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INTRODUCTION: The effective functioning of emergency departments (EDs) is essential for providing timely and appropriate medical care to patients with acute health issues. Triage, a critical aspect of ED operations, involves prioritizing patients based on the severity of their conditions. However, patients' understanding of the triage system plays a significant role in ensuring its efficient utilization. This study aims to examine the community's understanding of the triage system and the influencing factors. METHODOLOGY: A cross-sectional study included 775 participants from the Eastern region of Saudi Arabia, all of whom had prior visits to the ED during their lifetime. The data was randomly collected between June and July 2023 through a self-administered online questionnaire. RESULTS: The results showed that a substantial number of participants (73.8%) were aware of why some patients are prioritized over others in terms of room allocation, while 26.2% lacked this awareness. Among those aware, the majority (80.5%) believed that the priority system is fair, while 19.5% disagreed. Roughly two-thirds (64.8%) of the participants understood the concept of triage, while 35.2% lacked knowledge in this regard. The history of ED visits, age, and highest level of education were significantly associated with knowledge (p < 0.001). Participants who had a history of ED visits, were aged 20-29 years, and had a bachelor's degree had the highest percentage of adequate knowledge. The study also found that the most common reasons for non-urgent visits to the ED were the unavailability of appointments elsewhere (35%) and the perception that the ED provides faster care (30.4%). CONCLUSION: The study's assessment of triage knowledge reveals a moderate understanding among participants, with a majority demonstrating awareness of the prioritization system. The associations identified between demographic factors and triage knowledge highlight the importance of tailoring educational initiatives to specific groups. Individuals who visited the ED frequently and those who sought prior care exhibited better triage knowledge, suggesting potential opportunities for targeted interventions.
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BACKGROUND: Self-medication is vital to public health because it has an impact on people's health and the current healthcare system, both positively and negatively. During public health catastrophes like the COVID-19 disease, this is particularly true. AIM: This study aimed to examine the behavioral response of the community with regard to self-medication during the COVID-19 pandemic in the eastern region of the Kingdom of Saudi Arabia. METHODS: During the COVID-19 outbreak from March to September 2020, a cross-sectional online survey of 398 participants using structured questionnaires was conducted to observe knowledge, prevalence, patterns, and sources of self-medication among the respondents in the eastern region of the Kingdom of Saudi Arabia. RESULTS: The percentage of respondents who had heard about self-medication was 50.5%, and those who practiced self-medication during COVID-19 were 43.7% of the respondents. Regarding knowledge, 60.3% had a low overall knowledge level versus 39.7% who had a high knowledge level. Most of those who practiced self-medication took medication based on their own decision (34.4%). The most frequently used drugs during the outbreak were analgesics (43.5%) and vitamins (24.9%). Only 1% of participants reported using anti-malaria drugs (hydroxychloroquine). The most common reasons for self-medication practices were having a mild illness (30.4%), followed by fear of infection (26.6%). The symptoms for which the respondents took self-medication were headache (29.6%), cough (26.6%), and fever (24.6%). CONCLUSION: Our investigation showed a low level of knowledge about self-medication and a considerable level of self-medication practices. Therefore, self-medication may be minimized with ongoing awareness-raising and sensitization.
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BACKGROUND AND PURPOSE: Patients with acute stroke and mild or rapidly improving symptoms frequently show progression. The role of reperfusion treatment in such patients is not clear. We hypothesized that progression was most likely in patients with cortical localization and such patients may benefit from thrombolysis. MATERIAL AND METHODS: We interrogated Hamad Stroke Database to evaluate 90-days outcome in patients with acute ischemic stroke admitted within 4 hours and a NIHSS score of ≤6. Evaluation was based on localization (lacunar or cortical), multi-model imaging abnormalities and whether they received rt-PA. The 90-day mRS was used to determine outcome. RESULTS: During study period 6381 patients were admitted with acute stroke. Mild stroke within 4 hours was diagnosed in 506 [no thrombolysis: 381(lacunar: 213; cortical: 168), thrombolysis: 125 (lacunar: 45; cortical: 80)]. The rt-PA treated patients had significantly higher NIHSS (2.94±3.9 versus 1.28±2.46, p<0.0001), increased rates of complications (16.0% versus 3.9%, p<0.0001) and longer hospital stay (6.05±8.1 versus 3.78±3.6 days; p<0.001). In patients with cortical stroke, intracranial arterial occlusions (11.6% vs 3.9%, p<0.0001) and CTP mismatch (22.2% vs 4.4%, p<0.0001) were more frequent in rt-PA treated patients. Discharge mRS (33.6% versus 13.9%, p<0.001) and 90-days mRS (23.2% versus 11.8%, p = 0.002) was significantly worse in patients with cortical stroke (rt-PA-treated and untreated patients). CONCLUSIONS: The outcome in patients with mild stroke depends on lesion location (lacunar versus cortical) and severity of symptoms. Patients who receive rt-PA have significantly larger deficits, increased imaging abnormalities and higher rates of hospital complication, explaining the poor outcome in such subjects.
