Heike Geduld | University of Cape Town (original) (raw)
Papers by Heike Geduld
The proposed rapid scoping review has been commissioned by the World Health Organization (WHO) to... more The proposed rapid scoping review has been commissioned by the World Health Organization (WHO) to inform an Operational Readiness Framework for the Country Readiness Strengthening Department in the World Health Emergencies Program in WHO (Reference #: 2021/1145765; Unit: MST; Cluster: QNF/SCI). Objective: The objective of the rapid scoping review is to define and identify the critical elements of 'operational readiness' for public health emergencies, including COVID-19, and identify lessons learnt from addressing it, to inform the World Health Organisation (WHO) Operational Readiness Framework. Introduction: 'Readiness' comprises the immediate actions needed to respond to a developing risk or hazard. Knowledge about critical readiness components and actions required by countries at all levels in response to health emergencies is critical to inform operational readiness actions for future events. Inclusion criteria: Evidence sources (peer reviewed and grey literature)...
Additional file 8. Characteristics of included studies, synthesis of findings, risk of bias and c... more Additional file 8. Characteristics of included studies, synthesis of findings, risk of bias and certainty of evidence for research question 2
BMJ, 2021
Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There i... more Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline dev...
African Journal of Emergency Medicine
Emergency Medicine Journal
PREHOSPITAL SEIZURE MANAGEMENT Obtaining venous access and administering drugs to terminate seizu... more PREHOSPITAL SEIZURE MANAGEMENT Obtaining venous access and administering drugs to terminate seizures is difficult in the prehospital environment. Intramuscular (IM) midazolam is attractive as a potential treatment option for status epilepticus, as the drug is easily stored and can be rapidly administered. A randomised controlled trial from the USA recruited almost 900 patients of all age groups and compared the efficacy of IM midazolam and intravenous lorazepam. The results revealed IM midazolam to be at least as effective as intravenous lorazepam (N Engl J Med 2012;366:591e600).
African Journal of Emergency Medicine
Additional file 4. Search strategies research question 2
African Journal of Emergency Medicine, 2020
Background: Advanced life support (ALS) short training courses are in demand across Africa, thoug... more Background: Advanced life support (ALS) short training courses are in demand across Africa, though overwhelmingly designed and priced for non-African contexts. The continental expansion of emergency care is driving wider penetration of these courses, but their relevance and accessibility is not known. We surveyed clinicians within emergency settings to describe ALS courses' prevalence and perceived value in Africa. Methods: We conducted a cross-sectional quantitative analysis of 235 clinicians' responses to the African Federation for Emergency Medicine's online needs assessment for an open-access ALS course in Africa. Participants responded to multiple-choice and open answer questions assessing demographics, ALS course certification and availability, perceptions of ALS courses, and barriers and facilitators to undertaking such courses. Results: 235 clinicians working in 23 African nations responded. Most clinicians reported ALS course completion within the past three years (73%) and in-country access to ALS courses (76%). Most believed the content adequately met their region's needs (60%). Price and course availability were the most common barriers to taking an ALS course. The most common courses were cardiac and paediatric-focused, and the most common reasons to take a course included general career development, personal interest, and departmental requirements. Conclusion: One-quarter of emergency care clinicians lack access to ALS courses in twenty-three African nations. Most clinicians believe that ALS courses have value in their clinical settings and meet the needs of their region. Our findings illustrate the need for an affordable, widely available ALS course tailored to lower-resource African settings that could reach rural and peri-urban clinicians. African relevance • There is an increasing demand for ALS short course training as emergency care expands throughout Africa. • These courses are designed and priced for high-resource settings despite weak evidence to support their use in low-to-middle-income countries, yet may be regarded as a core criterion for employment or clinician privileging. • The accessibility, utility and value of ALS courses in Africa are unknown, as are clinicians' perceptions of such courses.
