Management Of Medical Emergencies Research Articles

Determination of Women and Reproductive Health Awareness in Emergency Department: A Descriptive Cross-Sectional Study

Aim: Emergency departments (EDs) are units in which acute management of traumatic and medical emergencies are provided; but also guidance on public health is provided as well as ensuring personal health and awareness. In this study, it was aimed to determine the level of knowledge about women’s and reproductive health and possible disease symptoms in female patients aged 18 years and older who applied to the emergency department, regardless of the complaint of admission. We also aimed to determine the role of EDs in contributing to the correct referral of these patients. Material and Methods: This was a descriptive cross-sectional study which took place in a tertiary care center. Women aged 18 years and older who applied to the emergency department with any complaint were assessed with a structured questionnaire consisting of 18 questions and multiple-choice options about women’s health. Participants' sociodemographic characteristics, fertility, menstrual cycle and contraception patterns, their knowledge about cancer prevention, gynecological and urological complaints were asked. It was also asked whether the ED physician gave any guidance on issues related to women's health, before discharge from ED. Results: Totally 523 women were included in the study. The mean age was 38.89±14.32 years. Most of them (91.6%) were lived in city center, 63.3% were married and 60% were high school and university graduates. The ratio of not using any contraceptive method and total number of pregnancies were higher at the lower education levels (p=0.003 and 0.004, respectively). The knowledge of women about cancer screening was low and 42.4% of them did not have information about screening issues. In comparison according to educational status, it was seen that the ratio of screening awareness, breast self-examination, HPV test, and mammography were higher and statistically significant in university graduates (p=0.000). ED physicians conducted appropriate outpatient clinic referral for screening and follow-up in 53.6% of 114 patients with gynecological complaints. Conclusion: The level of knowledge about women’s health is still not at the desired level. Although there are a wide variety of effective and modern methods available, not to use a contraceptive method is still common. With the increase, dissemination and continuity of reproductive health education and consultancy services, the lack of information on this subject will be eliminated to a large extent and wrong practices will be prevented. Emergency departments are places for preventing public health, besides managing acute conditions.

Construction of a 5G-based, three-dimensional, and efficiently connected emergency medical management system

BackgroundShenzhen is unique in its need for ad hoc responses to emergencies. The need for emergency medicine also demonstrates a trend of sustained growth. ObjectiveA three-dimensional and efficiently connected emergency medical management model using fifth generation mobile communication technology (5G) was established to improve the efficiency and level of management in emergency medicine. MethodA mixed-frequency band private network collaborative emergency treatment mode was built under daily emergency scenarios using 5G. The efficiency of a three-dimensional telemedicine treatment mode was tested using prehospital emergency medicine. Also, the feasibility of quickly establishing a temporary network information system using unmanned aerial vehicle (UAV) and/or high-throughput communication satellites under disaster-caused power outages and network interruptions was examined. A monitoring system was constructed for suspected cases using 5G amid public health emergencies, which raised the Emergency Department’s efficiency and security in responding to the pandemic. ResultsThe three-dimensional rescue system supported by 5G showed that the radius of the emergency medical rescue services expanded from 5 to 60 km, and the cross-district emergency reaction time reduced from 1 h to <20 min. Thus, it was feasible to construct a communication network expeditiously with devices carried by UAV under disastrous scenarios. The system developed based on 5G could be used in managing suspected cases of public emergencies. Among the 134 suspected cases in the early stage of the pandemic, no nosocomial infection was detected. ConclusionA three-dimensional, efficiently connected emergency medical management system based on 5G was constructed, following which the emergency rescue radius quickly expanded and the emergency response time reduced. Thus, with the aid of new technology, an emergency information network system was built expeditiously under specific scenarios, such as a natural disaster, and the level of management under public health emergencies advances. The confidentiality of patient information is a critical issue regarding the application of new technology.

Cross sectional study on the competence and confidence of dental students and graduates in the management of medically compromised patients and acute medical emergencies.

