Abstract P163: Accuracy to Diagnose Cardiac Arrest and Quickness to Start Chest Compression in Different BLS Algorithms; a Comparative Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tomoko Tamura ◽  
Koichi Tanigawa ◽  
Shinji Kusunoki ◽  
Takuma Sadamori ◽  
Tadatsugu Otani ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Health Care Providers ◽  
Chest Compression ◽  
Loss Of Consciousness ◽  
Care Providers ◽  
Clinical Experiences ◽  
European Resuscitation Council ◽  
The Subject ◽  
Erc Guidelines

Background; BLS algorithms for health care providers or experience personnel recommended by AHA, European Resuscitation Council (ERC), and Japanese Resuscitation Council (JPN) differ with respect to the sequence of assessment and procedures. The differences may affect accuracy to diagnose cardiac arrest and quickness to start chest compression. We compared BLS algorithms recommended by these organizations with respect to accuracy of respiratory/circulatory assessment, and quickness to start chest compression using a computed manikin model. Methods; Thirty three subjects (16 physicians and 17 medical students) were enrolled. The Sim-Man (Laerdal) was used to develop 2 scenarios (no pulse/no breathing, with pulse 60/min and breathing 10/min). The three algorithms and 2 scenarios were randomly assigned to the subject, and the accuracy to diagnose cardiac arrest and the time from confirmation of loss of consciousness to starting chest compression were evaluated. Results; The rates of incorrect assessment of respiratory/circulatory status were AHA;9.8% (13 out of 132), ERC;9.1%(12 out of 132) and JPN;6.8%(9 out of 132)(n.s. among algorithms). When the results were analyzed with respect to clinical experiences of the subjects, i.e. physicians vs. medical students, significant differences were found between the groups: AHA;17.2% (11 out of 64), ERC;15.6% (10 out of 64), JPN;12.5% (8 out of 64) in students, whereas AHA;2.9% (2 out of 68), ERC;2.9% (2 out of 68), JPN;1.5% (1 out of 68) in physicians* (* p<0.05 vs. students). The time to starting chest compression were AHA;27.8±5.1 sec, ERC;18.6±3.2** sec, JPN;23.7±4.2 sec (**p<0.05 vs. AHA and JPN), and no significant differences were found between physicians and students. Conclusions; No differences were found in accuracy of respiratory and circulatory assessment among the algorithms, although it may be influenced by clinical experiences of evaluators. The BLS algorithm starting CPR from chest compression such as ERC guidelines may reduce the time of no-flow status in cardiac arrest.

scholarly journals Premedical Student Exposure to Pharmaceutical Marketing: Too Much, Too Soon?

2019 ◽  
Vol 51 (9) ◽  
pp. 722-727
Author(s):  
Toby Keys ◽  
Mark H. Ryan ◽  
Sharon Dobie ◽  
David Satin ◽  
David V. Evans
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Health Care Providers ◽  
Direct Marketing ◽  
Medical Schools ◽  
Pharmaceutical Marketing ◽  
Care Providers ◽  
Clinical Experiences ◽  
Premedical Students ◽  
Pharmaceutical Representatives

Background and Objectives: Direct pharmaceutical marketing to physicians by pharmaceutical representatives is effective in changing behavior of health care providers, resulting in less evidence-based prescribing. Although much has been written about pharmaceutical marketing exposures among medical students, less is known about direct marketing exposures before students matriculate. This study examined the types of pharmaceutical representative direct marketing exposures for premedical students and where they occurred. Methods: From June to August of 2017, researchers surveyed students who accepted admission to US public medical schools. These prematriculated students completed our survey just prior to matriculation. The survey inquired about whether the students were exposed to pharmaceutical marketing directly from pharmaceutical salespeople, the types of marketing they observed or received, and where these interactions occurred. Results: Survey participants included 911 prematriculated students from 14 of the 188 medical schools invited to participate. Seventy-one percent (646) of the participants received or observed someone receiving pharmaceutical marketing gifts, small meals or snacks, articles, or samples. The two most common contexts for direct pharmaceutical marketing exposures were during shadowing experiences (54%, 346) and during employment (50%, 323). Conclusions: The findings suggest that it may be common for medical students to have interacted directly with pharmaceutical salespeople or observed other health professionals in these interactions before they matriculate in medical school. Because many of these interactions occur during clinical experiences required by institutions for admission, medical schools and premedical associations should consider delivering conflict-of-interest education early in medical school education or before students matriculate.

