Table 2.

Domains, Sub-domains and Items Emerging From the Included Studies

Domains	Sub-domains and items
Inputs Medical supplies and equipment	For Resuscitation ( Airway, Breathing and Circulation ): e.g., side lamp with stand, dressing trays, dressing table, urinary catheter, forceps, Magill forceps, scissors, suture materials, needle holder, suction apparatus, blades, IV stand, nasogastric tubes, cannulas and urinary catheters, needle syringe, Cervical collars, oxygen mask, oxygen cylinder with Standard fitting, Bag–valve–mask, Nebulizer, trolley, tracheostomy sets, intravenous fluid Administration Sets, Nasal prongs, chest tube, oral or nasal airway, gauze and bandage, Arterial tourniquet For specific injuries: e.g. Pocket torch, Glasgow Coma Scale sheet, Reflex hammer, Sling, Splint, Cervical collars, Backboard, Sandbag Supplies safety for health care personnel: e.g., gloves, goggles and etc
Support facilities	Diagnostic equipment : e.g. X-ray, Equipped ambulance cars, Stethoscope, Sphygmomanometer, Electrocardiograph, Minor Surgical Set, Cardiac Monitor, Defibrillator, Blood pressure cuff, Glucometer, Ultrasoundor, Otoscope, Ophthalmoscope, Laryngoscope, oesophageal detector device, Thermometer, Foetal stethoscope, Paediatric length-based (Broselow) tape, Sterilization equipment: e.g. Autoclave, hot-air oven, dry heat or four
Infrastructures	Physical space: presence of devoted place for emergency services and/or minor surgeries, location in the center (e.g., ground floor, near the entrance, separate entry, presence of sloped entry for the trolley, etc.), Separate drug cabinets for emergency services, Devoted registry for emergency case.
Emergency medicines	Anaesthesia (lidocaine, oxygen, diazepam, atropine), Pain, fever, inflammation (morphine, codeine, acetylsalicyclic acid, ibuprofen & paracetamol), Anaphylaxis (dexamethasone, hydrocortisone & epinephrine), Poisoning (naloxone), Anticonvulsants (phenobarbital, phenytoin & magnesium sulphate), Infections (amoxycillin/ampicillin, amoxycillin & clavulanic acid, benzylpenicillin, chloramphenicol, ciprofloxacin, cloxacillin, gentamicin, metronidazole, sulfamethoxazole & trimethoprim), Diuretics (furosemide & mannitol), Fluid and electrolyte balance (glucose solution (5%, 50%), normal saline solution (0.9% isotonic), glucose with sodium chloride (4% glucose, 0.18% NaCl), Ringer’s lactate solution, potassium chloride solution) Calcium chloride injection, antihistaminic injection, activated charcoal powder, metoclopramide, furosemide, hyoscine, Bronchodilators, Anti-scorpion& snake(Antivenin), Antihypertensive Drugs (oral), Prednisolone, Met ergotamine
Human resources	List of emergency room staff (physicians and nurses) who have been trained in first aid and cardiopulmonary resuscitation (CPR) The number of personnel and ratio
Protocol & Guideline	Clinical: e.g., Treatment protocol in early management of acute coronary syndrome and treatment of multi-trauma patients, Written clinical practice guidelines for providing primary emergency care , Guidelines for pediatric emergency triage, assessment and treatment (ETAT), protocols for the refered patients Non-clinical: e.g., Protocols for appropriate sterilization techniques
Proscess Assessment of the resuscitation and specific injuries processes	Staff Knowledge and skills (medical, nursing and others) in resuscitation: eg, 1)Assessment of airway compromise 2)manual manoeuvres (chin lift, jaw thrust, recovery position, etc.) 3)Insertion of oral or nasal airway 4)Assisted ventilation using bag–valve–mask 5)Endotracheal intubation 6)Use of suction 7)Cricothyroidotomy (with or without tracheostomy) 8) Administration of oxygen 9)Needle thoracostomy 10)Three-way dressing 11)Assessment of shock 12)Compression for control of haemorrhage 13)Arterial tourniquet in extreme situations 14)Splinting of fractures for haemorrhage control 15)Pelvic wrap for haemorrhage control 16)Reading ECG 17)Nebulisation & oxygen therapy 18)Simple suturing 19)NGT insertion 20)Administering IV fluid &medications 21)Inserting IV cannula 22)Cardiac compression 23)Defibrillation Staff Knowledge and skills (medical, nursing and others) in specific injuries: eg, 1)Recognize altered consciousness; lateralizing signs, pupils 2)External pressure for bleeding 3)Packing, balloon tamponade for bleeding 4)Adequate pain control for chest injuries/rib fractures 5)Clinical assessment of abdominal injuries (Visual examination, Percussion, Palpation &Auscultation) 6)Immobilization: using two sandbags for spinal injuries 7)Log-roll/log-lift 8)Assessment – recognition of presence or risk of spinal injury 9)Immobilization: C-collar, back board 10)Recognition of neurovascular compromise; disability-prone injuries 11)Basic immobilization (sling, splint) 12)Assessment of depth and extent burns and wounds 13)Sterile dressings 14) Use Autoclave and four
Maintenance of equipment	System for maintenance and repair of building, infrastructure & equipment Calibrating equipment: appraising the accessabiliy of needed resources to calibr equipment and appraise basic knowledge of the staff on calibration procedure of equipemtn.
Medicine storage capability	Storage of medicines in better conditions: Medicines should be stored in dry palces away from damp, sun light, , pests, and rodents Sufficient stock monitoring: e.g., the numbers of expired medicines, storing medicines based on their expiry date, accessibility of an up-to-date list of available medicines
Infection control	Availability of infection control items: e.g., soap, running water, sharp box, latex gloves and disinfectants in assessed areas Proper disposal system for infectious waste: gathering and disposal of infectious waste e.g., burning and dumping, service location or waste disposal area without infectious waste
Educating and training	Training courses for basic emergency management: e.g., BLS, Advanced Cardiac Life Support (ACLS), Advanced Truma Life Support (ATLS) and Pediatric Advanced Life Support courses, Newborn Resuscitation Program Continuing Medical Education: two criteria are used appraise continuous training: 1. At least 50% of service providers should have taken in-service training courses over last 12 months.2. Over last 6 months, at least 50% of service providers have reported their personal observations on this case
Quality control	Management capability: e.g., management committee meetings at least every 6 months and recent documents of these meetings should be appraised Quality assurance: e.g., report of quality assurance activities and at least one related documentation Referral systems: observation of referral notes or patient records, Number of emergency cases referred to the district hospital
Outcome Patients’ satisfaction	Using these components e.g. accessibility of care, availability, inter-personal relationship, informing patients, continuity of care, effectiveness of emergency care and timely care