable logistic regression analyses were applied to identify predictors of ICU mortality. Statistical significance was set at p<0.05. Results: Of the 101 obstetric ICU admissions analyzed, the predominant diagnoses were eclampsia (31.7%), postpartum hemorrhage (29.7%), and preeclampsia (27.7%). System specific medical emergencies such as respiratory, renal, infectious, hematologic and neurologic system were observed in two-thirds of patients. The overall in ICU mortality rate was 21.8% (95% CI: 14%-30%). Place of residence emerged as the only significant predictor of ICU mortality, with women residing outside Addis Ababa exhibiting higher odds of death compared to those from in the city (AOR: 6.17; 95%CI: 1.24–30.73). Conclusion: Eclampsia, post-partum hemorrhage and pre-eclampsia were the leading causes of ICU admission. strengthening early identification and timely intervention at primary and secondary health care facilities could help reduce the need for ICU admission. Place of residence was the only significant factor associated with in ICU mortality. It is recommended that strengthening referral and transportation systems for obstetric emergencies might help reduce morbidity and mortality.Item Knowledge,Practice and Associated Factors of Nurses Working in intensive Care Unit Towards Open-Endotracheal Suctioning for Mechanically Ventilated Patients in Public Hospital of Addis Ababa,Ethiopia,2023.(Addis Ababa University, 2023-06) Merchaw Abebe; Beyene Temesgen ; Abebe AsmamawIntroduction: Endotracheal suctioning is one of the commonly performed invasive procedures in intensive care unit so as to keep airway patent in intubated patients. Knowledge and practice of nurses working in intensive care unit towards endotracheal suctioning is directly related to minimize complications, to improve standard of care, to promote effective/safe suctioning and to reduce length of stay in intensive care unit. Objective: To assess knowledge, practice and associated factors of nurses working in intensive care unit towards open endotracheal suctioning for mechanically ventilated patient in public hospitals of Addis Ababa, Ethiopia, 2023. Methods: Institutional based cross-sectional study was conducted on nurses working in six public hospitals. Simple random sampling method was used and data were collected using structured self-administered questionnaire and observational checklist. Data were entered into epi data version 4.6 and analysis was done using SPSS version 27. Frequency and percentage were done for categorical data. In addition, mean and standard deviation were done for continuous data. Besides, binary logistic regression was used to determine association between dependent and independent variables. Result: A total of 136 were included with response rate of 97% (132). From this, 78 (59.1%) with 95% CI (50.67, 67.53) and 51 (38.6% with 95% CI (30.30, 46.91) of nurses had good knowledge and practice respectively. Qualification [AOR = 6.01; CI: 1.24–29.05] and training [AOR= 3.69; CI: 1.40-9.67] were significantly associated with knowledge with P-value <0.05.equipment supplies [AOR= 5.0; CI: 1.71-14.38],and experience => 6years [AOR= 6.8; CI: 2.21-20.86] were associated of practice. Conclusion: In this study, more than half of the nurses who were working in intensive care units had good knowledge, but majority had poor practice on endotracheal suctioning. Training, qualification, experience and availability of adequate equipment were major factors associated with knowledge and practice.