A rapidly aging population means many people have multiple health issues leading to an increased risk of acute medical emergencies. The objective of this study was to evaluate how essential experiential learning is in developing dental graduates' ability to manage medically compromised patients. Three hundred and twenty-seven students and graduates were invited to participate in an online survey to rate their confidence in managing medically compromised patients and acute medical emergencies using a 5-point Likert scale. Competence of knowledge was evaluated using 30 multiple choice questions (MCQs) across six domains. The respondents were also asked whether a theory-only training adequately prepared them to manage medically compromised patients, or whether it must be supplemented with clinical training. Two-hundred and sixty-four responses were collected from 75 undergraduates (UG), 96 junior dental officers (JDO) and 93 senior dental officers (SDO). The UG reported that they infrequently managed medically compromised patients, whereas both the JDO and SDO reported having frequent encounters with these patients. The mean confidence scale in the management of medically compromised patients were 2.62, 3.50 and 3.69 (out of 5), respectively. In contrast, their confidence scale in the management of acute medical emergencies was 2.05, 2.33 and 2.50 (out of 5), respectively. The MCQ scores were 25.51, 26.44 and 26.86 out of 30, respectively. The outcomes of the JDO and SDO were significantly better than the UG (t-tests, p<0.05). All three groups responded that a theory-only training in dental school did not adequately prepare them to manage medically compromised patients. Both the JDO and SDO felt that their clinical work experience better prepared them to manage these patients. Experiential learning from "real-life" clinical experience is an essential component in developing graduates' confidence and competence in the management of medically compromised patients. A dental curriculum with theory-only training in this aspect is inadequate.

Perioperative medical emergencies: The role of clinical pharmacists and a review of pharmacotherapy considerations

AbstractMedical emergencies arising in the perioperative period can have unique etiologies, medication management, and care complexities. Clinical pharmacists have established roles and demonstrated value in resuscitative efforts elsewhere within acute care settings, but very little published description of pharmacist participation in perioperative emergency response is currently available. Furthermore, specialized clinical and operational knowledge may be needed to effectively optimize medication use during a perioperative medical crisis. This narrative review offers recommended pharmacist roles, concise pharmacotherapeutic considerations, and key resources to support clinical pharmacists in all facets of perioperative medical emergency management and preparedness. Specific medical crises discussed include malignant hyperthermia, local anesthetic systemic toxicity, intraoperative cardiac arrest, anaphylaxis, carcinoid crisis, pheochromocytoma, and vasoplegia. Additional pharmacy practice studies are needed to validate clinical pharmacists as essential members of perioperative emergency response teams and delineate their associated impact on patient outcomes in this setting.

Assessment of Preparedness of Dental Graduates and Postgraduates in the Management of Medical Emergencies

Objective: This study aimed to assess the type of training concerning the management of medical emergencies, received by house officers and postgraduate trainees in different dental teaching institutes of Rawalpindi and Islamabad, Pakistan. Materials and Methods: A questionnaire was distributed in different dental teaching hospitals in Rawalpindi and Islamabad. It contained questions regarding what type of training they received, and whether they perceived that the training was sufficient when it was needed during a medical emergency. Data was analyzed by SPSS and frequencies were recorded. Results: All participants had received either theoretical or practical training. Less than 20% of house officers and postgraduate trainees perceived that they have handled a medical emergency ‘well’. Conclusion: This shows that our current curriculum is focused on the ‘theory’ and lacks practical training which leads to underprepared practitioners. To improve their skills, students should undergo drills and artificial and simulation-based training. Keywords: Medical emergency, CPR, BLS, dental practice

Potential Use of Artificial Intelligence (AI) in Disaster Risk and Emergency Health Management: A Critical Appraisal on Environmental Health

The risk evaluation of natural disasters is an obstacle to ensuring healthcare services during catastrophic events worldwide. Therefore, timely and appropriate environmental health risk evaluation is essential. In this study, we incorporated the information from databases such as PubMed, Google Scholar, and Scopus. We performed this study to explore the feasibility of using artificial intelligence (AI) in disaster risk and emergency health management. Natural disasters have some phenomenon that is bound to happen. So, we can use AI to inform healthcare authorities about environmental health risks and emergency medical management. The recent innovations in technology have created novel opportunities for improving healthcare services across the world. AI technology would be the backbone of the fourth industrial revolution because we are entering an AI-based world this decade. Therefore, we suggest the authorities consider this positive aspect of AI technology to minimize the disastrous outcomes of any catastrophic events.

