Dr. K. A. Ojifinni
Head of Department
BACKGROUND
The Emergency Department (ED) of the University College Hospital, Ibadan (UCH) is the acute critical care section of the Institution. Emergency care began from the period of establishment of the University College Hospital, Ibadan. At inception, the Department was situated in the South East ground of the Hospital, and was called Casualty, Accident and Emergency. (This name was later changed to Emergency Department to follow the modern medical trend in nomenclature). The Emergency Department was subsequently moved to the present complex which was officially commissioned by the then Military Head of State, General Mohammadu Buhari who is now the serving civilian President of Federal Republic of Nigeria.
The Emergency Department complex is strategically located towards the East of the Hospital. The complex houses, a sorting area for patients, a reception, some consulting rooms, a general resuscitation room and the modern resuscitation room where further procedures could be carried out under anaesthesia if need be. The Emergency Department complex also houses the Burns Unit, a plaster of paris room, a mini laboratory, operating theatres and staff offices.
Members of staff of the Emergency Department, include Clinical Consultants, Medical Officers, Nurses, Laboratory Scientists, Domestic Nursing staff, Cleaners, Administrative Staff, Statisticians, Pharmacists, Health Information Officers (Records Officers), Radiographers, Radiologists, Social Workers, Plaster Technicians, Fee Collectors, Service Officers, SERVICOM Officers and Security Officers.
The Emergency Department of the University College Hospital, Ibadan, started as a Unit from the South East ground of the Hospital which is the present Otunba Tunwase Children Emergency Ward (OTCHEW). The wing housed both the Adult and the Paediatric Emergency Units of the Hospital before the Adult Emergency Unit was separated and relocated to its present site.
The Emergency Unit was originally under the Surgery Department and was being managed by the Surgical Resident Doctors. Resident Doctors from the Obstetrics and Gynaecology and Medicine Department were also involved in the management of the Emergency Unit.
Some challenges attended the then arrangement of which co-ordination, accountability and continuity were big issues. This brought about the need to re-structure the Emergency Unit leading to the initiation of a new structure in 1999. Subsequently, the Hospital Management employed four Medical Officers between 2002 and 2003. These doctors were Dr. Adetona; Dr. Ogunnorin; Dr. Bamidele Alegbeleye and Dr. Ogbodeminu.
The Department of Orthopaedics and Trauma later took charge of the Emergency Unit in order to further ensure its smooth running. Consequently, these Medical Officers reported to the Head of the Department of Orthopaedics and Trauma. The first Orthopaedics Consultant to take charge of the Unit was Prof. Temitope Alonge. Subsequently, the Unit was coordinated by other Orthopaedics Consultants namely Prof. Omololu, and Prof. S.O. Ogunlade.
These consultants contributed immensely to the development of the Unit. However due to the work load in the Emergency Unit which continued to increase in significant geometric proportions, and the need for the Orthopaedics Consultants to attend to other core Orthopaedics related responsibilities, and research activities, a suggestion was raised for the employment of a substantive surgeon who would oversee the Unit. This later necessitated the employment of Dr. Dolapo Afuwape. Subsequently, the Unit became more structured and evolved into a Department. Dr. Dolapo Afuwape then became the first substantive Head of the Emergency Department in December, 2003. As the work load increased, Mr. Oyetunde, FRCS, worked in the Emergency Department as a Sessional Consultant in 2004. He later joined the Hospital to become the second Head of the Emergency Department in June 2006. To complement these two Surgeons, there was the need for an Anaesthesiologist in the Department. This need brought about the deployment of Dr. Amby Rukewe to the Department in 2007. He later became the third Head of Department and held the office between 2010 and 2013.
