Emergency Medicine

Strong emergency health services are needed to manage both the ordinary and extraordinary events that affect health, including natural disasters, epidemics and road traffic accidents. King’s Sierra Leone Partnership (KSLP) volunteers are working with Connaught Hospital staff and the Ministry of Health and Sanitation to strengthen emergency medicine and support it to be recognised as a national specialty area of practice.

Emergency medicine work is led from the UK by Dr Ling Harrison (hooi-ling.harrison@kcl.ac.uk) and in Sierra Leone by Dr Fiona Napier (fiona.napier@kcl.ac.uk).

To achieve this, Connaught Hospital with technical expertise support from KSLP has:

  • Implemented a new triage system that effectively prioritises the assessment of emergency patients 24 hours a day
  • Trained doctors, nurses, community health officers and students on the principles of emergency medicine
  • Conducted research on the effects of Ebola on emergency medicine within Sierra Leone and internationally,
  • Introduced improved trauma pathways and management.

All these new interventions are supported and sustained through the hospital’s revitalised and repurposed Emergency Department and resuscitation unit, opened in 2016, which formerly served as an Ebola Holding Unit.

Recent projects include:

  • Trauma checklist – introduced in May 2017 to improve assessment and documentation for trauma patients. These were areas requiring strengthening as highlighted by a previous audit of trauma care. The initial audit results are promising.
  • Mass casualty incident seminar – training for 50 junior doctors on the 14th & 15th October in conjunction with JUDASIL – the Junior Doctor’s Association of Sierra Leone. The seminar included lectures, a practical tabletop exercise, quiz and talk from Prof Tham, a visiting emergency medicine and teaching expert from Singapore.
  • Free Emergency Drug Trolleys – Hospital management are funding two emergency drug trolleys for red triage category patients (i.e. the sickest). The revenue comes from the registration fee which all patients pay on arrival, providing a sustainable supply of drugs (rather than relying on donations which inevitably run out). The trolleys were introduced in October 2017, one in the medical observation unit and the other in the trauma observation unit.
  • Clinical co-presence – A new way of doing clinical work for KSLP, which started in October 2017. From 14:00-21:00 every week day a KSLP doctor is present in the emergency department alongside our junior doctor partners. This is an opportunity to learn from each other and build relationships with local house officers who previously had difficulty getting more senior support in the evenings. For KSLP doctors it is also a chance to improve their Krio (the local language) and understand how the hospital functions. Attending the post-take ward round enables all to learn from the wisdom of the medical consultants.