Skills In Emergency Situations Research Articles

Augmented reality simulation-based training for midwifery students and its impact on perceived knowledge, confidence and skills for managing critical incidents

ProblemEmergency obstetric management is essential in midwifery training to prevent fetal and maternal morbidity. Repeating this management in practice is often not possible. Sustainable confidence in these procedures is usually achieved in the first few years of practice. BackgroundSimulation training complements hands-on learning and improves practical skills, benefiting both students and patients. Research on obstetric emergency simulation training have demonstrated this, but the use of digital simulation approaches, such as augmented reality (AR), is under-researched. AimTo investigate whether AR simulation training influences midwifery students' subjective perceptions of knowledge, confidence and practical skills in emergency situations. MethodsA descriptive exploratory study was conducted using a pre-post design. AR scenarios were developed on the topics of 'preparing emergency tocolysis', 'preparing a pregnant woman for caesarean section' and ‘resuscitation of newborns'. The AR simulation was conducted in the fourth to fifth semester of the midwifery programme. A questionnaire was developed for students (N = 133) to self-assess their competence in the categories of knowledge, confidence and practical skills. ResultsStudents rated their competence significantly better in the post-survey than in the pre-survey (p=<0.05). Simulation has an impact on self-assessment of professional knowledge, confidence and practical skills in emergency situations. It enhances students' procedural knowledge and practical skills in complex contexts, complements subject knowledge and builds confidence. ConclusionThe results provide initial evidence that AR simulation is an effective learning strategy for emergency management preparedness. Future studies should validate the effect with control cohorts and measure competence through practical examinations.

Emergency Response Time and Its Determinants in the Quick Response Team in Surabaya, Indonesia

Introduction: The response time in handling prehospital emergencies has not been fully optimal so that people still complain about it. Appropriate response time will reduce mortality and morbidity rates so that patient satisfaction can be met. The aim of this study was to describe the emergency response time and its determinants in the Quick Response Team (it is called “Tim Gerak Cepat”) Surabaya. Methods: This research was a descriptive research design with a cross sectional approach. The population of the study were all nurses in Tim Gerak Cepat (TGC) at the Integrated Command Post Surabaya totaling 126 nurses and a sample of 96 respondents were taken by purposive sampling. The variables were abilities, skills, education, emergency training, length of service, and motivation of nurses as well as the response time in handling emergencies. Collecting data using a questionnaire and presented in descriptive analytics. Results: The research results showed that the majority of respondents had high abilities (90.6%) and skills (93.8%). The majority of respondents had achieved a third diploma (D3) in nursing (82.3%) and had undergone basic emergency training (88.5%). Furthermore, more than half of the respondents had worked for more than 3 years (68.7%) and showed moderate motivation (51%). In general, the majority of respondents had a response time of ≤ 8 minutes (79.2%). Conclusion: Nurses at TGC Surabaya actually have a good response time. This is supported by high capacity and skills in emergency situations, as well as educational background, including emergency training. But nurses still need to increase self-motivation. Further research can explore further what are the priority determining factors for emergency response time, especially in Surabaya as the 2nd largest city in Indonesia, in order to assist the government in making the best setting and organization at TGC Surabaya.

Mixed Reality–To Better Prepare Medical First Responders for Mass-Casualty Incident Response

Introduction:Mass-casualty incidents (MCI) featuring a large number of injured persons caused by human-made or by natural disasters are increasing globally. During these incidents, medical first responders (MFR) need to take appropriate action that saves lives. In this context, the adage “practice makes perfect” is befitting to MCI training. However, providing large-scale MCI training is often difficult due to the significant effort required to create these types of exercises. Drawbacks include a large number of actors needed to portray victims, availability of infrastructure, and realistic treatments. Virtual Reality (VR) has been demonstrated in several domains to be a serious alternative, and in some areas also a significant improvement to conventional training. As an advanced alternative to VR, Mixed Reality (MR) have the potential to provide a dynamic simulation of an VR environment and hands-on practice on injured victims.The aim is: 1) to present insights of a newly developed MR training system for increasing MCI preparedness and 2) discuss pedagogical aspects e.g. how the intended learning outcomes are perceived in MR training, how the participants experience the learning in MR training, and what impact MR training will have in their future work practice.Method:An MR training system, designed for teams of up to four MFRs to perform training in real-time, will be pilot-tested at the beginning of 2023. The system features a fully functional touch-enabled human manikin design for practicing skills in emergency situations. The pilot tests will be carried out within the Med1stMR project (https://www.med1stmr.eu/) where approximately four teams of MFR will be evaluated based on the intended learning outcome.Results:Preliminary results from the pilot tests will be available at the conference.Conclusion:Research is needed to strengthen the knowledge and impact of MR training as a pedagogical method to better support MCI training and preparedness.

