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Resuscitation skills training

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https://www.readbyqxmd.com/read/28541177/when-teachable-moments-become-ethically-problematic
#1
Elizabeth Dzeng
There is frequently tension in medical education between teaching moments that provide skills and knowledge for medical trainees, and instrumentalizing patients for the purpose of teaching. In this commentary, I question the ethical acceptability of the practice of providing cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS) to dying patients who would be unlikely to survive resuscitation, as a teaching opportunity for medical trainees. This practice violates the principle of informed consent, as the patient agreed to resuscitation for the purpose of potentially prolonging life rather than to futile resuscitation as a teaching opportunity...
July 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28509774/the-role-of-the-anaesthesiologist-in-air-ambulance-medicine
#2
Stephen J M Sollid, Marius Rehn
PURPOSE OF REVIEW: The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. RECENT FINDINGS: Successful prehospital care requires the ability to perform a complex set of advanced diagnostics and interventions...
May 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#3
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28489804/comparison-of-learning-performance-of-2-intubating-laryngeal-mask-airways-in-novice-a-randomized-crossover-manikin-study
#4
Zi-Jia Liu, Jie Yi, Wei-Yun Chen, Xiu-Hua Zhang, Yu-Guang Huang
BACKGROUND: Intubating laryngeal mask airways (LMAs) such as i-gel and Aura-i could serve as rescue devices in resuscitation and further ensure the airway by facilitating trachea intubation without ventilation interruption. But data regarding intubating LMAs in novice are limited and skill degeneration without regular training has not been evaluated. So we designed this prospective randomized crossover manikin study to compare the learning performance of 2 intubating LMAs (i-gel and Aura-i)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28488551/-emergency-laparotomy-in-a-trauma-patient
#5
F Hietbrink, R K J Simmermacher, M B de Vries, K J P van Wessem, M B de Jong, L P H Leenen
- Emergency laparotomy in trauma patients can be part of the resuscitation process, is based on damage control principles and is therefore fundamentally different from elective laparotomy, for example in case of malignancies. - Indications for emergency laparotomy after trauma are based on haemodynamic instability of the patient and the procedure is focused on restoring the patient's physiological condition.- Haemodynamic and biochemical parameters are used to determine the rest of the strategy. In order to optimize the procedure, the entire treatment team should be practiced in this...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28482805/management-of-potentially-life-threatening-emergencies-at-74-primary-level-hospitals-in-mongolia-results-of-a-prospective-observational-multicenter-study
#6
Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger, Martin W Dünser
BACKGROUND: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. METHODS: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period...
May 8, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28460863/psychological-skills-to-improve-emergency-care-providers-performance-under-stress
#7
Michael J Lauria, Isabelle A Gallo, Stephen Rush, Jason Brooks, Rory Spiegel, Scott D Weingart
Stress experienced by emergency medical providers during the resuscitation of critically ill or injured patients can cause cognitive and technical performance to deteriorate. Psychological skills training offers a reasonable and easily implemented solution to this problem. In this article, a specific set of 4 performance-enhancing psychological skills is introduced: breathe, talk, see, and focus. These skills comprise breathing techniques, positive self-talk, visualization or mental practice, and implementing a focus "trigger word...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28409149/collaborative-implementation-strategy-for-newborn-resuscitation-and-essential-care-training-in-the-dominican-republic
#8
REVIEW
Alexandra Leader, Claudia Cadet, Davina Lazala, Wanny Roa, Olga Arroyo, Lloyd Jensen
BACKGROUND: Neonatal mortality accounts for 45% of under-5 mortality worldwide, with 98% of newborn deaths occurring in developing countries. The Dominican Republic (DR) demonstrates one of the highest neonatal mortality rates in Latin America despite broad access to care. Strategies to support professional capacity building and strengthen the local health care system are needed to improve neonatal outcomes in the DR. RATIONALE: Helping babies breathe (HBB) and essential care for every baby (ECEB) are evidence-based newborn resuscitation and essential care training programs that have been shown to improve providers' confidence, knowledge, and clinical skills...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28401617/the-effectiveness-of-crisis-resource-management-and-team-debriefing-in-resuscitation-of-nursing-students-a-randomized-controlled-trial
