scholarly journals Self-Perceived Skills of Pre Intern Doctors in Sri Lanka

2022 ◽  
Author(s):  
A.B Padeniya ◽  
H.M.B.H Denuwara ◽  
M.D Herath ◽  
A Gunawardena ◽  
P Mahipala ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Infusion Pump ◽  
Blood Gases ◽  
Venous Catheter ◽  
Skills Training ◽  
Training Programme ◽  
Medical Graduates ◽  
Research And Innovation ◽  
Arterial Blood ◽  
Medical Faculties

Abstract IntroductionThe transition from medical student to intern is a significant and challenging time in a doctor’s training. It can be stressful for the young doctor and there can be varying expectations from employers and supervisors on their capabilities. There is a time gap between graduation and internship for medical graduates in Sri Lanka. Also, there was no proper orientation prior the internship. Thus, the Good Intern Programme was developed as a skills training programme for pre interns who are awaiting internship, and this was conducted in collaboration with Ministry of Health (MOH), Government Medical Officers’ Association (GMOA), Society for Health Research and Innovation (SHRI). This study aimed to explore self-perceived competency of selected skills of pre-interns who were awaiting for internship. Methods Study populationSri Lankan medical Faculties (University of Colombo, Peradeniya, Sri Jayewardenapura, Jaffna, Kelaniya, Ruhuna, Eastern University- Batticaloa, Rajarata University and General Sir John Kotelawala Defence University -KDU), and foreign universities produce approximately 1000 medical graduates per year. In 2020, all pre- interns who joined the Good Intern Programme, Sri Lanka were invited to participate in this questionnaire survey. Statistical analyses were performed using SPSS 23.0 software. Descriptive data were presented as proportions.Results Mean age was 27.6 (+ SD 1.4). Majority of the pre-interns were females (66.5%). Majority of pre-interns perceived that they were able to performs suturing, cannulation, catheterization, setting up an Intravenous (IV) drip, infusion pump setup, blood and blood products transfusion, venipuncture, venipuncture for blood culture, injections-Subcutaneous (SC)/Intramuscular (IM), Glasgow Coma Scale (GCS) monitoring, Cardiopulmonary resuscitation (CPR), arterial puncture for Arterial Blood Gases (ABG), wound dressing, suture removal, bandaging, glucometer use, nebulization, connecting to an ECG (electrocardiogram) monitor competently with or without supervision respectively. Lack of competency perceived on the following skills. Nasogastric tube (NG) insertion, pleural tap, peritoneal tap, removal of an Intercostal tube, lumbar puncture, defibrillation, venous cut down, intubation, CVP (central venous catheter) line insertion, Intercostal (IC) tube insertion were rated by the majority of pre-interns as skills that could be performed competently with supervision or not able to perform the skill but has observed skill. ConclusionAlthough most of the skills were rated by majority of the pre-interns as skills that could be competently performed with or without supervision respectively, there were some skills which needed some improvement. This study suggests that Good Intern Programme in pre-intern period can help to prepare students for the intern role.

scholarly journals Unknown Partial Anomalous Pulmonary Venous Connection Causing Arterial Blood Gases During Central Venous Catheter Insertion

2020 ◽  
pp. 1-3
Author(s):  
Dirk Bandorski ◽  
Dirk Bandorski ◽  
Ivana Petkovic ◽  
Pascal Klingenberger ◽  
Samuel Dörr ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Blood Gases ◽  
Venous Catheter ◽  
Gas Analysis ◽  
Brachiocephalic Vein ◽  
Diagnostic Tools ◽  
Arterial Blood Gases ◽  
Central Venous ◽  
Arterial Blood ◽  
Anomalous Pulmonary Venous Connection

Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital anomaly. We report about the case with an “arterial blood gas” analysis taken from a newly inserted central venous catheter (CVC). Thoracic computed tomography (CT) verified the catheter in the left internal jugular vein. The contrast was given through the catheter which revealed a partial anomalous venous connection of the left upper pulmonary vein to the left brachiocephalic vein. PAPVC should be taken into consideration in cases of “arterial blood gases” taken from a correctly inserted CVC. Most patients are asymptomatic. Adequate diagnostic tools to detect PAPVC are TEE, CT or MRI.

