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OBJECTIVE EDs in Indonesia face an unprecedented increase in patient influx after the expansion of national health insurance system coverage. The present study aims to describe EDs' characteristics and capabilities utilisation in Jakarta. METHODS An ED inventory was created from the Jakarta Provincial Health Office and the Indonesian Hospital Association registries. The EDs that were accessible to the general public 24/7 were surveyed about their characteristics during the calendar year 2017. For further ED analysis, we stratified the hospitals into four types (A, B, C and D) based on their size and capabilities, with type A being the largest. RESULTS From the 118 (81%) out of 146 EDs that responded, there were 2 million ED visits or 202 per 1000 people. The median annual visit volume was 11 200 (interquartile range 4233-18 000). Further stratification highlights the annual visit difference among hospital types where type A hospitals reported the most with 32 000 (interquartile range 13 459-38 873). Almost half of the EDs (47%) answered that ≥60% of the inpatient census came from the ED. Less than half of the EDs (44%) can manage psychiatry, oral-maxillofacial and plastic surgery cases. Consultant coverage varied across hospitals and by hospital type (P

Objectives: Arterial blood gas measurements are not always immediately available despite their potential relevance to management of mechanically ventilated patients. Retrospective and prospective studies have validated the non-linear imputation of PaO2/FIO2 from SpO2/FIO2, predominantly in USA. In this study, the objective was to validate the non-linear imputation algorithm among mechanically ventilated patients in the Chinese population. Method: Mechanically ventilated patients admitted to the emergency departments or ICUs at two participating hospitals in China were enrolled prospectively. At the time of a clinical arterial blood gas being drawn, SpO2, oximeter waveform characteristics, receipt of vasopressor, and skin pigmentation were simultaneously recorded. For the various imputation methods, we calculated both imputation error and the area under the curve for patients meeting criteria for acute respiratory distress syndrome (PaO2/FIO2 ≤ 300) and moderate-severe acute respiratory distress syndrome (PaO2/FIO2 ≤ 150). Result: We studied 663 arterial blood gases from 646 patients; 177 (26%) arterial blood gases were associated with SpO2 less than or equal to 96%. Non-linear imputation had lower mean absolute error than linear imputation method when SpO2 was less than or equal to 96% (pConclusions: In this cohort of mechanically ventilated patients, non-linear imputation was not superior to linear and log-linear imputations for patients with SpO2 of 96% or less. All strategies performed similarly in estimating PaO2/FIO2 from SpO2/FIO2.

Objectives As an emerging country with the fourth largest population in the world, Indonesia's purchasing power has strengthened, leading to socioeconomic changes that affect its healthcare system. Additionally, there is a surge of healthcare utilisation after the implementation of a new national insurance scheme, particularly within emergency departments. Similar to other low- to middle-income countries, Indonesia has not prioritised the progress of emergency medicine despite existing evidence that suggests that the early intervention of many acute conditions lowers the rates of morbidity and mortality. This article will review the past and current state of emergency medicine in Indonesia. Methods The information gathered through PubMed, Ovid, and private and government institution databases, using the search term 'Indonesia', 'Emergency Medicine', 'Emergency Medical Services', and 'Disaster Medicine'. Additionally, we interviewed physicians who are involved in the development of emergency medicine in Indonesia. Results Indonesia's emergency medicine can be broken down into three sections: pre-hospital, hospital and the development of emergency medicine as a specialty. At the pre-hospital setting, disaster medicine and emergency medical service have not been established well enough to meet the demands of the population. For hospitals, there are two types of emergency departments - academic versus non-academic. Currently, there is no accredited emergency medicine residency programme despite the recognition of the specialty. Conclusion The development of emergency medicine in Indonesia is in its infancy and will require rapid improvement to meet its country's demand. Academic, private and government sectors need to collaborate to promote and invest in emergency medicine.