Browsing by Author "Saffy, Patricia"

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Locked down impact of covid 19 restrictions on trauma presentations to the emergency department
Venter, Anica; Lewis, Carolyn; Saffy, Patricia; Chadinha, Louis
Background: COVID-19 was recognised as a global pandemic on 11 March 2020. In South Africa (SA), a nationwide lockdown was implemented at midnight on 26 March to prepare for the predicted surge and slow the spread of the virus. Objectives: To compare the volume and type of presentations of trauma secondary to interpersonal violence and road traffic collisions (RTCs) during two 5-month periods, from February to June 2019 and 2020, in the emergency department (ED) of an academic tertiary hospital in Gauteng Province, SA. In 2020, February - June included the lockdown period. Methods: An observational retrospective audit of the patient register at the Helen Joseph Hospital ED was conducted, comparing the number of trauma presentations secondary to interpersonal violence (assaults with gunshot wounds, general assaults including mob assaults, assaults with stab wounds) and RTC presentations between February and June 2019 and 2020. Results: A total of 4 300 trauma presentations secondary to interpersonal violence and RTCs were noted in the 5-month period February - June 2019, as opposed to 3 239 presentations in February - June 2020 (25% decline). A 40% decline in the number of RTCs, from 1 704 in February - June 2019 to 1 026 in the corresponding period for 2020, was noted and found to be statistically significant (p=0.03). Declines in the volume of trauma cases secondary to interpersonal violence and of overall trauma cases were only directional in favour of 2020, but not statistically significant. Conclusions: The volume of trauma presentations secondary to interpersonal violence and RTCs in the Helen Joseph Hospital ED decreased during the lockdown period. The decline in the volume of RTCs was statistically significant, but declines in the volume of trauma presentations secondary to interpersonal violence and in the volume of overall trauma presentations were not.
Practices and outcomes of resuscitation in cardiac arrest at a South African Emergency Department
(University of the Witwatersrand, Johannesburg, 2022-12) Martin, Cathryn Sarah; Lewis, Carolyn; Saffy, Patricia
Objectives: This study aimed to investigate the patient and resuscitation factors affecting outcome after cardiac arrest in the low-middle income setting. Methods: We retrospectively reviewed the data of patient’s aged ≥18 who experienced in-hospital cardiac arrest in the Emergency Department between January 2020 and December 2020 at a tertiary hospital. The data collection period included the first wave of the COVID-19 pandemic in South Africa. Return of spontaneous circulation (ROSC) was the outcome of interest. The registry from which data was collected was audited. Results: 98 patients were included. The ROSC rate was 43%. Asystole was associated with poor outcomes (likelihood 7.73, p ≤0.01). Cardiac standstill on ultrasound was associated with poor outcome (likelihood ratio 6.559, p ≤0.01). There was a significant improvement in ROSC after the first wave of the COVID-19 pandemic and a transition from airway management with bag-valve-mask to endotracheal intubation intra-arrest (p=0.04). Demographic factors, defibrillation and drug-use were found to have no significant impact. Conclusions: The resuscitation practices and outcomes in the low-middle income setting are similar to high-income settings. Further research on the impact of the COVID-19 pandemic on resuscitation outcomes in this setting is necessary.
The experiences and impact of workplace violence on doctors and nurses working in Emergency Departments in the Gauteng Province, South Africa
(University of the Witwatersrand, Johannesburg, 2023-10) Kobe, Lerato; Saffy, Patricia; Bentley, Alison
Objectives: Workplace violence (WPV) remains grossly under-reported preventing a true appreciation of the problem. With South Africa currently rated in the top three in the world for crime, it is likely that such crime correlates with WPV experienced by health care workers. This study investigates the range of WPV experienced in the Emergency Department (ED), the demographics of the perpetrator, the impact of WPV on ED staff, and reporting behaviour. Study design: prospective, quantitative, observational, cross-sectional study of five public hospitals in Gauteng. Methods: During the period October 2020-March 2021 data was collected through the completion of a self-administered questionnaire. Nursing staff and doctors, with the exclusion of those in training, were enrolled. The questionnaire included questions on demographics, experience of physical and non-physical WPV over the last 12 months as well as responses and effects of those events. Results: There were 211 respondents. Seventy percent of respondents had experienced at least one physical WPV event and 84% had experienced at least one non-physical WPV event. In both types of violence most did not require treatment. The incidents, mainly perpetrated by patients or their relatives/visitors, left 42% of victims very worried about violence in their workplace and some with symptoms of post-traumatic stress disorder however reporting of events was severely lacking. Respondents indicated that there were no clear reporting procedures available to them. Conclusions: Workplace violence is a problem in the ED and more needs to be done in encouraging reporting of incidents but most importantly methods of preventing violence need to be prioritized.