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Background: Compartment syndrome is a medical emergency. It should be diagnosed promptly, and therapeutic measures should be taken to avoid limb ischemia. Measurement of compartment pressure is extremely important. Model: Knowledge about compartments and familiarity with the pressure monitoring device are important to diagnose acute compartment syndrome properly. Simulations provide an opportunity to learn the device and practice the procedure. Given their lower cost and the possibility of frequent reproduction, simulations using 3D-printed material are gaining popularity. We propose a simple low-fidelity model using a silicone-based lower leg soft tissue, 3D-printed tibia and fibula, Foley catheter, and syringes. Conclusion: This low-fidelity simulator helps to improve procedural skills and retention through repeated practice.

Background: Ocular injuries are common complaints in the emergency department (ED). In certain instances, a hematoma builds up behind the eyeball and can lead to increased intraocular pressure (IOP), restricting circulation and threatening vision. A lateral canthotomy can be vision-saving if performed appropriately and quickly. Unfortunately, not every physician in the ED is familiar with the procedure. Objective: Our objective was to build a hybrid 3D-printed model to simulate lateral canthotomy, hence improving physicians’ skills in performing the procedure. Method: Using a MakerBot 3D printer, a hemi-cranium and a sphere imitating the eyeball were printed. The model is supplemented with silicon skin and other materials. A hematoma is created using chocolate pudding. We present a low-fidelity, long-lasting hybrid model for lateral canthotomies. This model simulates the pathology, anatomy, and basic technical steps required to perform the procedure. Conclusion: This low-fidelity simulator helps to improve procedural skills and retention through repeated practice.

Background: Traumatic brain injury is a disease with high mortality with increased intracranial pressure included in the emergency department. Neuroimaging and intracranial pressure monitoring are limited in resource-limited settings. Optic nerve sheath diameter measurement to assess intracranial pressure indirectly using point-of-care ultrasound is appealing in diagnostics and decision-making. Objectives: We plan to evaluate the utility of point-of-care ultrasound on optic nerve sheath diameter role in traumatic brain injury patients. In these patients, optic nerve sheath diameter measurement was performed immediately postoperatively and 24 h later by trained residents. The procedure was repeated if any change in clinical status was observed. Results: A total of 50 patients were enrolled. Twenty-one patients underwent neurosurgical intervention. Three patients died in hospital. Eighteen patients had optic nerve sheath diameters less than 5 mm, 20 patients had optic nerve sheath diameter between 5 mm and 6 mm, and 12 patients had optic nerve sheath diameter > 6 mm. In 2 patients with changes in clinical condition, the repeat optic nerve sheath diameter assessment showed an increase in optic nerve sheath diameter. Conclusion: Despite limitations, trained health care providers can perform optic nerve sheath diameter. Longer training time and quality assurance are needed to appreciate the impact.

Introduction: The burden of stroke is increasing in many low- and middle-income countries. In Ethiopia, stroke has become a major cause of morbidity, long-term disability, and mortality. Time from stroke onset to hospital presentation is a critical factor in acute stroke care. This study aimed to describe risk factors for stroke and clinical presentation of patients presenting to the emergency centre with stroke. Methods: We conducted a cross sectional study conducted from August 2015 to January 2016 in an urban tertiary care centre in Addis Ababa, Ethiopia. Descriptive statistics and multivariable logistic regression models were used to evaluate associations between stroke types and stroke risk factors, and delayed presentation and clinical indicators. P-values less than .05 were considered statistically significant. Results: A total of 104 patients were included. The mean age was 53 years, and 56% were male. Only 30% of patients arrived using an ambulance service. The most common presenting symptoms were altered mental status (48%), hemiparesis (47%), facial palsy (45%), hemiplegia (29%), and aphasia (25%). Hypertension was the most common risk factor (49%), followed by cardiovascular disease (20.2%) and diabetes mellitus (11%). The majority of strokes were haemorrhagic in aetiology (56%). The median arrival time to the emergency centre was 24 h after symptoms onset; only 15% presented within three hours. Patients with hypertension, or presented with loss of consciousness were significantly more likely to have haemorrhagic stroke (p

Increased intracranial pressure is usually measured with invasive methods that are not practical in resource-limited countries. However, bedside ultrasound, a non-invasive method, measures the optic nerve sheath diameter and could be a safe and accurate alternative to measure intracranial pressure, even in children. Case report: We report a case of a 15-year old patient who presented with severe headache, projectile vomiting, and neck pain for two months. The bedside ultrasound showed a 10 mm optic nerve sheath diameter and a Computed Tomography scan of her brain revealed obstructive hydrocephalus secondary to a mass in the fourth ventricle. After intervening, we were able to monitor the decrease in her optic nerve sheath diameter with ultrasound. Conclusion: Performing invasive procedures continues to be a challenge in the resource limited setting. However, bedside ultrasound can be a useful tool in emergency centres for early detection and monitoring of intracranial pressure.