In view of the need to attend to patients requiring care from specialists in different fields, the Hospital in 2007, employed two physicians namely Dr. (Mrs) Aje and Dr. A. Aje. Dr. (Mrs) Aje later took over the Headship of the Department from Dr. Amby Rukewe in June, 2013.To further improve the outcome of the acute critically ill patients in the Emergency Department, the Management employed the services of two Anaesthesiologists in 2016. They are Drs. A.I. Badru and D.A. Aderinto. Dr. Aje later handed over the headship of the Department to Dr. Adewale Badru in September, 2016.
| S/N | NAME | PERIOD OF HEADSHIP |
| 1. | Dr. O.O Afuwape | 2003-2006 |
| 2. | Mr. O. Oyetunde(FRCS) | 2006-2010 |
| 3. | Dr. Ambrose Rukewe | 2010-2013 |
| 4. | Dr (Mrs) A. O. Aje | 2013-2016 |
| 5. | Dr. Adewale I. Badru | 2016-2020 |
| 6. | Dr. Tinuola Fakoya | 2020-till date |
Services
The Emergency Department renders services to patients requiring acute critical care form specialists in different fields of Medicine. About 10,000 patients are seen annually. The Department was the first to establish a disaster management initiative in Nigeria, a feat that other Institutions have come to understudy for further replication in other Hospitals.
The department renders services in electrocardiography and ultrasound scan. There are also radiological equipment in the department. These include a single slide CT Scan Machine, Digital X-ray and Mini-Laboratory to enhance prompt patients’ management.
At some point, there was an Endoscopic Suite in the Emergency Department. This was later relocated to the third floor to ensure closeness to the medical patients that readily require the service. This has also enabled the management to create more operating suites within the Emergency Department. Patients that are stabilized are subsequently moved to the Treatment Cubicles. There are eight of such Cubicles with several overflows across the Cubicles. The eighth cubicle is designated to care for infective diseases that are potentially of public health interest.
Minor procedures and dressings are undertaken in the Emergency Complex, Follow-up patients that require dressing are attended to in the Central Dressing Unit of the Emergency Department complex.
The Emergency Department has participated in various clinical trials one of which is the popular global CRASH trial.
Training
The Department is also a training complex for Resident Doctors, Medical Students, Nursing Students, Community Health Extension workers, Students of the School of Health Information Management, Students training in plaster of Paris application, Anaesthetic Technician Students among others.
The Management of UCH under the leadership of Prof. Temitope Alonge, envisioned the Emergency Department to be the first of its kind in Nigeria and beyond. One of the steps taken in this regard was the sponsorship of two medical officers in the Emergency Department to South Africa to get trained in Emergency Medicine. These are Dr. Kehinde A. Ojinfinni and Dr. Olurotimi O. Akinola.
The Emergency Department in collaboration with the Department of Surgery started the Basic Trauma Course which has evolved over time. The Emergency Department had at different times saved the lives of many patients right from inception. These are too many to mention however, some readily come to mind. They include the management of the disaster involving 23 medical students that were involved in accidents with 100% survivors. Others include:
- Management of the disaster involving many school children whose school bus was gutted with fire
- Management of the 2012 cholera outbreak in Oyo State
- Management of the hemorrhagic fever victims such as Lassa fever, Dengue etc.
- Management of mass casualties of robbery attacks in 2008.
- Management of the disaster of trailer passengers that somersaulted on Lagos-Ibadan Express Road involving close to fifty victims.
- Rescuing the stampede and sudden collapse of footballers and Fans from Ibadan Stadia
On the 26th of July, 2016, a fire outbreak gutted the Emergency Department. This was a gloomy day for all and a sad day in the history of the department. Patients were however safely evacuated to various wards within the Hospital including the first floor Modular Theatre reception and the Recovery Room. The gallant role exhibited by the CMD, Prof. Temitope Alonge to put the situation under control is noteworthy. Also remarkable was the role of several members of staff of the department and the Hospital at conducting and assisting with the necessary and urgent evacuation of the department, and in containing the spread of the fire even before the arrival of the fire services.
Sequel to the devastation caused by the fire outbreak, the Honourable Minister of Health, Prof Isaac Adewole visited the Institution and inspected the damages. He thereafter reiterated the support of the Federal Government to the Hospital, as well as the commitment of the Federal Government to build an extension of the Emergency Department extension.
After the fire outbreak, the Emergency Department was shifted to the sorting floor of the Family Medicine Department. The Emergency Department has since been renovated and restructured to conform with the current global concepts.
The commencement of the new Emergency Department Complex is in progress. The project is to solve the present problem of inadequate space.
Additionally, the commencement of the Emergency Medicine training is imminent in Nigeria, and UCH, Ibadan being the Centre of Excellence and the first among the Teaching Hospitals is set to lead the pace again.