Retracted: Optimization of Remote Public Medical Emergency Management System with Low Delay Based on Internet of Things.

[This retracts the article DOI: 10.1155/2021/5570500.].

Multimodal Deep Learning-based Medical Emergency Management, Wearable Device-based Physiological Data Examination, and Metaverse-basedMedical Imaging and Extended Reality Technologies for Digital Twin-based Clinical Treatments in Decentralized 3D Virtual Reality Environments

Multimodal Deep Learning-based Medical Emergency Management, Wearable Device-based Physiological Data Examination, and Metaverse-basedMedical Imaging and Extended Reality Technologies for Digital Twin-based Clinical Treatments in Decentralized 3D Virtual Reality Environments

Role of demographic variables in investigating occupational stress of disaster and emergency medical management center.

Emergency medical services face stressful environments such as departments dealing with injuries and sick patients that pose challenging situations for the healthcare staff. This present study investigates the role of demographic variables in investigating occupational stress of disaster and emergency medical management center in 2021. This present descriptive study selected a sample size of 200 medical personnel associated with disaster and emergency medical management center in Iran, according to the inclusion chosen criteria. The study used a tool consisting of two parts, including demographic information and a job stress Health and Safety Executive (HSE) standard questionnaire. The study selected respondents through Cochran's sample size formula using stratified random sampling with a cross-sectional research design for data collection. This present study has analyzed received data using performed the descriptive and inferential information (t-test and one-way ANOVA) at a significance level P < 0.05. The participants of the survey were males only. The study results specified that the mean age of respondents was 30.14 ± 5.96. The study results exhibited that the mean score of total occupational stress was 3.41 ± 0.26. The results showed the highest (4.34 ± 0.35) and the lowest (2.72 ± 0.86) stress levels were related to role dimensions. The study findings revealed a significant relationship between stress level and participants' age, marital status, educational level, type of base, workplace, and the number of work hours per month. Emergency medical personnel experience a high level of occupational stress. Senior managers can use similar studies to implement measures to reduce the experience of employees' stress.

Preparedness of University Personnel on the Management of Common Medical Emergencies

Preparation before an emergency is critical in ensuring that employers and workers have the necessary knowledge and skills on where to go and how to keep themselves safe. This study determined the level of preparedness of UNP personnel on the management of common medical emergencies and its relationship with selected socio-demographic factors. The study used the descriptive-correlational research method using the G power. 202 teaching and non-teaching personnel of the University of Northern Philippines were determined using the purposive sampling technique. The study findings were: A great number of the respondents are 40-44 years old, master's graduates with a monthly income of below Php30,000, 15-19 years in service, and male; a great majority are married. The majority of the respondent's sources of information are television, doctors, and newspapers. The respondents are highly prepared for the management of common medical emergencies. They are prepared to manage wounds, burns, nose bleeding, fainting, difficulty breathing, choking, bites, and fractures. The sex, educational attainment, and level of preparedness of the respondents have a significant relationship with their preparedness for the management of common medical emergencies. The male and those who have attained a higher education degree are well prepared to manage common medical emergencies. Although they have a high level of preparedness, their seminars and expertise must be improved.