#9
Imgard Coppens, Sofie Verhaege, Ann Van Hecke, Dimitri Beeckman
AIMS AND OBJECTIVES: The aim of this study was to investigate (1) if integrating a course on Crisis Resource Management principles, and team debriefings in simulation training, increases self-efficacy, team-efficacy and technical skills of nursing students in resuscitation settings and (2) which phases contribute the most to these outcomes. BACKGROUND: Crisis Resource Management principles have been introduced in healthcare to optimize teamwork. Simulation training offers patient safe training opportunities...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28399847/evaluation-of-helping-babies-breathe-quality-improvement-cycle-hbb-qic-on-retention-of-neonatal-resuscitation-skills-six-months-after-training-in-nepal
#10
Ashish Kc, Johan Wrammert, Viktoria Nelin, Robert B Clark, Uwe Ewald, Stefan Peterson, Mats Målqvist
BACKGROUND: Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and sustain the clinical competency of health workers on bag-and-mask ventilation. This study was conducted to evaluate the impact of multi-faceted implementation strategy for HBB, as a quality improvement cycle (HBB-QIC), on the retention of neonatal resuscitation skills in a tertiary hospital of Nepal...
April 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28388951/implementing-the-emergency-triage-assessment-and-treatment-plus-admission-care-etat-clinical-practice-guidelines-to-improve-quality-of-hospital-care-in-rwandan-district-hospitals-healthcare-workers-perspectives-on-relevance-and-challenges
#11
Celestin Hategeka, Leah Mwai, Lisine Tuyisenge
BACKGROUND: An emergency triage, assessment and treatment plus admission care (ETAT+) intervention was implemented in Rwandan district hospitals to improve hospital care for severely ill infants and children. Many interventions are rarely implemented with perfect fidelity under real-world conditions. Thus, evaluations of the real-world experiences of implementing ETAT+ are important in terms of identifying potential barriers to successful implementation. This study explored the perspectives of Rwandan healthcare workers (HCWs) on the relevance of ETAT+ and documented potential barriers to its successful implementation...
April 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28384553/neonatal-resuscitation-training-for-midwives-in-uganda-strengthening-skill-and-knowledge-retention
#12
Clare Mildenberger, Cathryn Ellis, Kelley Lee
The objective of this project was to improve birth outcomes for babies in a regional referral hospital in Uganda by strengthening factors that influence the retention and application of neonatal resuscitation skills. Initial training in neonatal resuscitation is not enough on its own. In order to better understand the gap between training and effective practice, an evaluation of a neonatal resuscitation program was carried out. This included practical skill testing of local midwives using a neonatal resuscitation doll pre- and post-training, as well as follow up testing at 1 month and 12 months, followed by focus groups and interviews...
March 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28383477/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-tele-mentoring-tele-diagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#13
Andrew W Kirkpatrick, Jessica McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather Wright-Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of post-traumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or Resuscitative-surgery in austere-environments. Revolutions in technology for remote-mentoring of ultrasound and surgery may enhance capabilities to utilize the skill-sets of non-physicians. Thus, our Research-Collaborative explored remote-mentoring to empower non-physicians to address junctional and torso hemorrhage-control in Austere-environments...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28382769/the-blindfolded-code-training-exercise
#14
Rami Ahmed, Kate Hughes, Patrick Hughes
BACKGROUND: Communication errors are the leading cause of preventable patient harm in medicine. There is little description in the literature of advanced techniques to teach crisis resource management (CRM) communication strategies, or how to improve real-time ineffective behaviour or habits that may persist despite appropriate behaviour and leadership witnessed in the simulation lab. CONTEXT: This article presents an advanced teaching technique to force the adoption of closed-loop communication strategies...
