A study on the nature of admissions to accident and emergency department in a tertiary care hospital in Sri Lanka

Priyamali Jayasekera; Dasanayake GKG; Bandara PMK; Jayawardhena DANL; Malkanthi KMS

doi:10.7861/clinmedicine.19-2-s42

Aims

To identify the nature of all the admissions to the accident and emergency department (A&E) at Kurunegala Teaching Hospital.

Methods

Prospective observational study was carried out from 1 July 2016 to 30 June 2017 (1 year) to identify the nature of admissions to the A&E. Study tool was a data sheet comprising demographic data, presenting complaint and diagnosis at A&E.

Results

There were 49,213 admissions to A&E during the study period. Average number of admissions was 135 (+/-17.9) per day. Deaths in A&E were 0.21%. The mean age of the admitted patients was 46.7 (+/- 21.7) years and 62% of them were male. The frequency of medical, surgical, paediatric and gynaecology and obstetrics were 55%, 42%, 3.5% and 0.22%, respectively. The common emergency medical presentations included chest pain (34%), shortness of breath (10%) and faintishness (9%). Among emergency surgical presentations, trauma due to accidents were 83%, in which road traffic accidents were 27%.The commonest emergency paediatric presentations were animal bites 66% and seizures 8.5%.

Conclusion

The A&E of Kurunegala Teaching Hospital provides services to a significantly high number of health emergencies every day. The majority of these admissions were due to chest pains and trauma from accidents. The lower recorded number of paediatric, gynaecological and obstetric emergencies presented to the A&E is a result of national A&E policy to admit such patients directly to their respective wards. Further infrastructure development, with a dedicated chest pain unit, staff recruitment and training has to be planned to cater this high number of A&E admissions to A&E of Kurunegala Teaching Hospital.