Perception of Dental House Officers Regarding the Management of Medical Emergencies in CMH Lahore Medical College &amp; IOD

Objective: The main purpose of this study is to assess the knowledge, attitude, experience, and perception about the management of medical emergencies in dental clinics amongst house officers at CMH LMC &amp; IOD. Study Duration: This questionnaire-based descriptive cross-sectional study was conducted between May 2022 and June 2022 at CMH Lahore Medical College and Institute of Dentistry. Material &amp; Methods: A previously tested questionnaire comprised of three parts was used for data collection. A total of 62 house officers were present. All of them responded to the questionnaire. The questionnaire consists of three sections; Section A: Contains the questions related to the understanding of the dental house officers in managing medical emergencies. Section B: Includes the evaluation of experiences and skills they have in managing medical emergencies if it occurs in dental clinics. Section C: Includes their perceptions related to the betterment of emergency management was evaluated. Data was analyzed using IBM SPSS Version 24. Data was analyzed using IBM SPSS Version 24. Results: Concerning Basic life support training, 64.5% had been given training during house job only. At least 67.7% of House officers came across 1-5 medical emergencies during their house job. Syncope was one of the most common (62.9%). Hypoglycemia was the second most common (35.5%) and asthma was reportedly the third most common medical emergency (1.6%). When facing a medical emergency, 90.3% report that they seek help. 96.8% reported that they can take a patient’s blood pressure, 72.4% can take a patient’s pulse, 27.4% can measure blood sugar level, only 38.7% can maintain an IV line, 41.9% can perform the Heimlich maneuver, 53.2% can carry out ventilation through a bag or mask and 35.5% are capable of performing CPR. Only 3.2% of house officers believe that their undergraduate training is sufficient to prepare them to manage medical emergencies. Though, 71.0 % think that house officers should undertake medical emergency training before starting their house job. Practical implication:There is scarcity of literature on how prepared dental house surgeons are to deal with medical emergencies so this study give future directions to dental house surgeons. Conclusion: It was concluded that practical training is lacking among dental house officers in managing medical emergencies and that there is a need to not only include medical emergency training at the undergraduate level but also allot a rotation to medical emergencies at the start of the house job. Keywords: Dental house officers, medical emergencies, management, training

Preference reversals in dynamic decision‐making under uncertainty based on regret theory

AbstractThis research aims at preference reversals in dynamic adjusting decisions made by decision‐makers who have regretful emotions. Our model incorporates a utility function that includes the regretful feeling into outcomes under uncertainty. Then, by using the process of backward induction, it analyzes differences in the decisions of three types of decision‐makers with perfect rationality, partially anticipated regret, and fully anticipated regret. Finally, we apply this dynamic adjusting model to emergency plans in which decision‐makers need to choose the best action from multiple selections quickly to reduce the loss caused by disaster incidents and uncertainty. This model allows to compare decisions made by rational and irrational agents, which is a more realistic estimate and measure of several applications in the real life, such as medical services and emergency management.

Easing the Transition From Medical School to Residency: Using Deliberate Practice to Improve Senior Medical Students' Performance Responding to Urgent Pages From Registered Nurses.