scholarly journals Usefulness of a stool to stabilize dental chairs for external chest compression

2019 ◽  
Author(s):  
Norimasa Awata ◽  
Takashi Hitosugi ◽  
Yoichiro Miki ◽  
Yoshifumi Kawakubo ◽  
Takeshi Yokoyama
Keyword(s):  
Cardiac Arrest ◽  
Health Care Providers ◽  
Chest Compression ◽  
Sudden Cardiac Arrest ◽  
Vertical Displacement ◽  
Care Providers ◽  
Dental Surgery ◽  
Dental Chair ◽  
External Chest Compression ◽  
Vertical Displacements

Abstract Objectives: Cardiopulmonary resuscitation (CPR) requires immediate start of external chest compression (ECC) and cardioversion as soon as possible. During dental surgery, CPR should be started in the dental chair considering difficulty to move the patient from the dental chair to the floor. However, all types of dental chairs are not stable for ECC. We previously developed a procedure to stabilize a dental chair by using a stool. ERC guideline 2015 adopted our procedure when cardiac arrest during dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of dental chairs. Materials and methods: Three health care providers participated in this study, and 8 dental chairs were examined. ECC were performed on a manikin that was laid on the backrest of a dental chair. A stool was placed under the backrest to stabilize the dental chair. The vertical displacement of the backrest by ECC were compared between with and without a stool, and recorded by a camcorder. Results: In all 8 dental chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by ECC. The reduction ratios were between nearly 39~85%, although it was different by chairs. Conclusions: Our procedure to stabilize dental chairs by using a stool significantly reduced the displacement of a backrest against ECC in all chairs. Clinical relevance: Effective ECC could be performed in dental chairs by using a stool when sudden cardiac arrest occurs during dental surgery.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

2021 ◽  
pp. 1-6
Author(s):  
Chuenruthai Angkoontassaneeyarat ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Pemika Rukthai ◽  
Marisa Seanpan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Care Providers ◽  
Chest Compressions ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). Methods: This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. Results: There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. Conclusion: Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

scholarly journals Assessment of knowledge and attitude about emergency contraception: a cross sectional study among medical students in North India

2017 ◽  
Vol 6 (9) ◽  
pp. 4042
Author(s):  
Rajiv Kumar Gupta ◽  
Parveen Singh ◽  
Rashmi Kumari ◽  
Bhavna Langer ◽  
Pawan Sharma ◽  
...  
Keyword(s):  
Medical Students ◽  
Sexual Intercourse ◽  
Health Care Providers ◽  
Emergency Contraception ◽  
Early Years ◽  
North India ◽  
Care Providers ◽  
Cross Sectional ◽  
Unprotected Sexual Intercourse ◽  
Knowledge And Attitude

Background: Emergency contraception (EC) which is the only method indicated after the unprotected sexual intercourse prevents unintended pregnancies and its harmful consequences like unsafe abortion or unintended child delivery. Since medical students are the future medical professional and would be the main channel to provide preventive, promotive and curative services to the population at large, their knowledge and attitude towards EC is an important context in the overall health scenario of India. The study aimed to assess the knowledge and attitudes of medical students towards use of EC.Methods: This cross sectional questionnaire based study was conducted among 2nd professional MBBS students in a Government Medical College in North India. The self administered questionnaire intended to seek information on knowledge and attitude of the students. The data so collected was expressed in percentages and Chi square test was used as test of significance.Results: All the respondents had heard of EC with mass media as the main source of information. More than 90% of the respondents knew about the indications for use of EC as well as the timing of the use of EC. Female respondents had better knowledge about composition of EC as well mechanism of action (p<0.05). More than 90% would recommend EC in case of unprotected sexual intercourse and 83.5% had positive attitude towards EC.Conclusions: Although knowledge about EC was good on certain parameters, yet lack of in depth knowledge among future health care providers is a cause of concern. So, attention be given to special issues relating to EC from early years of medical education till internship. 

