Initial injury care in Nairobi, Kenya: a call for trauma care regionalisation.
OBJECTIVE
To describe the emergency care of injuries at a main city hospital.


METHODS
A prospective study.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Saidi
H S
HS
Department of Human Anatomy and Surgery, College of Health Sciences, University of Nairobi, PO Box 30197, Nairobi, Kenya.
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017678:Sex Distribution; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy*