Epidemiology and Practice of Emergency Medicine in a Developing Country

Thomas D. Kirsch, Wilhelmus K. Hilwig, Yvette Holder, Gordon S. Smith, Suresh Pooran, Rawle Edwards

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


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. [Kirsch TD, Hilwig WK, Holder Y, Smith GS, Pooran S, Edwards R: Epidemiology and practice of emergency medicine in a developing country. Ann Emerg Med September 1995;26:361-367.].

Original languageEnglish (US)
Pages (from-to)361-367
Number of pages7
JournalAnnals of emergency medicine
Issue number3
StatePublished - Sep 1995
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine


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