Training and Delivery of Critical Care Medicine in India: Concerns Revealed by COVID-19 Pandemic

Ozair, Ahmad; Aujayeb, Avinash; Siddiqui, Suhail Sarwar

doi:10.5005/jp-journals-10071-23404

Cited by 7 publications

(4 citation statements)

References 4 publications

(6 reference statements)

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“…Many advisories and education modules have been designed by medical professionals worldwide to help the healthcare workers in the treatment of COVID-19 patients. [ 11 12 13 14 15 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of virtual training for medical officers and community health officers in the critical care management of COVID-19 patients in the intensive care unit

et al. 2021

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Background and Aims: The coronavirus disease -19 has changed various aspects of education and training in all fields, and e-learning has now become the preferred mode of training and teaching. The aim of this study was to assess the impact of online training and to overcome the limitations of e-learning. Methods: A total of 176 medical officers (MOs) and 720 community health officers (CHOs) were trained in four batches by using seven training modules with online videos and lecture series. Each batch received two days of training. A pre-test and post-test were conducted which consisted of 25 multiple-choice questions of 4 marks each. There was no negative marking. Candidates obtaining >80 marks were declared as having passed. The results of the pre-test and post-tests were compared. Results: There was remarkable improvement in the knowledge regarding critical care management after virtual training, as evidenced by the test results. None of the MOs scored more than 80% in the pre-test; however, 153 MOs scored more than 80% in the post-test. The average score improved from 47.82 (pre-test) to 89.05 (post-test). The difference was statically significant ( P < 0.0001). Similarly, 123 CHOs scored more than 80% in the pre-test, while 378 CHOs scored more than 80% in the post-test. Improvement in average marks was also seen: 90.5 in the post-test as compared to 62.76 in the pre-test. The difference was statically significant ( P < 0.0001). Conclusion: Online training is beneficial for many candidates from various locations within a short period. The interactive sessions after training are also helpful, and well-designed pre- and post-tests are adequate for assessment.

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“…Many advisories and education modules have been designed by medical professionals worldwide to help the healthcare workers in the treatment of COVID-19 patients. [ 11 12 13 14 15 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of virtual training for medical officers and community health officers in the critical care management of COVID-19 patients in the intensive care unit

et al. 2021

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“…Median time from the first interaction with the course website to a passing grade on the exam was 15 d (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23), with no difference between professions: 15 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) for nurses, 14 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) for physicians, and 15 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) for physiotherapists. We did not find any associations between the course duration and the moment when the students started (Figure 2b).…”

Section: Course Metricsmentioning

confidence: 99%

“…Even though these recommendations were published on time, there were still some logistic problems to cope with, many of which had been raised by others [14][15][16] : Which non-ICU health-care team members would be suitable to be included in these new teams? Who would oversee the new participants' training?…”

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confidence: 99%

Nonintensivist Training to Increase the Staff Capacity of Intensive Care Units During COVID-19 Pandemic Surge in Argentina

Monteverde

Bosque

Klappenbach

et al. 2021

Disaster med. public health prep.

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Objective: To report the results of a nationwide critical-care course for non-intensivists to increase staff capacity of intensive care units (ICU) during the COVID-19 pandemic in Argentina. Methods: Three academic organizations, with special funding from 55 private companies, developed a short virtual course comprised of web-based videos, virtual tutorials, and a forum chat. Each state assigned scholarships to non-ICU staff from public hospitals. Students received active follow-up for the completion of the course and took a survey upon course completion. Results: After four months, there were 10,123 students registered from 661 hospitals in 328 cities. Of these, 67.8% passed the course, 29.1% were still ongoing and 3.1% were inactive. Most students were female (74.2%) with a median of 37 years old (IQR 31-44). The group was composed of 56.5% nurses, 36.2% physicians, and 7.4% physiotherapists, of whom 48.3% did not have any experience in critical care. Mean overall satisfaction was 4.4/5 (SD 0.9), and 90.7% considered they were able to apply the contents to their practice. Conclusions: This course was effective for rapid training of non-ICU personnel. The assignment strategy, the educational techniques, and the close follow-up led to low dropout and high success rates and satisfaction.

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“…11 – 13 Therefore, the choice between early mechanical ventilation and HFNO/NPPV has to balance the contradictory priorities of protecting HCWs by minimizing aerosol-generation vs optimizing resource management. This may be particularly difficult in India, which has low numbers of ventilator beds and intensivists per capita , 14 , 15 and has already seen high numbers of HCWs infections even before the surge. 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

Non-invasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units: A Survey

Subramaniam

Haji²,

Kumar³

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract Background About 5% of hospitalized coronavirus disease 2019 (COVID-19) patients will need intensive care unit (ICU) admission for hypoxemic respiratory failure requiring oxygen support. The choice between early mechanical ventilation and noninvasive oxygen therapies, such as, high-flow nasal oxygen (HFNO) and/or noninvasive positive-pressure ventilation (NPPV) has to balance the contradictory priorities of protecting healthcare workers by minimizing aerosol-generation and optimizing resource management. This survey over two timeframes aimed to explore the controversial issue of location and noninvasive oxygen therapy in non-intubated ICU patients using a clinical vignette. Materials and methods An online survey was designed, piloted, and distributed electronically to Indian intensivists/anesthetists, from private hospitals, government hospitals, and medical college hospitals (the latter two referred to as first-responder hospitals), who are directly responsible for admitting/managing patients in ICU. Results Of the 204 responses (125/481 in phase 1 and 79/320 in phase 2), 183 responses were included. Respondents from first-responder hospitals were more willing to manage non-intubated hypoxemic patients in neutral pressure rooms, while respondents from private hospitals preferred negative-pressure rooms ( p < 0.001). In both the phases, private hospital doctors were less comfortable to use any form of noninvasive oxygen therapies in neutral-pressure rooms compared to first-responder hospitals (low-flow oxygen therapy: 72 vs 50%, p < 0.01; HFNO: 47 vs 24%, p < 0.01 and NPPV: 38 vs 28%, p = 0.20). Interpretation Variations existed in practices among first-responder and private intensivists/anesthetists. The resource optimal private hospital intensivists/anesthetists were less comfortable using noninvasive oxygen therapies in managing COVID-19 patients. This may reflect differential resource availability necessitating resolution at national, state, and local levels. How to cite this article Subramaniam A, Haji JY, Kumar P, Ramanathan K, Rajamani A. Noninvasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units: A Survey. Indian J Crit Care Med 2020;24(10):926–931.

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Training and Delivery of Critical Care Medicine in India: Concerns Revealed by COVID-19 Pandemic

Cited by 7 publications

References 4 publications

Effectiveness of virtual training for medical officers and community health officers in the critical care management of COVID-19 patients in the intensive care unit

Effectiveness of virtual training for medical officers and community health officers in the critical care management of COVID-19 patients in the intensive care unit

Nonintensivist Training to Increase the Staff Capacity of Intensive Care Units During COVID-19 Pandemic Surge in Argentina

Non-invasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units: A Survey

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