Purpose: New interns are expected to perform initial evaluation and management of medical emergencies for hospitalized patients, 1 yet many are unprepared to care for such patients. 2 To address this gap, we designed a specialty-specific simulated paging curriculum based on Ericsson’s model of deliberate practice 3 for senior medical students. The purpose was to assess whether this curriculum leads to improved performance handling specialty-specific medical emergencies. Approach: Graduating senior medical students enrolled in 1 of 6 required specialty-specific residency preparation courses (emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, and procedures) in 2020 and 2021 participated. Students received an electronic handover with information about simulated patients. Throughout the course, students received 4–6 urgent pages about these patients that were specific for each specialty (e.g., atrial fibrillation case in internal medicine course, postoperative pain case in procedures course). Upon receiving each page, students called a standardized registered nurse (SRN) who used a script to answer questions about the patient. Students explained next steps in evaluation and management. Immediately after the page was complete, the SRNs delivered verbal feedback about performance. Students also received written feedback by the SRNs within the week. Additionally, the gold standard approach to the case was reviewed with the class by course instructors. Clinical performance was graded by SRNs using a predefined weighted rubric for each case. The rubric consists of “must do” (+2 points), “should do” (+1 point), “could do” (0 points), “should not do” (−1 point), or “must not do” (−2 points) diagnostic, therapeutic, and communication items. 4 “Must do” items represented the most critical actions for new interns to take. Each rubric was based on clinical guidelines and was reviewed by at least 2 faculty members. All variables were analyzed using descriptive statistics including medians and proportions overall and by specialty. Continuous variables were expressed using median and interquartile range. The relationship between clinical performance scores and case number was evaluated with the Jonckheere–Terpstra test. Outcomes: There were 1,403 pages sent to 265 students (84.1%) during the study period. Clinical performance improved over time from median (interquartile range) of 59.4% (46.9%, 75.0%) on case 1 to 80.0% (68.0%, 86.7%) on case 6 (P < .001). The proportion of “must do” items improved significantly from 69.2% (53.8%, 81.8%) to 80.0% (66.7%, 88.9%) (P < .001). Discussion: This novel simulated paging curriculum allowed senior medical students to practice and improve handling medical emergencies in a safe setting before entering the clinical setting as a resident. The highly realistic scripts and guideline-based scoring rubrics cover common intern-level patient care scenarios, representing content validity. Limitations include that this was a single-institution study and thus may not be generalizable to courses at other institutions. Additionally, the cases were different throughout the RPCs with varied case order and difficulty which limits analysis. Significance: The Coalition for Physician Accountability’s Undergraduate Medical Education-Graduate Medical Education Review Committee recently advised that specialty-specific just-in-time training is necessary for all incoming first-year residents and that meaningful assessment data be collected about each graduate to help serve as a baseline and inform tailored learning plans. 5 Our curriculum achieves both of these objectives by providing advanced specialty-specific training and also collecting valuable assessment information. To our knowledge, this is the only paging curriculum that has demonstrated evidence for students entering multiple specialties. This curriculum could be easily expanded to other medical schools as well as residency programs as the cases are administered by phone and the grading is electronic. Given how common these paging scenarios are for new interns, this curriculum fills an important gap in the transition to residency.

Evaluation Of Cardiovascular Stress And Mental Workload During Simulated Casualty Evacuation (CASEVAC) Medical Scenarios

Service members injured on the battlefield are treated and stabilized by medical providers such as Navy Hospital Corpsmen (HMs) and Search and Rescue Medical Technicians (SMTs). Emerging military strategies have increased reliance on the MV-22 Osprey aircraft to transport injured warfighters from the battlefield to higher levels of care. Unique design and flight dynamics of the MV-22 may introduce substantial environmental and ergonomic barriers to providing high-quality care while en route. This work assesses performance and stress responses of HMs and SMTs during medical scenarios in an MV-22 simulator. PURPOSE Determine performance, cardiovascular stress, and mental workload while providing medical care in an MV-22 fuselage. METHODS Fourteen medical providers (7 HMs, 7 SMTs; mean ± SD age: 27 ± 6 yrs; ht: 177 ± 10 cm; wt: 84.0 ± 14.1 kg) completed two scenarios requiring recognition and management of medical emergencies on a high-fidelity mannequin. Scenarios occurred in a quiet room with ample space, lighting, and comfortable temperature (CON) and in an MV-22 with confined space, noise (105 dB), low light, and temperature variations (21-33°C;OSP). Heart rate (HR) was measured during each scenario while medical experts evaluated participants’ medical performance. Mental workload was assessed using the NASA Task Load Index. Considering training duration between HMs (10 weeks) and SMTs (50 weeks), a mixed-design analysis of variance was used to compare HM and SMT responses between CON and OSP. Significance was set at p < 0.05. RESULTS Medical performance was lower in OSP (mean ± SD: 55 ± 22%) compared with CON (68 ± 15%; p < 0.01). SMT performance was superior to HM in CON (SMT: 77 ± 11, HM: 59 ± 13%; p < 0.01) but not in OSP (p = 0.147). HR was lower in OSP (134 ± 19 bpm) compared with CON (146 ± 21 bpm; p < 0.001). In CON, SMTs had lower HR (135 ± 18 bpm) compared with HMs (157 ± 18 bpm), but similar HR was observed in OSP (p = 0.068). Mental workload was not different between CON and OSP (p = 0.176) or SMTs and HMs (p = 0.151). CONCL Findings suggest that performing simulated medical care in the MV-22 deteriorates performance with no appreciable increases in cardiovascular stress or mental workload between SMTs or HMs. This information is critical to military commands and leadership who oversee medical operations for the Department of Defense.

