Background: House-officers and medical officers are at
the forefront during medical emergencies in the ward
and casualty which impose cognitive, communication,
social and system challenges and yet, training in this
area is commonly lacking. A workshop was conducted
using simulation to provide training on some acute
medical emergencies like cord prolapse, post- partum
haemorrhage with collapse, poly-trauma and acute
exacerbation of asthma.
Objective: To determine the effectiveness of simulation
in developing competency in managing selected clinical
emergencies.
Methodology: There were 22 participants consisting
of house-officers, junior medical officers and nursing
clinical instructors. Only doctors were included in
the study. Four medical emergencies were chosen viz.:
Cord prolapse; post- partum haemorrhage with collapse;
poly-trauma and acute exacerbation of asthma. The
simulated sessions were conducted using high fidelity
manikins and simulated patients. Simulated patients
were trained and moulage was applied accordingly. The
skills stations were on airway equipment and techniques
of application, latest cardiac life support algorithm and
hands on chest compression using manikins.
Results: A 5 point Likert scale used to rate the
sessions. The skills station had 65% (n=13) rating as
excellent and 35% (n=7) good. The skills simulation
was rated excellent by 75% (n=15) and good by 25%
(n=5) of participants. Verbal feedback was that it was
very refreshing, informative, and helpful in terms of
improving their skills.
Conclusion: The simulated skills training for the junior
doctors was very well received and maybe beneficial for
work preparedness and in the long run address patient
safety.
With recent medical advances and the availability of newer sophisticated technologies, critically ill patients tend to survive longer. Thus, decisions to forgo life-sustaining medical treatment generate challenging issues that all doctors must face. The aim of this pilot study was to assess attitudes towards end-of-life care in ICU which included futile therapy (withholding and withdrawing therapy) among final year medical students who had received the same degree of clinical exposure and training in medical school. The results revealed varying attitudes and views towards end-of-life care in ICU suggesting other factors such as religion, ethnicity and culture may influence decision making.
Introduction: Standard precautions in health care is the essence of medical practice encompassing the safety of patients and health care workers including medical students. Barriers to the proper use of personal protective equipment (PPE) exist across the world but identification of areas of weaknesses and appropriate remedies will reduce them. This study assesses knowledge and use of PPE among fourth year students after a period of educational interventions.
Objective: To evaluate appropriate use, awareness and knowledge about PPE among fourth year students after interventions.
Method: A cross- sectional study where forty year 4 students (Group B) were randomly observed and later asked to answer a questionnaire. Students had undergone interventions to improve PPE use, which included lectures and video sessions during each posting. Results were compared with a previous group (Group A). Chi-square test or Fisher’s exact test was used to analyse the data.
Results: There was statistically significant improvement in the use of PPE like wearing and removing mask during invasive procedures (p < 0.001) and hand-washing before and after a non- invasive task (p < 0.001) . Comparison of Groups A and B on the results of the questionnaire for ‘Questions in which more than 10% students answered incorrectly’, showed that there was improvement in Group B in all the questions, some being statistically significant with p value=0.01.
Conclusion: An overall improvement in the use of the PPE and knowledge was noted. Sometimes, students’ attitude and personality may be a challenge and these students may defy changes, but this can be overcome if the strategies are embedded in the curriculum and taught from as early as the first semester.
Shock is a clinical challenge to neonatal intensivists and pediatricians alike. It occurs in critically ill babies for many reasons, but the main cause is sepsis that kills more than a million newborn globally every year. This article is designed to help young doctors and trainees have a better understanding of shock in the neonatal period and its management. The paper reviews the basic pathophysiology, risk factors, clinical investigation, management, supportive care, and complications in the common types of shock seen in neonates. Treatment is governed largely by the underlying cause, with the ultimate goal of achieving adequate tissue perfusion with delivery of oxygen and substrates to the cells, and removal of toxic metabolic waste products. Intervention needs to be anticipatory and urgent to prevent progression to uncompensated and irreversible shock respectively. Early recognition and urgent effective management are crucial to successful outcomes.