Table 2 Synopsis of feasible and useful structure-based performance indicators

a) Existence of these structures in the EC

 • A staffed triage area

 • Dedicated minors area

 • Infectious diseases isolation area

 • Dedicated area for bereaved families

 • A safe area for intoxicated/suicidal overdose patients for observation

 • Adequate stores of essential equipment for disaster management (checked regularly)

 • A central command area for disaster management

b) Availability of the following equipment/services in or to the EC

 • Resuscitation drugs and equipment (checked daily)

 • Warmed fluids for resuscitation

 • A full range of equipment to treat patients of all ages

 • Different categories of analgesics/sedatives/anaesthetic dugs

 • A difficult airway trolley in the EC

 • A delivery pack in the EC

 • Emergency HIV prophylaxis all hours

 • Expert staff to assist with the patient who has a difficult airway

 • Rapid ultrasound (FAST) for blunt abdominal trauma

 • Portable X-rays immediately

 • 24-h on-site availability of X-rays/CT scanning and reporting/ultrasound scanning and reporting

 • Patient information containing updated medical information (e.g., wound care)

 • Trauma/counselling/pastoral and social services

c) Guidelines/protocols for:

 • Referral of patients to other hospitals/institutions (including minor injuries)

 • The administration of blood products/management of massive transfusions

 • Current resuscitation protocols in the EC from the Resuscitation Council of SA

 • Termination of CPR

 • The difficult airway

 • Procedural sedation

 • Nurse initiated administration of opiate analgesia

 • Dealing with infectious diseases

 • Acutely psychotic/aggressive patients

 • Disaster management (and regular simulations)

 • Dealing with staff conflicts/discipline issues

d) Personnel/training/audit:

 • Supervised training of junior EC staff

 • CPR training program within the EC

 • Regular simulation training of emergencies for EC staff

 • Regular morbidity and mortality meetings amongst EC staff

 • An active/regular research/audit program amongst EC staff

 • Percentage staff with BLS or ALS qualifications; and relevant diplomas/degrees