Artificial intelligence in a communication system for air traffic controllers' emergency training

In the last few years, there has been a lot of research into the use of machine learning for speech recognition applications. However, applications to develop and evaluate air traffic controllers' communication skills in emergency situations have not been addressed so far. In this study, we proposed a new automatic speech recognition system using two architectures: The first architecture uses convolutional neural networks and gave satisfactory results: 96% accuracy and 3% error rate on the training dataset. The second architecture uses recurrent neural networks and gave very good results in terms of sequence prediction: 99% accuracy and 𝑒 −7% error rate on the training dataset. Our intelligent communication system (ICS) is used to evaluate aeronautical phraseology and to calculate the response time of air traffic controllers during their emergency management. The study was conducted at International Civil Aviation Academy, with third-year air traffic control engineering students. The results of the trainees' performance prove the effectiveness of the system. The instructors also appreciated the instantaneous and objective feedback.

Driving concerns among older adults: Associations with driving skill, behaviors, and experiences

Objectives: The purpose of this investigation was to determine what older adults find most concerning about driving as they age and how these concerns are related to driving skill, behaviors, and experiences.Methods: In partnership with the Maryland Motor Vehicle Administration, a sample of 751 older adults ages 65 and older completed an online survey between October 2017 and May 2018. A content analysis was used to code open-ended responses about driver concerns, and multivariate logistic regression models were used to analyze the associations between driving concerns and driving skill, behavior, and experiences.Results: Eighty-four percent of participants reported at least one driving concern, with 44% concerned about others’ driving, 34% concerned about their own driving, and 24% concerned about driving conditions. The most frequently mentioned driving concerns were other drivers in general, driving at night, visual ability and awareness, and other drivers being aggressive or reckless. Being concerned with their own driving was significantly associated with decreased perceived driving skill and increased odds of experiencing negative driving experiences in the past year. Being concerned about others’ driving was associated with increased odds of wearing a seat belt (adjusted odds ratio [AOR] = 2.67; 95% confidence interval [CI], 1.02, 7.00), having high perceived driving skills in emergency situations (AOR = 1.56; 95% CI, 1.14, 2.12), and getting in a near crash or collision in the past year (AOR = 1.50; 95% CI, 1.04, 2.18).Conclusions: Older adult drivers are frequently concerned about their own driving as well as the driving of others. Implications for future research and health practice are discussed.

Could Hong Kong Primary Schoolchildren be Taught to Perform Compression-Only CPR: A Pilot Study

Objective To evaluate whether Hong Kong primary schoolchildren could be taught to perform compression-only CPR. Design Prospective experimental trial Subjects Primary schoolchildren of age 9-12 years old from different Cub Scout packs attended a 2 hour voluntary compression-only CPR training session between late 2014 and mid-2015. Main outcome measures Cardiopulmonary resuscitation (CPR) knowledge in the format of pre- and post-test multiple choices questions (MCQ). Psychomotor skills assessment including correct hand position, compression depth, compression rate and chest wall recoil between each compression. Results A total of 112 primary schoolchildren attended the training session, in them 72% were boys. Pretest score and post-test score was 2.81/5 and 4.82/5, respectively. The difference was statistically significant (p&lt;0.05). About 96% of subjects had correct hand position at all time during CPR. Mean compression rate was 119/minute. Mean compression depth was 3 cm. About 47% of subjects had 100% complete recoil of chest wall following compression. Conclusion Primary schoolchildren above 9 years old are able to acquire essential knowledge and skills in compression-only CPR. Their physical strength may limit their ability to perform effective chest compression; it is still worthwhile to advocate CO-CPR education in primary schoolchildren in Hong Kong in order to raise their interest in this life saving skills and to equip them with essential cognitive skills in emergency situations. To achieve optimal cost-effectiveness and a compression depth of at least 4 cm, body weight of 53 kg or above should be considered as a selection criterion.

Pediatric advanced life support and sedation of pediatric dental patients.

Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

Effect of non-technical skills teaching on performance – An evaluation of additional non-technical skills teaching in Resuscitation Council ALS course

Sudden cardiac arrest remains the most common cause of cardiovascular death in the world. The delivery of timely and high quality cardiopulmonary resuscitation (CPR) is the key to patient survival. Observational studies have consistently demonstrated that quality of CPR delivered in training and in the clinical setting is substandard. Tremendous effort has been put into training healthcare providers in performing high quality CPR. Advanced life support (ALS) is now a core competency in both undergraduate and postgraduate medical training. ALS encompasses simple technical skills such as chest compression and ventilation and more complex technical skills such as the safe delivery of an appropriate defibrillating shock. Non-technical skills describe situational awareness, decision making, task management, leadership and team working. The importance of non-technical skills in emergency situations is now widely accepted across many acute medical specialties including resuscitation. A survey of advanced life support trained doctors revealed many did not feel ready to lead a cardiac arrest and did not feel equipped with adequate leadership skills. Simulation studies have found that competent ALS providers often lacked leadership attributes such as task allocation, effective communication. Previous research has demonstrated that leadership behaviour is correlated with quality of CPR, with shorter hands off time, pre-shock pauses and time to first shock. Understanding and improving non-technical skills may help to reduce errors, create more effective teams and improve patient outcome. In 2014, the ALS course will be updated with additional non-technical skills teaching in both online and face to face teaching. The planned launch of the updated ALS course in 2014 presents a unique opportunity to evaluate the impact of additional non-technical skills training on non-technical and technical skill performance compared to standard ALS course.