Additional file 2. Search strategies research question 1
Additional file 5. Selection criteria research question 2
Additional file 7. Characteristics of included studies, synthesis of findings, risk of bias and c... more Additional file 7. Characteristics of included studies, synthesis of findings, risk of bias and certainty of evidence for research question 1
Additional file 9. Evidence-based educational pathway on first aid for sub-Saharan Africa 221
Additional file 6. Description of consensus methods used during expert panel meeting
Additional file 1. PRISMA checklist2
South African Medical Journal, 2021
BMJ, 2020
Clinical question What is the role of drug interventions in the treatment of patients with covid-... more Clinical question What is the role of drug interventions in the treatment of patients with covid-19? New recommendation Increased attention on ivermectin as a potential treatment for covid-19 triggered this recommendation. The panel made a recommendation against ivermectin in patients with covid-19 regardless of disease severity, except in the context of a clinical trial. Prior recommendations ( a ) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (b) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (c) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; ( d ) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19, and ( e ) a conditional recommendation against remdesivir in hospitalised patients with covid-19. How this guideline was created This liv...
BMC Emergency Medicine, 2019
Background The number of Global Emergency Medicine (GEM) Fellowship training programs are increas... more Background The number of Global Emergency Medicine (GEM) Fellowship training programs are increasing worldwide. Despite the increasing number of GEM fellowships, there is not an agreed upon approach for assessment of GEM trainees. Main body In order to study the lack of standardized assessment in GEM fellowship training, a working group was established between the International EM Fellowship Consortium (IEMFC) and the International Federation for Emergency Medicine (IFEM). A needs assessment survey of IEMFC members and a review were undertaken to identify assessment tools currently in use by GEM fellowship programs; what relevant frameworks exist; and common elements used by programs with a wide diversity of emphases. A consensus framework was developed through iterative working group discussions. Thirty-two of 40 GEM fellowships responded (80% response). There is variability in the use and format of formal assessment between programs. Thirty programs reported training GEM fellows i...
African Journal of Emergency Medicine, 2012
The proposed rapid scoping review has been commissioned by the World Health Organization (WHO) to... more The proposed rapid scoping review has been commissioned by the World Health Organization (WHO) to inform an Operational Readiness Framework for the Country Readiness Strengthening Department in the World Health Emergencies Program in WHO (Reference #: 2021/1145765; Unit: MST; Cluster: QNF/SCI). Objective: The objective of the rapid scoping review is to define and identify the critical elements of 'operational readiness' for public health emergencies, including COVID-19, and identify lessons learnt from addressing it, to inform the World Health Organisation (WHO) Operational Readiness Framework. Introduction: 'Readiness' comprises the immediate actions needed to respond to a developing risk or hazard. Knowledge about critical readiness components and actions required by countries at all levels in response to health emergencies is critical to inform operational readiness actions for future events. Inclusion criteria: Evidence sources (peer reviewed and grey literature)...
Additional file 8. Characteristics of included studies, synthesis of findings, risk of bias and c... more Additional file 8. Characteristics of included studies, synthesis of findings, risk of bias and certainty of evidence for research question 2
BMJ, 2021
Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There i... more Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline dev...
African Journal of Emergency Medicine
Emergency Medicine Journal
PREHOSPITAL SEIZURE MANAGEMENT Obtaining venous access and administering drugs to terminate seizu... more PREHOSPITAL SEIZURE MANAGEMENT Obtaining venous access and administering drugs to terminate seizures is difficult in the prehospital environment. Intramuscular (IM) midazolam is attractive as a potential treatment option for status epilepticus, as the drug is easily stored and can be rapidly administered. A randomised controlled trial from the USA recruited almost 900 patients of all age groups and compared the efficacy of IM midazolam and intravenous lorazepam. The results revealed IM midazolam to be at least as effective as intravenous lorazepam (N Engl J Med 2012;366:591e600).