April 5, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28370414/simulation-based-team-training-improved-the-self-assessed-ability-of-physicians-nurses-and-midwives-to-perform-neonatal-resuscitation
#15
B Malmström, E Nohlert, U Ewald, M Widarsson
AIM: The use of simulation-based team training in neonatal resuscitation has increased in Sweden during the last decade, but no formal evaluation of this training method has been performed. This study evaluated the effect of simulation-based team training on the self-assessed ability of personnel to perform neonatal resuscitation. METHODS: We evaluated a full-day simulation-based team training course in neonatal resuscitation, by administering a questionnaire to 110 physicians, nurses and midwives before and after the training period...
March 31, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28368963/improved-retention-of-chest-compression-psychomotor-skills-with-brief-rolling-refresher-training
#16
Dana E Niles, Akira Nishisaki, Robert M Sutton, Okan U Elci, Peter A Meaney, Kathleen A OʼConnor, Jessica Leffelman, Jo Kramer-Johansen, Robert A Berg, Vinay Nadkarni
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical to improve survival from cardiac arrest. However, cardiopulmonary resuscitation knowledge and psychomotor skill proficiency are transient. We hypothesized that brief, in situ refresher training will improve chest compression (CC) psychomotor skill retention for bedside providers. METHODS: Nurses completed a baseline skill evaluation of CC quality 6 months after traditional basic life support recertification...
April 1, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28355934/simulation-based-trauma-education-for-medical-students-a-review-of-literature
#17
Alicia S Borggreve, Joost M R Meijer, Henk W R Schreuder, Olle Ten Cate
BACKGROUND: Medical students often do not feel prepared to manage emergency situations after graduation. They experience a lack of practical skills and show significant deficits in cognitive performance to assess and stabilize trauma patients. Most reports in the literature about simulation-based education pertain to postgraduate training. Simulation-based trauma education (SBTE) in undergraduate medical education could improve confidence and performance of recently graduated doctors in trauma resuscitation...
March 30, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28353609/assessing-practical-skills-in-cardiopulmonary-resuscitation-discrepancy-between-standard-visual-evaluation-and-a-mechanical-feedback-device
#18
Baltasar Sánchez González, Laura Martínez, Manel Cerdà, Enrique Piacentini, Josep Trenado, Salvador Quintana
This paper aims to analyze agreement in the assessment of external chest compressions (ECC) by 3 human raters and dedicated feedback software.While 54 volunteer health workers (medical transport technicians), trained and experienced in cardiopulmonary resuscitation (CPR), performed a complete sequence of basic CPR maneuvers on a manikin incorporating feedback software (Laerdal PC v 4.2.1 Skill Reporting Software) (L), 3 expert CPR instructors (A, B, and C) visually assessed ECC, evaluating hand placement, compression depth, chest decompression, and rate...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28353555/effect-of-dyad-training-on-medical-students-cardiopulmonary-resuscitation-performance
#19
Candice Wang, Chin-Chou Huang, Shing-Jong Lin, Jaw-Wen Chen
We investigated the effects of dyadic training on medical students' resuscitation performance during cardiopulmonary resuscitation (CPR) training.We provided students with a 2-hour training session on CPR for simulated cardiac arrest. Student teams were split into double groups (Dyad training groups: Groups A and B) or Single Groups. All groups received 2 CPR simulation rounds. CPR simulation training began with peer demonstration for Group A, and peer observation for Group B. Then the 2 groups switched roles...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28333831/deployed-skills-training-for-whole-blood-collection-by-a-special-operations-expeditionary-surgical-team
#20
Linda C Benavides, Iain M Smith, Jerome M Benavides, Douglas M Bowley, Heidi A Doughty, Jonathan B Lundy
BACKGROUND: Noncompressible hemorrhage is the leading cause of potentially preventable battlefield death. Combining casualty retrieval from the battlefield and damage control resuscitation (DCR) within the "golden hour" increases survival. However, transfusion requirements may exceed the current blood component stocks held by forward surgical teams. Warm fresh whole blood (WFWB) is an alternative. We report WFWB transfusion training developed by and delivered to a US Golden Hour Offset Surgical Treatment Team and the resulting improvement in confidence with WFWB transfusion...
June 2017: Journal of Trauma and Acute Care Surgery
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