Background: The measurement of, and reporting on clinical outcomes, is an integral part of clinical governance but no consensus has been reached about which measures to use and the validity thereof. Objective: To compare an administrative predictive model (Hospital Standardised Mortality Ratio [HSMR]) with a physiological predictive model (APACHE ®IV) to determine the correlation in the predicted risk adjusted mortality rates. To determine whether stratifying the patients into low (<10%), medium (<50%) or high (>80%) risk bands will lead to more accurate comparisons. Design: Prospective cohort study Setting: 63 critical care units in 34 private acute care facilities across South Africa Methods: Both HSMR and APACHE ®IV are calculated routinely in all participating facilities and the research study will use the data generated. An additional audit process will be implemented to determine and ensure the integrity of the data. Ethics: The healthcare facilities have standard processes in place to ensure confidentiality and the statistician analysing the data is employed by the healthcare group and bound to a confidentiality agreement. Ethics approval has also been obtained by the University of Cape Town ethic committee before the approval of the research proposal.

Includes bibliographical references / Includes abstract. / The evidence suggests an association between HIV, TB and DVT. There are no studies of this link in the Southern African setting, where the incidence of both of these conditions (HIV and TB) is high. We therefore undertook a study to define the incidence of HIV and TB in patients with confirmed DVT in this setting. The aim of this study is to describe the incidence of HIV, TB and the more commonly accepted risk factors in patients with confirmed DVT in a South African public hospital.

Includes bibliographical references. / The aim of this study is to determine whether routine blood cultures performed in a secondary level hospital Emergency Centre affect the choice of antibiotic used in treating patients with bacterial infections. A secondary aim is to determine if staff in the EC are aware of correct procedures for drawing blood cultures, and whether their practice reflects this. This will be a retrospective analysis of all blood cultures done in GF Jooste hospital over a 12 month period (1 April 2008 - 31 March 2009). The EC sees approximately 45 000 patients per year, and approximately 300 blood cultures are performed every month. Inclusion criteria: Age 18 or greater; Blood culture performed by EC staff in EC; Recorded blood culture result by laboratory; Patient in hospital when results received. The data will be analysed and presented as simple descriptive statistics.

Includes abstract. / Includes bibliographical references (leaves 35-37). / Patients with COPD presenting to the Emergency Unit with acute hypercapnic respiratory failure often require invasive mechanical ventilation and subsequent admission to the intensive care unit (ICU). These patients are at an increased risk of prolonged and complicated ventilation and often experience weaning difficulties. In addition, the impact of a previous episode of pulmonary tuberculosis that might have resulted in structural lung disease on the duration of mechanical ventilation in such patients has not previously been evaluated. Methods: All patients with COPD admitted to the Respiratory ICU at Tygerberg academic hospital from the 01st January 2004 until 31st December 2007 requiring intubation and invasive mechanical ventilation for acute hypercapnic respiratory failure were included in the study.

Includes abstract. / Includes abstract. / Outcomes of cardiac arrest and cardiopulmonary resuscitation (CPR) are poorly monitored or evaluated in our hospitals in South Africa. CPR plays a significant role in emergency medicine, and regardless of poor outcomes internationally, efforts should continuously be made to improve these outcomes. In this study we set out to establish the outcomes of CPR performed on all cardiac arrest patients in two hospitals in the Cape Metropole region.

Includes bibliographical references. / Data regarding health literacy in South Africa is limited, yet health literacy is critical to consider when addressing the needs of a population that is underserved by the medical community. An increase in health literacy can have a dramatic impact upon community members’ quality of life, life expectancy, and patient outcomes, as well as the successful advancement of the country. Townships and informal settlements surrounding Cape Town have limited access to timely health services, including life-saving emergency care. In recent years a community-based emergency first aid responder (EFAR) program has been created to address this need. EFARs have expressed interest in participating in other health related projects, and have the potential to help address health literacy needs in the Cape Town area. The aim of this study was to validate the use of the HLQ (Health Literacy Questionnaire) in South Africa and use it to develop a framework for EFARs to measure and respond to health literacy needs. After some revision, a validated combined Afrikaans/English HLQ was created for use in South Africa.

Background: Unintentional injury remains one of the leading causes of morbidity and mortality among children worldwide. The aim of this study will be to ascertain if teachers and teacher's assistants in early childhood development facilities have training in first aid or emergency care, what their attitudes towards first aid are and how competent they feel to manage emergencies. Methods: A cross-sectional survey will be carried out among early childhood development (ECD) practitioners who are studying at the Goodwood campus of Northlink College in the Western Cape. The survey will be optional and anonymous. A standardised collection of demographics will be performed and participants will be given a questionnaire that assesses the participant's knowledge and attitudes towards first aid and basic life support.

Includes abstract. Includes bibliographical references.

The aim of this study is to determine the current door to needle time for administration of fibrinolytics in acute myocardial infarction in Emergency Centres in the Cape Metropole. This study will also aim to identify the factors contributing to the delay.

Paediatric resuscitation can be a stressful event for many clinicians. It is compounded by the need to calculate accurate drug dosages and equipment sizes for many interventions. These calculations are most often based on weight, which is a difficult parameter to obtain. It is rare that one is able to weigh a child before a resuscitation. There are many different methods available for weight estimation. Most of these are formulae based on age but length based tools are often used. Most of these formulae were derived in developed world populations and have become inaccurate due to the changing weights and heights of children. The aim of this study was to evaluate 4 weight estimation methods (APLS, Luscombe and Owens, Best Guess and Broselow® Tape) to determine which are accurate for weight estimation in South African Children. These 4 formulae were also used to calculate the doses of adrenaline (0.1 m/kg of 1: 10000), Fluid bolus (20ml/kg) and First Shock defibrillation dose (2J/Kg) to determine which were clinically useful. A database of 3233 children between 1 and 12 years seen at Red Cross Hospital· Trauma Unit in Cape Town during 2002 was used. Measured weight was compared to estimated weights from all 4 methods and Intervention doses calculated from measured weight was compared to doses from weight estimation methods. APLS formula and the Broselow® Tape showed the best correlation with measured weight. Mean percent error- 6.4% for APLS for 1-10 year olds and -10% error for Broselow® tape in children &lt;145cm length. Both the Best Guess and Luscombe and Owens formulae tended to overestimate weight (+13.4% and +17.6 % respectively). The Broselow tape was most accurate for dosages of all interventions but little difference existed between methods. The APLS and Broselow® tape are most accurate in estimating weight in the South African population, even though they have a tendency to underestimate weight.