Release of antidiuretic hormone during mass-induced elevation of intracranial pressure

1977 ◽  
Vol 46 (5) ◽  
pp. 627-637 ◽  
Author(s):  
Lynn Gaufin ◽  
W. Ronald Skowsky ◽  
Stanley J. Goodman
Keyword(s):  
Intracranial Pressure ◽  
Antidiuretic Hormone ◽  
Rhesus Monkeys ◽  
Infusion Pump ◽  
Blood Gases ◽  
Content Type ◽  
Temporal Lobes ◽  
Balloon Catheters ◽  
Arterial Blood ◽  
Mass Expansion

✓ There are complex osmotic and non-osmotic factors regulating release of antidiuretic hormone (ADH). A wide variety of intracranial pathological processes may trigger ADH release sufficient to produce clinically recognizable hyponatremia, or the “inappropriate ADH syndrome.” We systematically studied one non-osmotic trigger, namely mass-induced elevated intracranial pressure (ICP). Initial experiments established baseline data in normal rhesus monkeys: anesthetized animals displayed appropriate rises and falls in immunoreactive urinary ADH in response to intravenously administered hypertonic and hypotonic infusions. Next, balloon catheters were implanted subdurally over temporal lobes and the animals were allowed to recover. The final experiment consisted of anesthetizing the animals, monitoring arterial blood pressure and blood gases, and retrieving timed urinary specimens while continuously recording ICP during infusion-pump expansion of the subdural balloon. A nonlethal and a lethal series of balloon-expansion experiments were done. Control values of urinary ADH were 783 ± 125 µU/15 min, and ICP was less than 10 mm Hg. During nonlethal mass expansion ADH output rose to 3433 ± 269 µU/15 min while ICP averaged 65 mm Hg (measured at completion of mass expansion). While the mass was maintained, hypotonic infusion produced unchanged urinary ADH output of 3452 ± 277 µU/15 min. During lethal experiments, urinary ADH rose still higher to 4339 ± 1887 µU/15 min associated with ICP averaging 100 mm Hg. We concluded that there is a direct relationship between the magnitude of ICP and the amount of ADH release, and that during elevated ICP the ADH release is not suppressed by hypotonic infusion.

Virtual reality in social skills training programs for people with schizophrenia: A systematic review and focus group

2021 ◽  
pp. 030802262110113
Author(s):  
Catarina Oliveira ◽  
Raquel Simões de Almeida ◽  
António Marques
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Virtual Reality ◽  
Social Skills ◽  
Focus Group ◽  
Social Skills Training ◽  
Occupational Therapists ◽  
Skills Training ◽  
Training Programme ◽  
Cochrane Library

Introduction This study aims to determine the guidelines for the design of a social skills training programme for people with schizophrenia using virtual reality. Methods This article encompasses two studies: Study 1, a systematic review of five articles indexed in the databases B-on, PubMed, Clinical trials and Cochrane Library (2010–2020); Study 2, a focus group of occupational therapists trained in mental health and multimedia professionals, in which they discussed the outline of such a programme. Results A set of guidelines were identified as central and consensual which should be included in the programme. It must have multilevel logic and gradual learning, with simulations of everyday situations, in which it is possible to practise the skills of conversation and communication. Virtual reality provides people with schizophrenia with unlimited opportunities, enhancing a personalized intervention. Conclusion Social skills training could be part of the treatment for people with schizophrenia, and virtual reality is a promising tool to complement traditional training, although still little implemented in mental health services. Occupational therapists have a prominent role in the development and application of this because of their knowledge of activity analysis and their ability to facilitate the generalization of skills in different contexts.

scholarly journals Elimination of nasal obstruction improves pulmonary functions and oxygenation

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eman Sobh ◽  
Fatma Elhussieny ◽  
Taghreed Ismail
Keyword(s):  
Nasal Obstruction ◽  
Blood Gases ◽  
Medical Problem ◽  
Forced Expiratory Volume ◽  
Nasal Packing ◽  
Nasal Pack ◽  
Arterial Blood ◽  
Study Population ◽  
The Mean ◽  
The Impact

Abstract Background Nasal obstruction is a significant medical problem. This study aimed to examine the effect of nasal obstruction and nasal packing on arterial blood gases and pulmonary function indices, and the impact of the elimination of nasal obstruction on preoperative values. Results The mean age of the study population was 26.6 ± 10.1 years, males represented 50.8%. Spirometric indices showed statistically significant improvement (preoperative forced expiratory volume in 1st second 66.9 ± 13.9 vs 79.6 ± 14.9 postoperative and preoperative forced vital capacity 65.5 ± 12.7 vs 80.4 ± 13.8 postoperative). Oxygen saturation was significantly lower during nasal packing (95.6 ± 1.6 preoperative vs 94.7 ± 2.8 with nasal pack), and significant improvement (97.2 ± 1.4) was observed after removal of the nasal pack. Nasal obstruction scores significantly improved. Conclusion The results of this study indicate that either simple nasal obstruction or nasal packing may cause hypoxemia and abnormalities in lung function tests. Hypoxemia was more evident with nasal packing.