The Contribution of Death-Related Experiences to Health Care Providers' Attitudes toward Dying Patients: II. Medical and Nursing Students with No Professional Experience

1993 ◽  
Vol 26 (3) ◽  
pp. 181-205 ◽  
Author(s):  
Sandor B. Brent ◽  
Mark W. Speece ◽  
Marie F. Gates ◽  
Manju Kaul
Keyword(s):  
Medical Students ◽  
Nursing Students ◽  
Health Care Providers ◽  
Professional Education ◽  
Death And Dying ◽  
Professional Experience ◽  
Care Providers ◽  
Professional Career ◽  
Dying Patients ◽  
Attitude Measures

Beginning medical and nursing students with no professional death-related experience were compared in order to discover the attitudes they bring to their respective careers prior to their professional education and socialization. Hypotheses were derived from psychological models for the effects of professional choice, gender, and non-professional experience on these attitudes. On five of the six attitude measures female nursing students expressed a more positive attitude than cither male or female medical students, as predicted. However, contrary to expectation, the attitudes of the female medical students were not more positive than those of the male medical students on any of these measures. Hours of death-and-dying coursework and general life experience exerted a significant influence on attitudes toward talking to dying patients about death and dying but not on any of the other attitude measures. These data also suggest the existence of an underlying attitude structure, representing these students' Overall Attitude toward caring for dying patients, which remains stable across group differences in professional career choice, gender, and death-related experience. The original theoretical models were enriched and revised in the light of these findings.

scholarly journals Cardiopulmonary resuscitation during the COVID-19 pandemic: a scientific statement on CPR management protocol of Kasr Al-Ainy University Hospital is presented

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Hesham S. Taha ◽  
Mirna M. Shaker ◽  
Mohamed M. Abdelghany
Keyword(s):  
Health Care ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
University Hospital ◽  
Rapid Sequence Intubation ◽  
Main Body ◽  
Care Providers ◽  
Management Protocol ◽  
Scientific Statement

Abstract Background The COVID-19 pandemic poses a major burden to the healthcare system in Egypt, and in the face of a highly infective disease which can prove fatal, healthcare systems need to change their management protocols to meet these new challenges. Main body This scientific statement, developed by the cardiology department at Cairo University, emphasized 6 different aspects that are intended to guide healthcare providers during cardiopulmonary resuscitation (CPR) in the era of the COVID-19 pandemic. It highlighted the importance of dealing with all cardiac arrest victims, during the pandemic, as potential COVID-19 cases, and the use of appropriate personal protective equipment (PPE) by health care providers during the procedure. It also stated that the CPR procedure should be done in a separate room with the door closed and that the number of providers present during the procedure should be limited to only those who are essential for patient resuscitation. It also stressed that family members and accompanying personnel of patients with possible COVID-19 should not be in the vicinity of CPR site. The statement also pointed out that CPR procedure should be done in the standard manner with precautions to minimize spread of infection to the staff and accompanying people. Early intubation was prioritized, and the use of rapid sequence intubation with appropriate PPE was recommended. For delivery of CPR for the prone ventilated patient, delivery of chest compressions by pressing the patient’s back, while a team prepares to turn the patient supine, was recommended. During intra-hospital transport, it was emphasized that the receiving intensive care unit (ICU) should be notified about the possibility of the patient being COVID-19 positive, so that appropriate infection control precautions are taken. Conclusion Cardiopulmonary resuscitation of cardiac arrest patients in the COVID-19 era poses a significant challenge, and all health care providers should deal with any cardiac arrest victim presenting to the emergency department as potential COVID-19 suspects and should use the appropriate PPE.

A comparative analysis of two alternative programmes to counter stigma and discrimination associated with mental illness delivered to medical students

2020 ◽  
pp. 103985622097193
Author(s):  
Sarah E Gordon ◽  
Leah A Kininmonth ◽  
Giles Newton-Howes ◽  
Gordon L Purdie ◽  
Tracey Gardiner
Keyword(s):  
Medical Students ◽  
Health Care Providers ◽  
Mental Distress ◽  
Healthcare Providers ◽  
Care Providers ◽  
Stigma And Discrimination ◽  
Positive Attitudes ◽  
Effective Contact ◽  
Students Attitudes ◽  
Over Time

