IntroductionIn medical education, Web-based learning is increasingly used as a complement to practical classes. The objective of the study was to perform a comparative analysis of three different forms of e-learning course on emergency medicine in terms of an indicator of knowledge growth and students’ satisfaction.Material and methodsFor the purpose of the study, we developed and implemented a tool in the form of an online course: A – non-animated presentation, B – video, C – interactive video. The participants were undergraduate students of emergency medicine and nursing (n = 106). A pre-test and a post-test were carried out, and the resulting data were analyzed using parametric tests (t-test, ANOVA, post-hoc). Final questionnaires assessing six parameters of satisfaction were also evaluated.ResultsA significant increase in knowledge in the experimental group which used an interactive video was observed (p = 0.04). Moreover, the number of replays of learning material was the highest in group C (2.09 ±2.48). The level of post-course satisfaction turned out to be comparable in all three groups (p = 0.62).ConclusionsThe study allowed the interactive course to be identified as the most effective method of distance learning among selected ones. Due to the limitations of the study, we conclude that there is a need for further studies on the effectiveness of e-learning in emergency medicine.
Background. Patients with acute myocardial infarction (AMI) or acute trauma (AT) are transported by air to save time. Helicopter Emergency Medical Service (HEMS) provides both flights to and from the emergency scene, as well as interhospital transport (interHtransport).Objectives. The objective of this study was to compare aeromedical transport and HEMS missions of AMI and AT patients regarding safety, medical procedures and the length of flights.Material and methods. This is a case-control study analyzing the medical history records of AMI and AT patients transported between hospitals and from the scene identified using ICD-10 codes. Research of customary data (age, sex and general health status measured with Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS)) was performed.Results. There were 48,555 flights in the years 2011-2016, of which 7,645 (15.7%) were interhospital (19% AMI and 12% AT). Out of these, 40,910 (84.3%) HEMS missions were to patients on the scene (10% AMI and 13% AT). No fatalities were noted. The AMI GCS score was higher than in AT patients: 15.0 vs 14.0, respectively. The medical procedures during transport of AMI patients between hospitals and from the scene were the following: cardiopulmonary resuscitation (CPR): 6 vs 73 cases (p < 0.001); oxygen therapy: 41. 1% vs 50.2%, respectively. The median distance was 59.4 km vs 52. 1 km (p < 0.001), while median flight time was 45.0 min vs 38.0 min (p < 0.001), respectively. Regarding AT patients, the procedures performed (during interhospital and from the scene transport) were the following: CPR: 5 vs 244 cases (p < 0.001); intubation: 10.7% vs 17.3% (p < 0.001); sedation: 50. 1% vs 24.3% (p < 0.001); oxygen therapy: 17.6% vs 36.6% (p < 0.001); spinal board: 17. 1% vs 66% (p < 0.001); cervical collar: 15.9% vs 63.4% (p < 0.001), respectively. Interhospital transport and HEMS mission median flight distance was 135.9 km vs 56.3 km (p < 0.001), while median flight time was 66.0 min vs 45.0 min (p < 0.001), respectively.Conclusions. Aeromedical transport is safe and very rarely requires resuscitation during the flight. The long distances of flights and time required can reflect the scarcity of trauma centers (TCs) compared to cardiovascular wards. The location of hemodynamic centers in Poland is optimal.
StreszczenieWstęp: Ze względu na wykorzystanie różnego rodzaju maszyn przemysłowo-rolniczych wypadki w pracy należą do najpoważ-niejszych i niejednokrotnie powodują u poszkodowanego trwałe kalectwo pourazowe. W Polsce od 2010 r. działa serwis replantacyjny, co oznacza, że każdego dnia 1 z 6 ośrodków pełni dyżur replantacyjny, przyjmując z terenu całego kraju zgłoszenia dotyczące amputacji kończyn. Pacjenci zakwalifikowani do replantacji często wymagają transportu do szpitala docelowego z miejsc odległych nawet o kilkaset kilometrów. Materiał i metody: Analizie poddano 174 misje śmigłowcowej służby ratownictwa medycznego (Helicopter Emergency Medical Service -HEMS) oraz 112 transportów międzyszpitalnych. Dane otrzymano w wyniku retrospektywnej analizy dokumentacji lotniczej i medycznej 23 460 misji wykonanych przez statki powietrzne Samodzielny Publiczny Zakład Opieki Zdrowotnej Lotniczego Pogotowia Ratunkowego (SP ZOZ LPR) w latach 2011-2013. Wyniki: W analizowanych latach śmigłowce SP ZOZ LPR w ramach misji HEMS zaopatrzyły na miejscu zdarzenia i przetransportowały do szpitali 135 pacjentów z amputacjami w obrębie kończyny górnej. W tym samym okresie statki powietrzne SP ZOZ LPR wykonały 102 transporty międzyszpitalne. Dziewięćdziesięciu pacjentów zostało zakwalifikowanych do leczenia w ośrodkach serwisu replantacyjnego. Średni czas transportu lotniczego wyniósł 76 min, a całkowity czas transportu -172,3 min. Przy transporcie powyżej 300 km średni zysk czasowy w porównaniu z transportem lądowym wyniósł ok. 1,5 godz. Wnioski: W uzasadnionych przypadkach wykorzystanie śmigłowców i samolotów jest optymalnym sposobem transportu pacjentów z ciężkimi urazami koń-czyn górnych. Med. Pr. 2014;65(6):765-776 Słowa kluczowe: urazy kończyn górnych, amputacja urazowa, wypadki w pracy, replantacja, transport lotniczy, Lotnicze Pogotowie Ratunkowe Abstract Background: Due to the growing use of various types of industrial and agricultural machinery, occupational accidents are among the most serious ones and quite frequently result in the permanent posttraumatic disability of the injured person. In Poland, a replantation service has been operating since 2010. Each day, one out of six centres provides emergency replantation service accepting amputation calls from across the country. Patients qualified for replantation often need to be transported from places located even
in patients with ST-elevation myocardial infarction (STEMI). However, access to hospital performing PPCI is limited for some patients. In urban areas, PPCI is available to most; however, providing access to PPCI to patients living in rural areas constitutes a challenge for healthcare systems in many countries around the world.
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