Epidemiology and practice of emergency medicine in a developing country

Ann Emerg Med. 1995 Sep;26(3):361-7. doi: 10.1016/s0196-0644(95)70087-0.


Study objective: To analyze the emergency medicine system in a developing country and identify areas of need and potential collaboration.

Design: Convenience sample surveys of all emergency visits over a 2-week period, hospital admission and health department statistics, and interviews with government officials, health providers, and EMS managers.

Setting: Port of Spain General Hospital, Trinidad and Tobago.

Results: The ED has more than 100,000 visits per year. No records are kept. No physician in this study had emergency medicine training; only one had completed any residency. The survey included 3,710 patients: 40.5% were admitted, and .3% died. Injuries accounted for 41.6% of all visits, asthma 7.8%. The mean time elapsed before a patient was seen was .5 hour; mean time to discharge, 1.9 hours. In only 9% of patients were laboratory tests performed. Prehospital providers had limited equipment and training.

Conclusion: The ED and prehospital systems provide high-volume and often high-acuteness care. Barriers to improved care include limited specialized training and lack of medical records.

Publication types

  • Comment

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Delivery of Health Care / organization & administration*
  • Developing Countries
  • Emergency Medical Services / organization & administration*
  • Emergency Medicine / education
  • Emergency Medicine / organization & administration
  • Female
  • Health Services Needs and Demand
  • Health Services Research
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Morbidity*
  • Surveys and Questionnaires
  • Time Factors
  • Trinidad and Tobago / epidemiology