Differences in the pre-hospital management of women and men with stroke by emergency medical services in New South Wales.

ObjectivesTo examine whether pre‐hospital emergency medical service care differs for women and men subsequently admitted to hospital with stroke.Design, setting, participantsPopulation‐based cohort study; analysis of linked Admitted Patient Data Collection and NSW Ambulance data for people admitted to New South Wales hospitals with a principal diagnosis of stroke at separation, 1 July 2005 – 31 December 2018.Main outcome measuresEmergency medical service assessments, protocols, and management for patients subsequently diagnosed with stroke, by sex.ResultsOf 202 231 people hospitalised with stroke (mean age, 73 [SD, 14] years; 98 599 women [51.0%]), 101 357 were conveyed to hospital by ambulance (50.1%). A larger proportion of women than men travelled by ambulance (52.4% v 47.9%; odds ratio [OR], 1.09; 95% CI, 1.07–1.11), but time between the emergency call and emergency department admission was similar for both sexes. The likelihood of being assessed as having a stroke (adjusted OR [aOR], 0.97; 95% CI, 0.93–1.01) or subarachnoid haemorrhage (aOR, 1.22; 95% CI, 0.73–2.03) was similar for women and men, but women under 70 years of age were less likely than men to be assessed as having a stroke (aOR, 0.89; 95% CI, 0.82–0.97). Women were more likely than men to be assessed by paramedics as having migraine, other headache, anxiety, unconsciousness, hypertension, or nausea. Women were less likely than men to be managed according to the NSW Ambulance pre‐hospital stroke care protocol (aOR, 0.95; 95% CI, 0.92–0.97), but the likelihood of basic pre‐hospital care was similar for both sexes (aOR, 1.01; 95% CI, 0.99–1.04).ConclusionOur large population‐based study identified sex differences in pre‐hospital management by emergency medical services of women and men admitted to hospital with stroke. Paramedics should receive training that improves the recognition of stroke symptoms in women.

Simulation-based randomized trial of medical emergency cognitive aids

BackgroundMedical emergencies are complex and stressful, especially for the young and inexperienced. Cognitive aids (CA) have been shown to facilitate management of simulated medical emergencies by experienced teams. In this randomized trial we evaluated guideline adherence and treatment efficacy in simulated medical emergencies managed by residents with and without CA.MethodsPhysicians attending educational courses executed simulated medical emergencies. Teams were randomly assigned to manage emergencies with or without CA. Primary outcome was risk reduction of essential working steps. Secondary outcomes included prior experience in emergency medicine and CA, perceptions of usefulness, clinical relevance, acceptability, and accuracy in CA selection. Participants were grouped as “medical” (internal medicine and neurology) and “perioperative” (anesthesia and surgery) regarding their specialty. The study was designed as a prospective randomized single-blind study that was approved by the ethical committee of the University Duisburg-Essen (19-8966-BO). Trial registration: DRKS, DRKS00024781. Registered 16 March 2021—Retrospectively registered, http://www.drks.de/DRKS00024781.ResultsEighty teams participated in 240 simulated medical emergencies. Cognitive aid usage led to 9% absolute and 15% relative risk reduction. Per protocol analysis showed 17% absolute and 28% relative risk reduction. Wrong CA were used in 4%. Cognitive aids were judged as helpful by 94% of the participants. Teams performed significantly better when emergency CA were available (p < 0.05 for successful completion of critical work steps). Stress reduction using CA was more likely in “medical” than in “perioperative” subspecialties (3.7 ± 1.2 vs. 2.9 ± 1.2, p < 0.05).ConclusionsIn a high-fidelity simulation study, CA usage was associated with significant reduction of incorrect working steps in medical emergencies management and was characterized by high acceptance. These findings suggest that CA for medical emergencies may have the potential to improve emergency care.