Advanced teamworking in emergency surgical situations: Improving patient safety through the design of a multi-professional, multi-disciplinary course focusing on non-technical skills

Advanced teamworking in emergency surgical situations: Improving patient safety through the design of a multi-professional, multi-disciplinary course focusing on non-technical skills

Cricothyrotomy performed with the MelkerTM set or the QuickTrachTM kit: procedure times, learning curves and operators� preference

Cricothyroidotomy is a surgical airway technique in which an airway device is inserted into the trachea through an incision made at the cricothyroid membrane. It is used for the management of the "difficult airways" and may be a lifesaving procedure in "can't intubate, can't oxygenate" situations. However, many healthcare professionals working in emergency settings have little of no experience with this procedure. Achievement of theoretical and practical knowledge of different cricothyrotomy techniques is therefore a fundamental prerequisite for those healthcare professionals. In this study, 40 volunteers representative of different categories of healthcare professionals were enrolled for the theoretical and practical 1-day training course on cricothyrotomy. Two commercially available device for cricothyrotomy were used during the course, the Melker™ set, which involves the Seldinger technique, and the QuickTrach™ kit, which does not rely on the use of a guide-wire. Each participant performed a series of 5 attempts on a manikin with each kit. Procedure time was recorded, and satisfaction with the course, preference for each cricothyrotomy kit and self-rating of cricothyrotomy skills were assessed by a self-administered questionnaire. Mean procedure time significantly decreased from the first to the last attempt (48.7±21.9 and 27.8±13.7 seconds, respectively; p<0.0001). The Melker™ set was the most preferred, being rated as "excellent" by 62% of participants. This preference was even more pronounced among anaesthesiologists, that are more familiar with the Seldinger technique. Participants' satisfaction was high: the course was rated as "excellent" by 66.7% of attendees, the theoretical and practical knowledge achieved was rated as "very useful" by 94% of all attendees and by 100% of the anaesthesiologists. A systematic approach to teach healthcare professionals in the application of various devices for the management of the socalled "difficult airways" may maximize intubation success and minimize complication. The present study provides evidence for the efficacy of training courses in Emergency Departments aimed at improving theoretical and practical cricothyrotomy skills in emergency situations.

The role of information technology in maritime education for hazard avoidance

Maritime transport is an important aspect of the economy of every maritime state and this needs safety and efficiency. It is well known that one of the major factors of accident prevention is perfect theoretical and practical knowledge, which can help reduce accidents at sea and in harbours, ship collisions and sinking and loss of human lives and protects the environment. There are many different tools and systems used to satisfy these demands. Our forefathers have sailed using paper charts and sextants; today we use radar, Automatic Radar Plotting Aid (ARPA), Global Positioning System (GPS), nautical charts and publications. This study provides an experience of teaching graduate students how new technologies and techniques (Petri nets, genetic algorithms) have been applied. All these are very effective for improving engineers' and officers' management experiences and operational skills in emergency situations. But the cadets who lack practical experience have to spend most of their time learning theoretical courses on land. To meet the challenge of modern maritime development, the responsibility of education is to produce a great number of talents with ideas and work abilities. This paper's conclusion is that the use of interactive computer simulations in maritime education results in increased emergency preparedness, which consequently leads to hazard mitigation and reduces the risk of human error in the operation and maintenance of marine equipment.

Perceived Self-Efficacy in Performing Lifesaving Skills: An Assessment of the American Red Cross's Responding to Emergencies Course

The purpose of this study was to assess the effects of the American Red Cross (ARC) Responding to Emergencies course on college students' perceived ability and willingness to perform lifesaving skills in emergency situations. A total of 214 male and female undergraduate college students who were enrolled in 12 classes of the ARC Responding to Emergencies course at a midwestern university completed pretest and posttest surveys. Surveys were completed prior to instruction and on completion of the course and skills training (approximately 8 weeks later). Results show that the course was highly effective in improving students' perceived self-efficacy of performing lifesaving skills. Pretest-posttest differences were significant for all items on the self-efficacy subscales except the outcome values for rescue breathing and control for severe bleeding. The course was also effective in reducing the impact of barriers on students' willingness to perform lifesaving skills. Bandura's self-efficacy model was useful in predicting students' willingness to perform lifesaving skills. The course was effective in increasing students' perceived efficacy expectations, outcome expectations, and outcome values for performing lifesaving skills and thus has the potential to increase emergency response rates of persons trained in first aid and cardiopulmonary resuscitation. Program implications and recommendations for future studies are offered.