Pathway to the Emergency Department in a Tertiary Hospital in Port Harcourt, Nigeria: A Prospective Study of 614 Unconscious Patients

Background: Patients arrive at the emergency department by a different array of means of transportation. This depends on the availability of ambulance and paramedic services. This is a challenge in Nigeria and the worst affected are the critically ill, unconscious patients and the unknown patient. The study investigated the companions, mode of arrival and where the unconscious patients are coming from unconscious patients to the Accident and emergency department (A&E) of the University of Port Harcourt Teaching Hospital (UPTH). Method: This is a 10-months prospective study conducted at the A&E of UPTH from September 2023 to June 2024. Convenience sampling technique was used for data collection. Results: Six hundred and fourteen unconscious patients were recruited into this study. Most of the informants were the patients' spouses 253(41.4%) and children 184(30.0%). The patient's companions included people who have close acquaintances with the patient. Most of the unconscious patients were accompanied by 1-3 persons. Only 10.6% arrived in an ambulance including those that were brought from another health facility. Most of the patients arrived from home and another health facility. Most of the patients with trauma were brought directly from the accident scene. Conclusion: Most of the unconscious patients arrived the A&E in taxis and personal vehicles that are not designed for the transportation of the critically ill. A central ambulance system should be established in Rivers State that can transport a critically ill patient.