Capacity building in the public health field in the Tunisian medical faculties

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Coman ◽  
O Oltean ◽  
M Palianopoulou ◽  
D Plancikova ◽  
C Zedini ◽  
...  
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Health Knowledge ◽  
National Level ◽  
Training Programme ◽  
Local Health ◽  
The Public ◽  
Public Health Training ◽  
Medical Faculties ◽  
Health Field

Abstract Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training. The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian trainers; (2) shadowing sessions - the trainers participated in shadowing sessions in the European partner institutions; (3) training delivery - the CONFIDE trainers, assisted by the European experts, delivered the training to an interdisciplinary group of 25 students and professionals; (4) internships - the students participated in internships in local health institutions. Three modules have been built within the Research into Policy training programme: Public health research, Health promotion policies and Evidence based public health policy. They contributed to increasing the public health knowledge and skills of the professionals trained. The training programme was well received by the Tunisian universities and the material developed so far during the project was adapted to the Tunisian context in the third step of implementation. On the long term, the project is expected to have an impact at the national level and produce updates at curricula level in the Tunisian medical faculties. Key messages Research into Policy training programme developed by the EC partners and culturally adapted by the Tunisian partners to the Tunisian public health context. Research into Policy training is a well-received tool for the high quality learning process in the public health field in Tunisian medical faculties.

scholarly journals Pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest

2020 ◽  
Vol 8 (S1) ◽  
Author(s):  
Chiara Robba ◽  
Dorota Siwicka-Gieroba ◽  
Andras Sikter ◽  
Denise Battaglini ◽  
Wojciech Dąbrowski ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Oxygen Demand ◽  
Blood Gases ◽  
Metabolic Energy ◽  
High Morbidity ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Clinical Consequences

AbstractPost cardiac arrest syndrome is associated with high morbidity and mortality, which is related not only to a poor neurological outcome but also to respiratory and cardiovascular dysfunctions. The control of gas exchange, and in particular oxygenation and carbon dioxide levels, is fundamental in mechanically ventilated patients after resuscitation, as arterial blood gases derangement might have important effects on the cerebral blood flow and systemic physiology.In particular, the pathophysiological role of carbon dioxide (CO2) levels is strongly underestimated, as its alterations quickly affect also the changes of intracellular pH, and consequently influence metabolic energy and oxygen demand. Hypo/hypercapnia, as well as mechanical ventilation during and after resuscitation, can affect CO2 levels and trigger a dangerous pathophysiological vicious circle related to the relationship between pH, cellular demand, and catecholamine levels. The developing hypocapnia can nullify the beneficial effects of the hypothermia. The aim of this review was to describe the pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest.According to our findings, the optimal ventilator strategies in post cardiac arrest patients are not fully understood, and oxygen and carbon dioxide targets should take in consideration a complex pattern of pathophysiological factors. Further studies are warranted to define the optimal settings of mechanical ventilation in patients after cardiac arrest.

scholarly journals Prehospital Diagnosis of Shortness of Breath Caused by Profound Metformin-Associated Metabolic Acidosis

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 74
Author(s):  
Pietro Elias Fubini ◽  
Laurent Suppan
Keyword(s):  
Metabolic Acidosis ◽  
Hospital Setting ◽  
Blood Gases ◽  
Shortness Of Breath ◽  
Potential Harm ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Common Causes ◽  
Prehospital Diagnosis ◽  
Gas Measurement

Shortness of breath is a common complaint among patients in emergency medicine. While most common causes are usually promptly identified, less frequent aetiologies might be challenging to diagnose, especially in the pre-hospital setting. We report a case of prehospital dyspnoea initially ascribed to pulmonary oedema which turned out to be the result of profound metformin-associated metabolic acidosis. This diagnosis was already made during the prehospital phase by virtue of arterial blood gas measurement. Pre-hospital measurement of arterial blood gases is therefore feasible and can improve diagnostic accuracy in the field, thus avoiding unnecessary delay and potential harm to the patient before initiating the appropriate therapeutic actions.

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