RESUMEN
Information on arrival, attendance and discharge times, age, sex, diagnoses, outcome, trauma classification and procedures and investigations performed was recorded in a specially designed form in 4,041 consecutive cases attending the Port-of-Spain General Hospital Accident & Emergency (A & E) department over a two-week period and was prospectively analyzed; 468 patients were referred to health centres, 1, 397 (35 percent) were admitted, and 2,171 (54 percent) were seen and discharged; 83 percent of all cases were seen without prior referral. The average time before being seen by a doctor was 31 minutes and the maximum period spent by any patient (admission - discharge) was 5 hours and 42 minutes. Medical procedures (adult and paediatric), general and orthopaedic surgery accounted for 78.4 percent of all cases. The most commonly encountered diagnoses in these specialities were asthma, lacerations and upper limb fractures. Based on these findings, the efficiency of the A & E department may be improved by increasing screening at the primary care level, training A & E officers in high-volume specialities, supplementing casualty staff with a paediatrician during peak hours and providing 'ensuite' plaster room for minor orthopaedi trauma (AU)