Background: Although road traffic accident (RTA) rates have decreased in Saudi Arabia, regional variations remain. First aid, combined with early emergency calls, may reduce mortality and morbidity. However, public awareness and confidence levels regarding the provision of first aid after RTAs are still low. This study assessed the knowledge, attitudes, and barriers among the public in the Makkah region. Methods: This cross-sectional study assessed public awareness and knowledge toward first aid management of RTAs in Makkah City, Saudi Arabia. Data were collected from March 16 to September 26, 2025, and an anonymous online survey was distributed electronically to the public. Results: A total of 390 participants were enrolled. Almost half (49.2%) of the participants reported having received previous first aid training. Most respondents were aged 18–44 years (85.9%), and trained individuals were more likely to be younger than 44 years (91.1% vs. 80.8%; p=0.009). Females comprised 71.5% of participants. Training was significantly more prevalent among individuals with a high school education or lower (p=0.019). Awareness of emergency numbers was reported in 80.2% of participants, which was significantly higher among those who were trained (88% versus 72.7%; p<0.001). Conclusion: The level of first aid preparedness in the Makkah region is not uniform. Formal first aid training was associated with higher knowledge levels, although barriers to providing first aid remained common. Community-based first aid programs for bystanders should be more widely implemented and could potentially enhance bystanders’ levels of response and outcomes in RTAs.
Background: Fixed drug eruptions (FDEs) are a form of delayed-type hypersensitivity mediated by CD8+ T cells triggered by offending agents resulting in recurrent lesions. Multifocal bullous subtypes are rarer but do exist and can mimic other blistering diseases posing a diagnostic challenge in the emergency department setting. Case Presentation: A 54-year-old Malay lady presented to the emergency department with a painful blistering rash over bilateral extensor forearm and elbow. They appeared as dusky, well-demarcated round plaques with central tense bullae. She had six to seven similar episodes over the past two years, recurring every three to four months with self-resolution each time. Skin biopsy demonstrated superficial perivascular dermatitis with pigmentary incontinence. Direct immunofluorescence and autoimmune serology with blistering disease BP 180 and BP 230 were negative. These findings support a diagnosis of probable multifocal bullous fixed drug eruption. The culprit agent was not identified, and the patient was advised for cessation of potential triggers. Conclusion: Early dermatology review with skin biopsy in patients presenting with blistering diseases is important for accurate diagnosis and to exclude other life-threatening blistering diseases. FDE may occur without clearly identifiable drug triggers and thorough history taking is essential.
Background: This systematic review synthesizes evidence on the prevalence, causes, and associated factors of non-urgent emergency department (ED) visits in Saudi Arabia, which contribute to overcrowding, increased costs, and delays in urgent care. Methods: We conducted a systematic review following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched from inception to the search date. We included observational studies from Saudi Arabia reporting prevalence, reasons, or factors associated with non-urgent ED visits. Three reviewers screened titles/abstracts and assessed full texts. Two reviewers extracted data using a standardized form and assessed study quality using Joanna Briggs Institute critical appraisal tools. Because of heterogeneity across definitions and outcomes, we synthesized findings narratively. Results: Eleven studies published between 2002 and 2024 were included (total sample size 30,684). Non-urgent ED visit prevalence ranged from 20.7% to 82.4% (mean 49.75%). Most studies defined non-urgent visits using the Canadian Triage and Acuity Scale levels IV–V. Younger age groups were most frequently associated with non-urgent ED use. Commonly reported drivers included dissatisfaction with primary healthcare services, limited appointment availability or working hours, and perceived faster or better ED care. Risk of bias was low to moderate. Conclusions: Non-urgent ED visits represent a substantial burden in Saudi Arabia. Improving access to high-quality primary healthcare, strengthening triage and referral processes, and increasing public awareness may reduce non-urgent ED use and preserve ED capacity for urgent care.
Background: Emphysematous gastritis is a rare, life-threatening infection of the stomach wall caused by gas-forming bacteria. Fewer than 200 cases have been reported. The mortality rate has declined from 60% to 33% owing to earlier diagnosis and improved care. This report presents a case of emphysematous gastritis, highlighting the challenges with diagnosis and management. Case presentation: A 70-year-old woman with unresectable cholangiocarcinoma and hepatic metastases presented with fever, abdominal pain, and coffee-ground vomiting. Imaging revealed gas within the gastric wall consistent with emphysematous gastritis. She was managed conservatively with intravenous antibiotics, fluids, and proton-pump inhibitors. Despite treatment, her condition worsened and she was transitioned to palliative care. She died on hospital day 21. Conclusion: This case describes the difficulties in managing emphysematous gastritis in a patient with a complex medical history and advanced malignancy and the unfavorable outcome despite timely and appropriate treatment. It highlights the need for early recognition of emphysematous gastritis using imaging, aggressive medical therapy, and management by a multidisciplinary team.
Objective: This study aimed to describe occupational injury patterns and outcomes and explore associations between injury characteristics and clinical outcomes. Methods: A retrospective cross-sectional study was conducted in the Emergency Department (ED) of Rashid Hospital Trauma Center (RHTC), Dubai Health (DH), between November 2019 and December 2021. Adults aged 18–60 years who were identified during ED triage by nurses as having sustained an occupational injury, defined as a physical injury incurred as a direct result of employment, were included. Results: Among 6,730 included patients, 6,480 were male (96.3%), and the median age was 32 years (interquartile range 12; range 18–60). The most common causes of injury were direct trauma (30.1%), falls (25.6%), and sharp objects (20.5%). Isolated soft tissue injury was the predominant injury type (69.7%). Hospital admission occurred in 896 patients (13.3%), and 66 (1.0%) required intensive care unit (ICU) admission, most commonly due to head injuries. Eight deaths were recorded (0.1%), predominantly following falls and head trauma. Cause of injury was significantly associated with injury type and ICU admission (p < 0.001). Conclusion: Occupational injuries presenting to this ED predominantly affected young male workers, with direct trauma, falls, and sharp-object injuries being the leading mechanisms. Head injuries were strongly associated with ICU admission and death, highlighting the need for strengthened workplace safety measures, enhanced surveillance, and a national occupational injury registry.
