The causes of emergency as well as the age and sex distribution are shown in Table 3. Trauma was the most frequent cause of an emergency in 102 patients (96.2%). Other reasons for presentation include Ludwig’s angina, acute erythema multiforme and a rapidly growing tumour later diagnosed as rhabdomyosarcoma.

Sixty-three patients (59.4%) were brought to the Accident and Emergency by commercial transport. Twenty-seven patients (25.5%) came in private vehicles, 7 (6.6%) were brought by an ambulance and two (1.9%) came on foot (or were carried by relations) (Figure 1).

Majority of the patients 88 (83%) were fully conscious at presentation, 14 (13.2%) were semi conscious and 4 (3.8%) were in a coma. The level of brain injury as assessed for all the 102 trauma patients using the Glasgow Coma Scale (GCS) showed 4 patients (3.9%) had severe brain injury (GCS 4-8), 12 patients (11.8%) had moderate brain injury (GCS 9-12) while 6 patients (5.9%) had a mild brain injury (GCS 13-

14). The duration of the patients’ condition could only be determined in 86 patients. Thirty-one of them (36.1%) presented within the first hour, 75 (87.2%) within 24 hours and 11 patients (12.9%) presented after 24 hours. In the trauma victims, the soft tissue of midface was involved in 63 patients (61.8%), the upper third of the face in 57 (55.9%) and the lower third in 30 patients (29.4%) (Figure 2).

The combined percentage is greater than 100 as more than a third of the face was often involved in the same patient. The mandible was the most commonly observed fractured bone in 20 patients (19.6%) while the zygoma and mid facial skeleton fracture accounted for 17 patients (16.7%) and 10 patients (9.8%) respectively.

Limb injuries (hard and soft tissue) were the most commonly observed associated injuries in the trauma victims seen in 43 patients (42.2%). Sixteen patients (15.7%) had brain injuries 8 (7.8%) had eye injuries, 3 (2.9%) had cervical injuries and 2 patients (1.9%) sustained injuries to the chest. Seventy six (71.2%) had a packed cell volume check (PCV) while in the emergency department, grouping and cross matching of blood was requested in 31 patients (29.2%) though only 8 patients (7.5%) actually received blood transfusion while in the Accident and Emergency department. The postero-anterior view of the skull was the most commonly requested radiographic view in 71 patients or 67%. This was followed by the occipitomental view, which was ordered in 38 patients or 35.8%. The other views are the oblique lateral views of the mandible in 34 patients (32.1%), true lateral view of the skull in 17 patients (16%), submentovertex skull view and Townes view in 4 patients (3.8%). Fifteen patients (14.2%) required limb radiographs while 10 patients (9.4%) had chest radiographs. Computed tomographic scan was done in only 5 patients out of those suspected with head injuries (4.7%).