Introduction: This study aims to evaluate the knowledge and confidence of emergency healthcare workers (EHCW) in facing the COVID-19 pandemic. Materials and Methods: A cross-sectional online study using a validated questionnaire was distributed to doctors (MD), assistant medical officers (AMO), and staff nurses (SN) at an urban tertiary Emergency Department. It comprised of 40 knowledge and 10 confidence-level questions related to resuscitation and airway management steps. Results: A total of 135 from 167 eligible EHCW were enrolled. 68.9% (n = 93) had high knowledge while 53.3% (n = 72) possessed high confidence level. Overall knowledge mean score was 32.96/40 (SD = 3.63) between MD (33.88±3.09), AMO (32.28±4.03), and SN (32.00±3.60), P = 0.025. EHCWs with a length of service (LOS) between 4–10 years had the highest knowledge compared to those with LOS <4-year (33.71±3.39 versus 31.21±3.19 P = 0.002). Airway-related knowledge was significantly different between the designations and LOS (P = 0.002 and P = 0.003, respectively). Overall, EHCW confidence level against LOS showed significant difference [F (2, 132) = 5.46, P = 0.005] with longer LOS showing better confidence. MD showed the highest confidence compared to AMO and SN (3.67±0.69, 3.53±0.68, 3.26±0.64) P = 0.049. The majority EHCW were confident in performing highquality chest-compression, and handling of Personal Protective Equipment but less than half were confident in resuscitating, leading the resuscitation, managing the airway or being successful in first intubation attempt. Conclusions: EHCW possessed good knowledge in airway and resuscitation of COVID-19 patients, but differed between designations and LOS. A longer LOS was associated with better confidence, but there were some aspects in airway management and resuscitation that needed improvement. Keywords: Airway; Confidence; COVID-19; Knowledge; Resuscitation (CPR).
Local anesthesia systemic toxicity (LAST) and anaphylaxis are the life-threatening adverse effects of lignocaine. Both have different presentations and treatments. We report a case of 35-year-old female who came to our Emergency Department (ED) with symptoms of lethargy, drowsiness, and difficulty breathing with foreign body sensation and a metallic taste in the throat which started 15 minutes after a right shoulder injection with 250 mg of lignocaine mixed with Triamcinolone in the Orthopedic Clinic. She was pushed to the resuscitation bay and was treated as anaphylaxis. Upon further evaluation, the blood pressure was never hypotensive, no sign of compromised airway, no gastrointestinal symptom, and no mucosal involvement which directs to the diagnosis of LAST rather than anaphylaxis. Surprisingly, she was gradually improving and was discharged home after six hours of observation in the ED. This is the first case report that LAST had been effectively treated as anaphylaxis.
Kepatahan tulang femur proksimal bagi pesakit kanak-kanak jarang berlaku dan boleh terlepas pandang, terutamanya apabila sejarah trauma tidak begitu serius dan melibatkan kepatahan tulang patologi. Kami melaporkan sebuah kes tentang seorang kanak-kanak perempuan yang berumur 6 tahun, dibawa ke Jabatan Kecemasan mengadu kesakitan pada lutut kiri selepas jatuh dari ketinggian dua kaki. Pesakit pada mulanya telah dirawat sebagai kecederaan tisu lembut pada lutut kiri setelah mendapati X-ray lutut kiri yang normal. Dia telah diperiksa semula pada hari ketiga di mana keadaannya telah bertambah teruk. X-ray pada bahagian pelvis dan lutut kiri menunjukkan terdapat kepatahan tulang "intertrochanteric" pada femur kiri dengan sista tulang. Kami melaporkan kes ini bagi mengelakkan pengabaian kepatahan tulang femur proksimal di mana trauma kecil menyebabkan sakit lutut yang tidak spesis Kepatahan tulang femur pada kanak-kanak boleh mengakibatkan komplikasi kepada pertumbuhan seperti osteoporosis.
To improve public awareness and the rate of bystander cardiopulmonary resuscitation )CPR(, a novel and exciting approach called fit-CPR that incorporates mass CPR with high-intensity physical activity into the beat of locally favoured music was proposed. This study was conducted to measure the effectiveness of fit-CPR compared to the standard classroom method )CCM(. Methods: Between 30th August to 29th November 2018, 129 participants from
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