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Objective: to converge towards a general agreement on the organization and operation of an emergency department., Methods: A participatory approach using the Delphi method was carried out with experts from emergency department staff and teaching hospital managers of Blida (Algeria).In the first round, experts were asked to express their degree of agreement on 30 items of the questionnaire on a seven point Likert scale, this to identify consensual items on the basis of an average rating of at least six. In the second round, the experts were asked to prioritize the consensual items. The experts participated anonymously in the study and any direct meetings between the experts were avoided., Results: A total of 190 experts participated in the first round, representing an overall participation rate of 77.2%. The first round identified 12 consensual items. Consensus was predictable for some items, such as the important role of the nurse or doctor reception in a emergency department (m = 6.0±1.5), but the response to other items was unexpected. Thus, the proposal that a patient already hospitalized in a required specialty service should never return to the emergency department was not the subject of consensus (m = 5.2±2.2). Correlation of rankings of consensual items by experts was significant but weak (Kendall W = 0.164, p < 10-3)., Conclusion: This study highlights contradictions and inconsistencies resulting from the improvisation that accompanied the birth of the emergency department in the teaching hospital of Blida.Major information and pedagogical efforts are needed to organize a new emergency department.

Objective: Establishing the incidence and mortality data for stroke in the Blida region (Algeria) for 2018, through the setting up of a population-based register, was the objective of this study., Methods: The World Health Organization criteria were used to define the stroke. Cerebral imaging was required to confirm stroke and its hemorrhagic or ischemic mechanism. The target population of the study was inhabitants of the region (wilaya) of Blida (Algeria) aged 25 and over. The ratios of overall incidence and mortality rates and age-specific stroke rates were considered to be relative risk (RR). The Standardized Mortality Ratio (SMR) was the ratio of standardized rates., Results: A total of 828 stroke were reported, 85.1% ischemic and 13.5% hemorrhagic. The first-ever strokes constituted 70.5% of the strokes for which the occurrence was documented. The overall incidence rate of stroke for 2018, regardless of mechanism and occurrence, was estimated at 130.3/100000. The corresponding standardized rate for age was 138.1/100000. The incidence rate among men (143.6/100000) was significantly higher than that of women (116.9/100000): RR = 0.81 (95% CI: 0.71; 0.93). The median age of onset of stroke was 70 years. The case-fatality rate at 28 days was 22.1%. The overall mortality rate was 28.8/100000 while the corresponding standardized rate was 29.9/100000. The standardized mortality rate for men (34.5/100000) was significantly higher than for women (25.3/100000): SMR = 0.73 (95% CI: 0.54; 0.99)., Conclusion: The setting up of a register for stroke in the Blida region has made it possible to quantify the risk of stroke, occurrence and death, and to alert about the burden of disease attributable to this health problem.