The aim of the study was to conduct a comparative analysis of three forms of knowledge transfer online, taking into account the long-term knowledge growth rate and the satisfaction of students surveyed in respect to distance learning. The cohort of participants for this survey were students of the first degree, studying in the Emergency Medical Services. The authors created three e-learning courses in basic and advanced resuscitation procedures. The level of course participants’ satisfaction was analysed, as well as the knowledge growth rate measured three times: 7, 30 and 90 days, respectively, after finishing the course. The level of satisfaction in all the groups surveyed was comparable. The growth rate for knowledge was the highest in group C in the second and third survey, respectively (30 and 90 days after the end of the course), and a significant difference in favour of course C was demonstrated one month after finishing classes.
Introduction: In medical education, Web-based learning is increasingly used as a complement to practical classes. The objective of the study was to perform a comparative analysis of three different forms of e-learning course on emergency medicine in terms of an indicator of knowledge growth...
28 November 2019 in Advances in Clinical and Experimental Medicine
Patients with acute myocardial infarction (AMI) or acute trauma (AT) are transported by air to save time. Helicopter Emergency Medical Service (HEMS) provides both flights to and from the emergency scene, as well as interhospital transport (interHtransport). The objective of this study was to compare aeromedical transport and HEMS missions of AMI and AT patients regarding safety, medical procedures and the length of flights. This is a case-control study analyzing the medical history records of AMI and AT patients transported between hospitals and from the scene identified using ICD-10 codes. Research of customary data (age, sex and general health status measured with Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS)) was performed. There were 48,555 flights in the years 2011-2016, of which 7,645 (15.7%) were interhospital (19% AMI and 12% AT). Out of these, 40,910 (84.3%) HEMS missions were to patients on the scene (10% AMI and 13% AT). No fatalities were noted. The AMI GCS score was higher than in AT patients: 15.0 vs 14.0, respectively. The medical procedures during transport of AMI patients between hospitals and from the scene were the following: cardiopulmonary resuscitation (CPR): 6 vs 73 cases (p < 0.001); oxygen therapy: 41.1% vs 50.2%, respectively. The median distance was 59.4 km vs 52.1 km (p < 0.001), while median flight time was 45.0 min vs 38.0 min (p < 0.001), respectively. Regarding AT patients, the procedures performed (during interhospital and from the scene transport) were the following: CPR: 5 vs 244 cases (p < 0.001); intubation: 10.7% vs 17.3% (p < 0.001); sedation: 50.1% vs 24.3% (p < 0.001); oxygen therapy: 17.6% vs 36.6% (p < 0.001); spinal board: 17.1% vs 66% (p < 0.001); cervical collar: 15.9% vs 63.4% (p < 0.001), respectively. Interhospital transport and HEMS mission median flight distance was 135.9 km vs 56.3 km (p < 0.001), while median flight time was 66.0 min vs 45.0 min (p < 0.001), respectively. Aeromedical transport is safe and very rarely requires resuscitation during the flight. The long distances of flights and time required can reflect the scarcity of trauma centers (TCs) compared to cardiovascular wards. The location of hemodynamic centers in Poland is optimal.
DOI: 10.33963/KP.15190, Published online: February 14, 2020, Authors: Stanisław Paweł Świeżewski, Arkadiusz Wejnarski, Piotr Konrad Leszczyński, Anna Wojak, Adam Fronczak, Tomasz Darocha, Robert Gałązkowski, Grzegorz Opolski, Patryk Rzońca
The purpose of this study was to present the characteristics of Emergency Medical Services (EMS) team responses to calls regarding suspected labour in out-of-hospital settings in Poland. We performed a retrospective analysis of EMS team interventions in cases of suspected onset of labour outside a hospital setting. The analysis included 12,816 EMS team responses to calls regarding women in suspected labour in the period between January 2018 and December 2019. The mean age of the patients studied was 28.24 years (SD = 6.47). The majority of patients were at term (76.36%) and in their second pregnancy (29.96%). EMS teams were most often dispatched in the summer (25.95%) and in urban areas (63.26%). Most EMS teams were basic (68.99%) and interventions most often took place between 19:00 and 06:59 (63.14%). Significant differences were observed between preterm and term pregnant women attended by EMS teams in terms of variables such as the age of the patient, number of previous labours, history of miscarriage, presence of vaginal bleeding, time of year, location of call, type and composition of EMS team dispatched, urgency code and time of call, duration of intervention, selected emergency medical procedures performed and test results.
Background: Paramedics are authorised to perform emergency procedures, including trauma assessment according to global standards. The aim of the study was to answer the question whether the use of cadavers in teaching practical competencies to medical rescue students, in the field of trauma assessment, is necessary as a supplement to learning in simulated conditions with the use of mannequins.Methods: Research included several stages. The first stage was conduction of classes for 27 students in the field of rapid trauma assessment, in accordance with the guidelines of the International Trauma Life Support. In the second stage, a plan of a test in which students had to perform an analogous procedure of rapid trauma assessment, but with the use of cadavers, human unfixed specimens, was prepared. The Delphi method was used to develop and approve checklists, as well as a scale to assess the global correctness of identification of head, torso and limb injuries by medical rescue students.Results: The identification rate was 76.54% in the head area, 67.90% in the torso area, while in the limb area it equalled 44.45%. A significant difference in scores, compared to the examination performed on a mannequin, was observed (Wilcoxon = 4.541;p = 0.000). The most difficult to make a correct diagnosis were injuries related to a fracture of the proximal end of the femur and a dislocated wrist (only 18.52% of correct answers). The students highly rated the usefulness of the examination, by awarding it an average of 4.76 points (SD ± 0.56) on the Likert scale (0–5).Conclusions: The study shows that the use of cadavers to teach practical competencies in the field of trauma assessment to medical rescue students can be an effective supplement to simulated learning. Students could feel the difference between the human body and the mannequin. More research is needed to assess whether realistic simulation translates into objective endpoints, such as the effectiveness of diagnosis in the examination of trauma patients. However, it should be remembered that the introduction of this teaching method is expensive and requires adequate base, as well as the compliance with a number of formal requirements.