Challenges of Management and Outcome of Neonatal Medical Emergencies in a Peripheral Hospital, Bangladesh

Background: Respiratory distress and desaturation remains a significant cause of neonatal intensive care admission ,althoughmanagement has evolved gradually over the years resulting in improving survival for the these neonates . Still 10% of neonatesrequire respiratory support immediately after delivery due to respiratory disorder, and up to 1% of neonates are in need ofresuscitation. Objectives: The aim of the study is to present some fundamental steps of emergency neonatal management which includerapid identification and admission , followed by assessment for respiratory distress, hypoxemia and hypoglycemia ,initialstabilization when required and early administration of medications. Methods: This hospital based retrospective study was conducted at Combined Military Hospital ,sylhet ,Bangladesh fromApril 2021 to September 2022 .A total 224 sick neonates shortly after delivery included for this study. Results: From April ,2021 to september 2022, 917 newborn were born, of which 224 neonates were identified and admitted as a emergency cases immediate after delivery at combined military hospital,sylhet .Immediately after admission around allcases were assessed for hypoxemia ,hypoglycaemia and hypothermia.Around 66% were hypoxemic (preterm 71.4% ,22.3%in full term and 6.2% in post term ).There was male predominance 55% .Respiratory distress syndrome (RDS ) was found to bethe commonest 35.7% causes followed by persistent pulmonary hypertension with large patent ductus arteriosus(PPHN withPDA) 17.8% ,septicemia 16.9% ,meconium aspiration syndrome (MAS) 8.9%, transient tachypnea of newborn (TTN) 8%,congenital pneumonia 4.9% ,perinatal asphyxia (PNA) 3.5% , large atrial septal defect (ASD) with ventricular setal defect(VSD) 2.6% and 1.75% was hypoglycemic .All babies received immediately oxygenation . Bubble CPAP was required in 90(40.1%) cases. Vascular access was established in all cases and 2.6% neonates received medications bycentral (femoral) line.Mortality was 2( 0.8%) in neonates with respiratory distress due to respiratory distress syndrome with multiple congenitalanomalies . 2(0.8%) cases referred to tertiary hospital (Combined Military Hospital,Dhaka ) requiring mechanical ventilation. Conclusion: Early and appropriate treatment seeking is one of the most important aspects for interrupting the pathways to neonatal deaths due to severe illness. In developing countries, the role of Paediatrician is multidimensional . paediatrician by early detection of risk factors and timely intervention can reduce significantly neonatal mortality rate.

Editorial 2022

The prevention, diagnosis, and management of medical emergencies are of utmost importance in the practice of dentistry. Dental students and dental surgeons must be well trained and prepared to manage all possible medical emergencies in their daily professional practices. The team must be competent and confident in handling the initial basic emergency treatment with quality. Proper management of life-threatening medical emergencies may lead to the prevention of possible death and complications. This may also avert the psychological trauma that the healthcare professional may go through and the stigma attached to the hospital or clinic. Besides that, the ethical and legal implications of medical emergencies related to the obligations of the healthcare practitioner cannot be overlooked. The teaching of medical emergencies in our dental schools starts at the pre-clinical undergraduate level. However, the program is not well structured. Despite the consensus on the importance of training in medical emergencies, several international studies show unsatisfactory results by demonstrating low knowledge and confidence of professionals in managing medical emergencies and first aid. As a result of these international research findings, there has been aparadigm shift in teaching undergraduate students in most developed countries. The fundamental change in the approach now is emphasizing on a more competency-based curriculum and more hands-on teaching. Hence the need for a revision and inclusion of medical emergencies in our curricula in Ghana.

