Failed tracheal intubation in primary health care.

Tracheal intubation in primary health care is a necessary skill and usually one that is necessary for appropriate emergency management of unstable patients. Primary care practitioners may not have an anaesthetist or critical care doctor available to help them in these emergencies and must manage these patients themselves. Often tracheal intubation may fail because of multiple possible factors and a different course of action may be needed to minimise the potential for harm to the patient. The primary care professional or family physician will have to manage this failed intubation. Primary health care facilities providing obstetric services must have guidelines and appropriate equipment for management of airway problems. This article will explore reasons for the failure of tracheal intubation and how this can be managed.

Palpitations: Evaluation and management by primary care practitioners.

Palpitations are a common, non-specific presenting complaint in primary healthcare and emergency departments. Palpitations are mostly a symptom of benign underlying disease but a sign of life-threatening conditions. Importantly, palpitations are a symptom and not a diagnosis, and cardiac causes are the most concerning aetiology. Clinicians should seek to identify the underlying cause. History and physical examination are important in the assessment of patients with palpitations, and the use of a 12-lead electrographic (ECG) monitor on presentation is the gold standard of diagnosis. If the aetiology cannot be determined, an ambulatory Holter 24-48-h monitor can be used. Treatment and follow-up of patients presenting with palpitations as the main complaint will depend on the aetiology and investigation findings. Patients with palpitations accompanied by dizziness, excessive fatigue, or chest pains should receive adequate acute care aiming to stabilise their condition before referring to a higher level of care.

Preparedness level of frontline healthcare professionals in Tshwane regarding the COVID-19 pandemic.

BACKGROUND: Facing the highly transmissible viral infection referred to as the coronavirus disease 2019 (COVID-19) that threatens human life, South African frontline healthcare professionals have faced a major challenge. Being one of the African countries with a higher prevalence of COVID-19 cases, this study aimed to assess the preparedness levels of emergency doctors, nurses and clinical associates in the Tshwane district of South Africa regarding the COVID-19 pandemic. METHODS: This was a cross-sectional survey using a developed and piloted online questionnaire. It was conducted in the casualty departments (emergency medical units) of seven hospitals in the Tshwane district of South Africa. Only emergency doctors, nurses and clinical associates took part. RESULTS: Of the 87 respondents, the mean age was 33.9 years and the minimum and maximum ages were 22 and 62 years, respectively; 37 (42.5%) were aged 26-30 years, 54 (62.1%) were females, 46 (52.9%) were single persons, 35 (40.2%) were medical officers, 42 (48.3%) were healthcare professionals with 0-5 years of experience and 21 (24.1%) were from a provincial tertiary hospital. Of the healthcare professionals, 63 (72.4%) were assessed as being prepared regarding the COVID-19 pandemic. CONCLUSION: The current online survey demonstrated a good preparedness level regarding the COVID-19 pandemic management amongst frontline healthcare professionals working in seven hospitals of the Tshwane district. An educational training programme on disaster management or the COVID-19 pandemic should be implemented to ensure that all frontline healthcare professionals are adequately prepared for current and future outbreaks.

A description of events surrounding the index COVID-19 diagnosis in a staff member at Kalafong Provincial Tertiary Hospital in Gauteng, South Africa.

The ongoing coronavirus disease 2019 (COVID-19) pandemic presented a huge challenge to the health systems across the world. When the virus hit South Africa, and the state of national disaster was announced by the president, the healthcare system had to work on its COVID-19 response preparedness. Initially, a few hospitals were then designated facilities for managing COVID-19 patients. Kalafong Hospital, which was not amongst a list of designated facilities for COVID-19 was forced to evaluate its level of preparedness after an intern doctor tested positive. The objectives of this report are to illustrate the hospital's response around the management of the index case to share our facility's general response to the pandemic.