Table 2. Mode of Transportation by Age
Table 1. Living Location by Time to ED Live in Monrovia Yes
No
Mean (omitted outliers) Median Standard deviation (SD) [*omitted outliers]
Taxi
Car
Other
P-value= 0.013
AGE
TIME TO ED (MIN) Mean
Transportation
P-value = <0.001
<2 (n=19)
17 (89.5%)
0 (0%)
2 (10.5%)
151
2–10 (n=16)
9 (56.3%)
3 (18.7%)
4 (25.0%)
30
180
>10 (n=27)
12 (44.4%)
9 (33.3%)
6 (22.3%)
36.75
177.42
55.71 38.82
268.18
*omitted data included min = 1440 and 990 P-value based on mean (omitted outliers), performed by t-test
Patients who lived in Monrovia reported a significantly shorter traveling time to ED (38.8 min) than patients who did not live in Monrovia (P<0.001)
them to provide first aid skills, safe rescue, and transport. There would have to be some subsequent payment and recognition of these activities. As the data show, the most available form of transport in Monrovia are taxis, which represent nearly two-thirds of transport utilized, especially by the more critically ill patients <2 years of age. In 2002, Kumasi, Ghana pioneered a program designed to train taxi drivers in roadway casualties. They experienced improvements in the process of pre-hospital trauma care by building on existing, although informal, patterns of PHC transport.4,5 However, this study looked at initial trauma management interventions and not critical medical care. The majority of the critically ill arriving at our emergency area were young children. That might argue for a specialized concentration on initial pediatric life support given the serious consequences. In urban GuineaBissau, 20 of 125 acutely ill children died either on the way to the hospital or in the waiting room awaiting medical care.4,6 In Sierra Leone, a vehicle and a communication system led to a two-fold increase in utilization of emergency obstetric services and a 50% reduction of in case fatalities.4,7 A substantial number of Liberians carry cell phones, allowing them to call an emergency dispatch number for assistance and transport if an emergency medical condition was immediately recognized. This suggest a need for community training to recognize
Significant test performed by Fisher's Exact
Patients under the age of 2 were more likely to be transported by taxi to the ER (89.5%) than other age groups (P=0.013) Table 3. Mode of Transportation by Severity of Condition Transportation Taxi
Car
Other
Blue (n=26)
16 (61.5%)
5 (19.2%)
7 (26.9%)
Red (n=28)
19 (67.9%)
6 (21.4%)
2 (7.1%)
Green (n=8)
3 (37.5%)
0 (0%)
5 (62.5%)
P-value= 0.028
CONDITION
REFERENCES
Significant test performed by Fisher’s Exact
1. Liberia Health Sector Needs Assessment. 2008. World Health Organization. http:// www.who.int/hac/ donorinfo/liberia_ cap2008_eng.pdf
Patients who were transported by taxi were more likely to have a serious health condition (red or blue)
2. Sasser S, Varghese M, Kellermann A, Lormand JD. Prehospital trauma care systems. Geneva, World Health Organization, 2005. 3. Razzak JA, Kellermann AL. Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ. 2002;80:900-905. 4. Tiska M, Adu-Ampofo M, Boakye G, Tuuli L, Mock CN. A model of prehospital trauma training for lay persons devised in Africa. Emerg Med J. 2004;21:237239. More refs on page 14
Table 4. Condition by Age Condition Blue
Red
Green
<2 (n=19)
11 (57.9%)
8 (42.1%)
0 (0%)
2-10 (n=16)
6 (37.5%)
8 (50.0%)
2 (12.5%)
>10 (n=27)
9 (33.3%)
12 (44.4%)
6 (22.2%)
P-value= 0.185
AGE
Significant test performed by Fisher’s Exact
A higher percentage of patients <2 years of age presented with more critical health condition, but the difference was not statistically significant. Table 5. Condition by Time to ER Condition Blue
Red
Green
mean
41.35
91.29
281.25
mean (omitted outliers)
41.35
58
105
30
35
105
33.39
71.74
130.97
P-value= 0.173
TIME TO ER (MIN)
median std.dev (omitted outliers)
*omitted data included min = 1440 and 990 p-value based on mean (omitted outliers), performed by t-test
Patients with less serious health condition reported a longer traveling time to the ER, but the difference was not statistically significant. www.epijournal.com
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