Awareness of medical emergencies and preparedness of undergraduate clinical dental students in a tertiary institution in Nigeria

Background : Medical emergency can be described as an unwanted, unexpected reaction or complication which usually requires immediate attention or intervention. Aim: This study aims to assess awareness and preparedness for medical emergencies amongst undergraduate clinical dental students at the University of Benin, Nigeria.Materials and Methods : A descriptive cross-sectional study involving all clinical dental students in the School of Dentistry, University of Benin. The questionnaire was divided into three main sections: Socio-demographic characteristics of the respondents; Selfassessed medical emergency preparedness among the respondents; Self-evaluation of knowledge of specific medical procedures about medical emergencies.Results : The age of the respondents ranged from 19 to 31 years, with a mean age of 24.49 ± 3.1 years. A higher proportion of the respondents were male (47; 72.3%). Seventy-two percent of students adequately assessed the patient’s medical history, but only 40.0% regularly used medical Pro-forma to obtain the patients' health history. About 41.5% of the students had poor knowledge about medical emergencies, while 43.1% had adequate knowledge. Only 15.4% of the students had good knowledge.Conclusion : The study showed that only 15.4% of the students had good knowledge of handling medical emergencies, although 69.2% of the dental students specified good emergency preparedness. The findings point to a deficiency in the dental students’ curriculum regarding medical emergencies, which makes them inadequately prepared to handle them. This emphasizes the need for a review of clinical dental students’ curricula to introduce the management of medical emergencies.

The Effect of Dark Personality Traits (Machiavellianism, Narcissism and Antisocialism) on Organizational Misconduct by Explaining the Mediating Role of Organizational Mindfulness

Complete Article Title: The Effect of Dark Personality Traits (Machiavellianism, Narcissism and Antisocialism) on Organizational Misconduct by Explaining the Mediating Role of Organizational Mindfulness (A study on the Field of Disaster and Emergency Medical Management - Lorestan's 115 Emergency)&#x0D; Background: Organizational misconduct as a destructive or negative phenomenon has challenged common social values, norms and organizational expectations. Therefore, the study of predictors of organizational misconduct, with the aim of reducing the effect of unpleasant personality traits of employees by directing employees towards behavioral standards, policies and organizational strategies in health care systems seems necessary. Therefore, in this study, dark personality traits and organizational mindfulness were investigated to reduce organizational misconduct.&#x0D; Methods: The present cross-sectional study was conducted with the structural equation modeling approach in 2021. The target population was the staff of the 115 Emergency from Medical Emergency Management Department of Lorestan. The sample size was calculated 217 based on Krejcie-Morgan table. Divergent and convergent validity were used to determine the validity of the structures, and Cronbach's alpha coefficient and combined reliability were used to determine the reliability of the instrument. Data analysis was done using structural equation modeling through SPSS 23 and Smart PLS 3.5 softwares.&#x0D; Results: Findings showed that dark personality traits with the significant value of 6.232 and path coefficient of 0.401 had a positive and significant effect on organizational misconduct and with the significant level of 8.741 and path coefficient of - 0.455, it had a negative and significant effect on organizational mindfulness. Organizational mindfulness with a significant level of 5.187 and the path coefficient of - 0.373 had a negative and significant effect on organizational misconduct. Moreover, organizational mindfulness with direct impact factor of - 0.455 , indirect impact factor of - 0.373, direct significance level of 5.187, and indirect significance of 8.741 (- 1.96 &lt; t &lt; 1.96) determines the mediating role between dark personality traits and organizational misconduct. The quality of the final research model with GOF index (0.379) had a suitable fit.&#x0D; Conclusion: Given the significant role of dark personality traits and organizational mindfulness in relation to predicting organizational misconduct of the employees, while identifying and managing these traits, it is suggested that the managers of 115 emergency medical services in Lorestan, prevent the intentional violation of organizational norms by employees through strengthening the organizational mindfulness of employees.