Emergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.

BackgroundWhile emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blended learning (BL) refers to the systematic integration of online and face-to-face learning aimed to facilitate complex thinking skills and flexible participation at a reduced financial, time and manpower cost. This study was conducted to evaluate its effectiveness in emergency airway management training.MethodsA single-center prospective randomised controlled trial involving 30 doctors from Sarawak General Hospital, Malaysia was conducted from September 2016 to February 2017 to compare the effectiveness of BL versus F2FL for emergency airway management training. Participants in the BL arm were given a period of 12 days to go through the online materials in a learning management system while those in the F2FL arm attended a-day of face-to-face lectures (8 h). Participants from both arms then attended a day of hands-on session consisting of simulation skills training with airway manikins. Pre- and post-tests in knowledge and practical skills were administered. E-learning experience and the perception towards BL among participants in the BL arm were also assessed.ResultsSignificant improvements in post-test scores as compared to pre-test scores were noted for participants in both BL and F2FL arms for knowledge, practical, and total scores. The degree of increment between the BL group and the F2FL arms for all categories were not significantly different (total scores: 35 marks, inter-quartile range (IQR) 15.0 – 41.0 vs. 31 marks, IQR 24.0 – 41.0, p = 0.690; theory scores: 18 marks, IQR 9 – 24 vs. 19 marks, IQR 15 – 20, p = 0.992; practical scores: 11 marks, IQR 5 -18 vs. 10 marks, IQR 9 – 20, p = 0.461 respectively). The overall perception towards BL was positive.ConclusionsBlended learning is as effective as face-to-face learning for emergency airway management training of junior doctors, suggesting that blended learning may be a feasible alternative to face-to-face learning for such skill training in emergency departments.Trial registrationMalaysian National Medical Research NMRR-16-696-30190. Registered 28 April 2016.Electronic supplementary materialThe online version of this article (10.1186/s12873-018-0152-y) contains supplementary material, which is available to authorized users.

BackgroundConcerns over high transmission risk of SARS-CoV-2 have led to innovation and usage of an aerosol box to protect healthcare workers during airway intubation in patients with COVID-19. Its efficacy as a barrier protection in addition to the use of a standard personal protective equipment (PPE) is not fully known. We performed a simulated study to investigate the relationship between aerosol box usage during intubation and contaminations on healthcare workers pre-doffing and post-doffing of PPE.MethodsThis was a randomised cross-over study conducted between 9 April to 5 May 2020 in the ED of University Malaya Medical Centre. Postgraduate Emergency Medicine trainees performed video laryngoscope-assisted intubation on an airway manikin with and without an aerosol box in a random order. Contamination was simulated by nebulised Glo Germ. Primary outcome was number of contaminated front and back body regions pre-doffing and post-doffing of PPE of the intubator and assistant. Secondary outcomes were intubation time, Cormack-Lehane score, number of intubation attempts and participants’ feedback.ResultsThirty-six trainees completed the study interventions. The number of contaminated front and back body regions pre-doffing of PPE was significantly higher without the aerosol box (all p values<0.001). However, there was no significant difference in the number of contaminations post-doffing of PPE between using and not using the aerosol box, with a median contamination of zero. Intubation time was longer with the aerosol box (42.5 s vs 35.5 s, p<0.001). Cormack-Lehane scores were similar with and without the aerosol box. First-pass intubation success rate was 94.4% and 100% with and without the aerosol box, respectively. More participants reported reduced mobility and visibility when intubating with the aerosol box.ConclusionsAn aerosol box may significantly reduce exposure to contaminations but with increased intubation time and reduced operator’s mobility and visibility. Furthermore, the difference in degree of contamination between using and not using an aerosol box could be offset by proper doffing of PPE.

Introduction: Burnout is a syndrome occurring from an overwhelming workplace stress. The study was done at a large teaching hospital identified as a COVID-19 treating hospital. During COVID-19 pandemic, the country was in Movement Control Order since 18 March 2020 to contain the spread of the virus, and thus, it has increased the job workload and responsibility. The purpose of this study was to identify the prevalence of burnout among emergency healthcare worker in this hospital and to identify the factors contributed to the burnout. Methods: A cross-sectional study was conducted using a questionnaire among emergency healthcare worker from 8 May 2020 to 15 May 2020 during the Conditional Movement Control Order. The questionnaire was adapted from Michelle Post, Public Welfare, Vol. 39, No. 1, 1981, American Public Welfare Association and distributed via Google Forms. It consisted of 28 questions and was rated based on a five-point Likert-type scale. The questions were then summed up to determine the burnout levels. Results: There were 216 respondents with 65.7% were nurses, 17.1% were doctors, and the rest were assistant medical officer. 51.3% of the respondents had burnout with 61.2% of nurses, 35.1% of doctors, and 29.6% of assistant medical officer. There was weak correlation ( r = 0.148) with the years of experience working in emergency department and the level of burnout ( p = 0.03). Among the burnout features were fatigue with 52.2% and frequent physical illness and feel unappreciated with 48.6% and 45.9%, respectively. The job-related issues which predisposed to burnout were demand coping with an angry public with 70.2%, job overload 63.9%, lack clear guideline or rapid program changes 54%, and pay too little 53.1%. Conclusion: Emergency healthcare worker has a high rate of burnout especially among the nurses. The factors leading to burnout were frequent exposure to angry public, job overload, lack of clear guidelines, and perception of underpaid.