Objective: To assess and compare attitudes of medical students in response to two service-user-led anti-stigma and discrimination education programmes. Method: Two programmes, consistent with the key elements of effective contact-based anti-stigma and discrimination education programmes for healthcare providers, were delivered to medical students in their penultimate and final year: a more intensive version of the programme in 2015/2016 and a briefer programme in 2016/2017. Attitudes were assessed using the Recovery Attitudes Questionnaire (RAQ) and the Opening Minds Stigma Scale for Health Care Providers (OMS-HC-20) at the beginning and end of their final year. Results: There were no significant differences between the years in initial scores on either scale. Both cohorts showed statistically significant reductions in scores on both scales after completion of the programme, indicating overall improvements in students’ attitudes with reductions in stigma, and more positive attitudes towards recovery of those in mental distress. The more intensive programme led to significantly greater improvement in reductions in stigma than the less intensive programme. Conclusion: Findings support the need for contact-based anti-stigma and discrimination education programmes for medical students that are both intensive and repeated over time.

scholarly journals Awareness about human papilloma virus vaccine among medical students

2016 ◽  
Vol 7 (4) ◽  
pp. 64-67 ◽  
Author(s):  
Snigdha Kamini ◽  
Devi Madhavi Bhimarasetty
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Medical Students ◽  
Human Papilloma Virus ◽  
Health Care Providers ◽  
Hpv Vaccination ◽  
Human Papilloma Virus Vaccine ◽  
Care Providers ◽  
Papilloma Virus ◽  
Medical College

Background: Human papilloma virus is a causative agent of cervical cancer. Hence,vaccination against HPV is an important mode of primary prevention against cervical cancer. Two vaccines against HPV have been approved and recommended for use in India. However the availability of these vaccines is hardly known and seldom utilised even among the medical fraternity.Aims and Objectives: This study aims to find out the awareness about HPV vaccination among medical students of Andhra Medical College, India. Results of this study will help in assessing the need for awareness programs among health care professionals regarding this important public health issue. Materials and Methods: An observational descriptive study was conducted to know the awareness of HPV infection and vaccination among medical students of a government medical college at Visakhapatnam in Andhra Pradesh. A pretested questionnaire was administered to students of final MBBS Part 1 and final MBBS part 2. Results were analyzed in MS excel and the statistical significance of difference in knowledge between males and females was assessed. Results: Overall, the level of awareness reported was 54.5%. Females had slightly better knowledge than males. Students of final year Part 2 had better knowledge the Final year part 1. The most commonly cited source of information was medical education and the most important factor that deterred subjects from receiving/advising HPV vaccination was lack of knowledge. Conclusion: There exists a large gap in knowledge regarding HPV vaccination. Addressing this gap is necessary if we want to decrease the burden of cervical cancer in India. Medical students, health care providers should be sensitized first and then we should reach out to the public.Asian Journal of Medical Sciences Vol.7(4) 2016 64-67

scholarly journals Medical Students’ Experiences and Outcomes Using a Virtual Human Simulation to Improve Communication Skills: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Timothy C Guetterman ◽  
Rae Sakakibara ◽  
Srikar Baireddy ◽  
Frederick W Kron ◽  
Mark W Scerbo ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Medical Students ◽  
Communication Skills ◽  
Health Care Providers ◽  
Mixed Methods Study ◽  
Virtual Human ◽  
Care Providers ◽  
Empathic Communication ◽  
Nonverbal Skills

BACKGROUND Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial. OBJECTIVE This mixed methods study aimed to investigate the differential effects of a VH-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication. METHODS We employed a mixed methods intervention design, involving a comparison of 2 quantitative measures—MPathic-VR–calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by medical students about their experiences. This paper is a secondary, focused analysis of intervention arm data from the larger trial. Students at 3 medical schools in the United States (n=206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis. RESULTS OSCE scores were significantly improved for learners in the intervention group (mean 0.806, SD 0.201) compared with the control group (mean 0.752, SD 0.198; <italic>F</italic><sub>1,414</sub>=6.09; <italic>P</italic>=.01). Qualitative analysis revealed 3 major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal skills in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated that most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers. CONCLUSIONS VHs are a promising strategy for improving empathic communication in health care. Higher performers seemed most engaged to learn, particularly nonverbal skills.

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