First-Response ABCDE Management of Status Epilepticus: A Prospective High-Fidelity Simulation Study

Respiratory infections following status epilepticus (SE) are frequent, and associated with higher mortality, prolonged ICU stay, and higher rates of refractory SE. Lack of airway protection may contribute to respiratory infectious complications. This study investigates the order and frequency of physicians treating a simulated SE following a systematic Airways-Breathing-Circulation-Disability-Exposure (ABCDE) approach, identifies risk factors for non-adherence, and analyzes the compliance of an ABCDE guided approach to SE with current guidelines. We conducted a prospective single-blinded high-fidelity trial at a Swiss academic simulator training center. Physicians of different affiliations were confronted with a simulated SE. Physicians (n = 74) recognized SE and performed a median of four of the five ABCDE checks (interquartile range 3–4). Thereof, 5% performed a complete assessment. Airways were checked within the recommended timeframe in 46%, breathing in 66%, circulation in 92%, and disability in 96%. Head-to-toe (exposure) examination was performed in 15%. Airways were protected in a timely manner in 14%, oxygen supplied in 69%, and antiseizure drugs (ASDs) administered in 99%. Participants’ neurologic affiliation was associated with performance of fewer checks (regression coefficient −0.49; p = 0.015). We conclude that adherence to the ABCDE approach in a simulated SE was infrequent, but, if followed, resulted in adherence to treatment steps and more frequent protection of airways.

Features of changes in heart rate variability indices in driving school cadets with different levels of preparedness

The research was carried out on two independent experimental groups of boys and girls. The first was observed in traffic conditions, the second during the period of auto-simulator training. The HRV indices were determined: HR - heart rate, IN - index of tension of regulatory systems, AMo - amplitude of the mode, LF/HF - index of vagosympathetic interaction. A pronounced sympathetic reaction of more prepared cadets to the training load with the subsequent restoration of the studied characteristics was revealed. Key words: heart rate variability, autonomic regulation, vagosympathetic interaction, driver training, level of preparedness.

THE RE-DESIGN OF A MARINE ENGINE ROOM SIMULATOR IN CONSIDERATION TO ERGONOMICS DESIGN PRINCIPLES

Simulators can be used as sophisticated, flexible and realistic training tools which are capable of meeting many of the designated functions and tasks. An engine room simulator consists of simulation of various machinery systems in the engine room of a ship. This type of simulator is very significant and compulsory for marine engineering education. Istanbul Technical University Maritime Faculty (ITUMF) obtained a set of full-mission simulator and workstation simulators in 2001. However, it was realized that the ergonomic principles were not applied properly. Therefore it was not possible to generate the real engine room conditions with this simulator due to lack of some operations and displays on the mimic panel. Some of the mimics and displays were not similar to ones on board ship. This situation was negatively affecting the performance of engine room simulator training. And the mimic panel was re-designed and installed in 2006. In this study, the ergonomics principles for designing a mimic panel are determined and the application of ergonomic principles to a mimic panel is explained. The ergonomic gains of applied ergonomics principles are mentioned. Even more the effects on the marine engineering education are stated.

Alternatives in Education—Evaluation of Rat Simulators in Laboratory Animal Training Courses from Participants’ Perspective

In laboratory animal science (LAS) education and training, five simulators are available for exercises on handling and routine procedures on the rat, which is—beside mice—the most commonly used species in LAS. Since these simulators may have high potential in protecting laboratory rats, the aim of this study is to investigate the simulators’ impact on the 3R (replace, reduce, refine) principle in LAS education and training. Therefore, the simulators were evaluated by 332 course participants in 27 different LAS courses via a practical simulator training workshop and a paper-based two-part questionnaire—both integrated in the official LAS course schedule. The results showed a high positive resonance for simulator training and it was considered especially useful for the inexperienced. However, the current simulators may not completely replace exercises on live animals and improvements regarding more realistic simulators are demanded. In accordance with literature data on simulator-use also in other fields of education, more research on simulators and new developments are needed, particularly with the aim for a broad implementation in LAS education and training benefiting all 3Rs.

Three-dimensional simulator: training for beginners in endovascular embolization with liquid agents

Background To design a simulator for novices without prior experience in embolization with liquid agents such as n-Butyl cyanoacrylate (n-BCA) and to evaluate the simulator using surveys and post hoc video analysis. Materials and methods The simulator was created using computer-aided design software and three-dimensionally printed. Before an embolization, trainees completed questionnaires regarding their level of expertise and self-reported confidence level. The participants were shown an instruction video and each participant performed four embolizations on the simulator. Subsequently, the participants completed surveys on self-reported confidence level and assessed the simulator’s face and content validity. Results Five experts and twelve novices trained on the simulator. The experts were radiology residents and fellows with at least 5 years of work experience in interventional radiology. The novices were medical students and radiology residents without any previous experience with embolization. Based on the surveys, the experts assessed the simulator as very useful for embolization training. Performance, e.g. mean duration embolization between experts (mean ± standard deviation = 189 ± 42 s) and novices (mean ± standard deviation = 235 ± 66 s) were significantly different (p = .001). The overall simulation of the embolization process, simulated complications, and educational capabilities of the simulator were evaluated positively. In the novice group the self-reported confidence level significantly increased (p = .001). Conclusion The liquid embolization simulator proposed here is a suitable educational tool for training embolization procedures. It reduces the duration of embolization procedures and improves the confidence level of beginners in embolization.

Impact and Adaptation of Reproductive Training During COVID-19 Pandemic in Malaysia

The novel coronavirus (COVID-19) pandemic has affected the community at large. It has affected almost everyone and every aspect of social, economic and educational activities. Training in reproductive medicine has not been spared, as training in this field requires a combination of clinical interaction with patients, procedural experience, constant discussions and the element of research. The changes to numbers of new infections or active cases dictate the restrictions placed on the community and health care services alike. At the beginning of the pandemic, both the patients’ fear of going to a health care facility and movement restrictions had caused a significant reduction in the number of COVID-19 cases. Furthermore, the Ministry of Health (MOH) Malaysia’s recommendation to withhold all non-essential medical services, including those related to reproductive medicine, falls under this category. Therefore, it could negatively impact the quality of training and lead to an extension of training duration in reproductive medicine. Thus, the procedural experience could be supplemented with simulator training, teleconsultation could replace standard clinic sessions and online meeting platforms could replace routine academic meetings. Any modifications must be adaptable or flexible, as similar infectious pandemics and restrictions could recur from time to time.