African Journal of Emergency Medicine
Additional file 4. Search strategies research question 2
African Journal of Emergency Medicine, 2020
Background: Advanced life support (ALS) short training courses are in demand across Africa, thoug... more Background: Advanced life support (ALS) short training courses are in demand across Africa, though overwhelmingly designed and priced for non-African contexts. The continental expansion of emergency care is driving wider penetration of these courses, but their relevance and accessibility is not known. We surveyed clinicians within emergency settings to describe ALS courses' prevalence and perceived value in Africa. Methods: We conducted a cross-sectional quantitative analysis of 235 clinicians' responses to the African Federation for Emergency Medicine's online needs assessment for an open-access ALS course in Africa. Participants responded to multiple-choice and open answer questions assessing demographics, ALS course certification and availability, perceptions of ALS courses, and barriers and facilitators to undertaking such courses. Results: 235 clinicians working in 23 African nations responded. Most clinicians reported ALS course completion within the past three years (73%) and in-country access to ALS courses (76%). Most believed the content adequately met their region's needs (60%). Price and course availability were the most common barriers to taking an ALS course. The most common courses were cardiac and paediatric-focused, and the most common reasons to take a course included general career development, personal interest, and departmental requirements. Conclusion: One-quarter of emergency care clinicians lack access to ALS courses in twenty-three African nations. Most clinicians believe that ALS courses have value in their clinical settings and meet the needs of their region. Our findings illustrate the need for an affordable, widely available ALS course tailored to lower-resource African settings that could reach rural and peri-urban clinicians. African relevance • There is an increasing demand for ALS short course training as emergency care expands throughout Africa. • These courses are designed and priced for high-resource settings despite weak evidence to support their use in low-to-middle-income countries, yet may be regarded as a core criterion for employment or clinician privileging. • The accessibility, utility and value of ALS courses in Africa are unknown, as are clinicians' perceptions of such courses.
Additional file 2. Search strategies research question 1
Additional file 5. Selection criteria research question 2
Additional file 7. Characteristics of included studies, synthesis of findings, risk of bias and c... more Additional file 7. Characteristics of included studies, synthesis of findings, risk of bias and certainty of evidence for research question 1
Additional file 9. Evidence-based educational pathway on first aid for sub-Saharan Africa 221
Additional file 6. Description of consensus methods used during expert panel meeting
Additional file 1. PRISMA checklist2
South African Medical Journal, 2021
BMJ, 2020
Clinical question What is the role of drug interventions in the treatment of patients with covid-... more Clinical question What is the role of drug interventions in the treatment of patients with covid-19? New recommendation Increased attention on ivermectin as a potential treatment for covid-19 triggered this recommendation. The panel made a recommendation against ivermectin in patients with covid-19 regardless of disease severity, except in the context of a clinical trial. Prior recommendations ( a ) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (b) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (c) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; ( d ) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19, and ( e ) a conditional recommendation against remdesivir in hospitalised patients with covid-19. How this guideline was created This liv...
BMC Emergency Medicine, 2019
Background The number of Global Emergency Medicine (GEM) Fellowship training programs are increas... more Background The number of Global Emergency Medicine (GEM) Fellowship training programs are increasing worldwide. Despite the increasing number of GEM fellowships, there is not an agreed upon approach for assessment of GEM trainees. Main body In order to study the lack of standardized assessment in GEM fellowship training, a working group was established between the International EM Fellowship Consortium (IEMFC) and the International Federation for Emergency Medicine (IFEM). A needs assessment survey of IEMFC members and a review were undertaken to identify assessment tools currently in use by GEM fellowship programs; what relevant frameworks exist; and common elements used by programs with a wide diversity of emphases. A consensus framework was developed through iterative working group discussions. Thirty-two of 40 GEM fellowships responded (80% response). There is variability in the use and format of formal assessment between programs. Thirty programs reported training GEM fellows i...
African Journal of Emergency Medicine, 2012