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).
Introduction: Teaching disaster response medicine (DRM) to medical students requires considerable resources. We evaluate the effectiveness of e-learning in teaching emergency disaster response (ELITE-DR), a novel initiative, in educating medical students of the cognitive aspect of DRM.Methods: A prospective cross-sectional study among pre-clinical year medical students was carried out to determine their knowledge on DRM and perception regarding the ELITE-DR initiative using a validated online questionnaire. A three-part self-learning video covering the principles and medical management of DRM were distributed before answering the questionnaire served as the training.Results: A total of 168 students participated in the study. Their overall knowledge showed a significant increase in between pre-and-post-interventions. Recall and simple decision-making knowledge aspects were better than complex decision-making knowledge. It appeared that participants assimilate knowledge better from visual rather than audio stimuli. Participants with high perception-scores demonstrated better knowledge-scores. However, e-learning was not preferred as a substitute for face-to-face (F2F) teaching.Conclusion: ELITE-DR shows promise in teaching DRM. Simple recall and comprehension levels of knowledge were well-served through this technique. However, for more complex decision-making knowledge, a different approach might be required. ELITE-DR offers flexibility, accessibility, and personalized learning. The content presentation is improved by using several different visual stimuli. This approach is useful for cognitive aspect learning, but it should not replace standard F2F teaching.
Such a facility could expedite safe and appropriate management of envenomed patients.
The emergence of COVID-19 pandemic has caused difficulty to emergency-HCW (EHCW) in resuscitating high-risk patients. We set out to explore EHCW’s perception after undergoing COVID-ACLS resuscitation training and address their anxiety of working in this pandemic. A qualitative case study using focused group discussion was conducted among EHCW who have undergone COVID-ACLS training. Five semi-structured questions exploring respondent’s confidence level, anxiety factors, areas of improvement for COVID-ACLS and if this COVID-ACLS training is sufficient. Inductive and deductive thematic analysis approach was done to analyse the result. 20 EHCW participated in this study. Out of 4 themes, 11 subthemes were identified based on the respondents. They were acquired new knowledge, self-precaution, method of delivery, concerns of self and family members, stigmatisation, insufficient protective methods, underappreciation, regular training sessions, other modalities for learning, course duration; and unsatisfactory reading material. New knowledge and self-precaution were noted to be an important aspect that boosts confidence among EHCW. The main factor that increased anxiety was safety issues and disease spreading to family members, colleagues, and society. In conclusion, COVID-ACLS training is able to boost EHCW confidence in resuscitating high-risk patients. Factors leading to anxiety among EHCW should also be addressed during this pandemic to ensure psychological welfare and mental health are not affected. Regular training and utilisation of other teaching modalities such as video are perceived as a helpful adjunct in boosting their confidence. The utilisation of new training approach should be explored in enhancing EHCW’s knowledge and confidence.
ABSTRAK ABSTRACTFractures may occur after an episode of seizures. Although rare, with a high index of suspicion and proper physical examination, delay of diagnosis and treatment can be avoided. We report a case of near missed bilateral proximal humerus fracture after an episode of generalized tonic-clonic seizure. A 58-year-old lady with a background history of epilepsy complained of generalized body ache after a generalized tonic-clonic seizure which happened few hours before presentation 309
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