Emergency Training Research Articles

An environmental scan of emergency medicine research support, training, and infrastructure across Canada.

Our study objective was to describe the Canadian emergency medicine (EM) research community landscape prior to the initiation of a nationwide network. A two-phase electronic survey was sent to 17 Canadian medical schools. The Phase 1 Environmental Scan was administered to department chairs/hospital EM chiefs, to identify EM physicians conducting clinical or educational research. The Phase 2 Survey was sent to the identified EM researchers to assess four themes: 1) geographic distribution, 2) training/career satisfaction, 3) time/financial compensation, and 4) research facilitators/barriers. Descriptive analyses were conducted, and results were stratified by Canadian regions. A total of 92 EM researchers were identified in Phase 1; 67 (73%) responded to the Phase 2 Survey. Of those, 42 (63%) reported being clinical researchers, and 19 (45%) had a graduate degree. Three provinces encompassed most of the researchers (n = 35). Of the respondents, 61% had a research degree, 66% felt adequately trained for their research career, 73% had financial support, 83% had access to office spaces, 52% had no mentor during their first years of their career, 69% felt satisfied with their research career, and 82% suggested that they will still be conducting research in 5 years. EM researchers reported being adequately trained, even though only a little over half had a graduate degree. Only two-thirds had financial support, and mentorship was lacking in one-third of the participants. Not all respondents had a form of infrastructure, but most felt optimistic about their careers. The Canadian EM research environment could be improved to ensure better research capacity.

Türk spor bilimleri fakültesi öğrencileri dental travma ve ağız koruyucular hakkında ne biliyor? Tanımlayıcı bir araştırma

Objective: Sports-related dental-orofacial-injuries can be reduced significantly through training on primary prevention and using proper equipment before engaging in sporting activities. This study aimed to determine the level of knowledge regarding dental trauma and prevention by mouthguards among the students in the Faculty of Sport Sciences. Materials and Method: This was a descriptive study conducted at Ankara, Gazi, and Hacettepe Universities. Although intended to include all students at the faculties (N=3097), only those who were at the faculty and volunteered (28.2%) on the day the data were gathered participated. Data were gathered via a questionnaire comprising 31 questions on sociodemographic characteristics, dental trauma history, mouthguard use, and knowledge of dental trauma. Results: In total, 875 students with a mean age of 22.5±2.9 (60.3% male) participated. Of these students, 20.6% had dental trauma history, 72.0% had first aid and emergency training, and 20.9% had oral dental injuries training. Of the students, 69.5% had heard about mouthguards, although only 19.7% of these had used them. Mouthguards were mostly used in professional sports activities such as far-eastern sports and ice hockey. The average number of true answers out of ten dental trauma-related questions was 2.75±1.68 and 66.6% stated they wished to learn more about the topic. Conclusion: Results showed a lack-of-knowledge about both dental trauma and mouthguards and inadequate use of mouthguards in sports activities. Therefore, basic information about these topics should be implemented in the curriculum to instruct students before they graduate.

P031: Multidisciplinary healthcare and first aid provider training for in-flight medical emergencies: a crowdsourcing session followed by an airplane simulation

Innovation Concept: Is there a healthcare provider on board? Healthcare providers may be less confident for in-flight medical emergencies (IFME), as these situations are not part of usual curriculum or practice contexts (e.g. hospitals). For example, the literature reveals that medical students and physicians lack IFME basic knowledge and preparedness. The goal is to pilot a training session for healthcare providers to improve their confidence in navigating IFME. Methods: This training innovation involved: i) a session to crowdsource insights from multidisciplinary healthcare and first aid providers, followed by reviewing considerations of a CMAJ 2018 article on airplane emergencies, and ii) 2 airplane simulations (syncope and cardiac arrest). During crowdsourcing, 7 IFME learning objectives were explored: i) challenges, ii) solutions, iii) equipment, iv) taking vitals, v) general approach, vi) cardiac arrest approach, and vii) human resources / role-delegation. Knowledge and approaches extracted were then applied in simulations. Participants provided scores out of 7.00 for: i) satisfaction of crowdsourcing session and simulation and ii) self-rated confidence on learning objectives at baseline, post-crowdsourcing session, and post-simulation. Results were analyzed with repeated measures ANOVA with post-hoc Tukey. Curriculum, Tool, or Material: The workshop curriculum was a crowdsourcing session and simulation to mentally rehearse and practice clinical skills in airplane settings to improve IFME preparedness. Conclusion: Participants rated the crowdsourcing activity (6.70/7.00, n = 11) and simulation (6.50/7.00, n = 11) positively. Confidence in the 7 topics improved from baseline (2.49/7.00) to post-crowdsourcing (5.23/7.00) to post-simulation (5.94/7.00). Significant differences (p < 0.01) between baseline and post-crowdsourcing, and between baseline and post-simulation were observed. There was no significant difference between post-crowdsourcing and post-simulation. One simulation limitation was not all could be rescuers; therefore, debriefing is important to meet learning objectives. Second, the simulation was not within an airplane; housing simulations inside an airplane with flight attendants is a potential next step. Overall, self-confidence in topics of IFME may improve after just one crowdsourcing session, facilitated through group discussions and mental rehearsal. Added simulations may maintain self-confidence on these topics, by promoting memory retention through active learning and repetition.

Study on Development of Fire Fighting Training System for Aircrafts Using Light

The cabin crew plays a very important role in ensuring safe flight operations and quality services. In particular, it is their responsibility to successfully implement emergency evacuations of passengers in the event of an emergency. As a result, cabin crews undergo intense emergency training. In order to support firefighter training of cabin crews, this study investigated the method of firefighter training that can be easily carried out in small spaces in the office or indoor spaces without water supplies and drainages using light as an aircraft fire suppression training device. The fire suppression training device using the light presented in this study consists of a screen part, fire extinguisher part, and control part. The flame images classified as per the fire causes are displayed on the screen by using visible light, and it is set to correspond to each fire cause. Fire extinguishing drills can be conducted using fire extinguishers that emit infrared light in a specific wavelength band.

A GIS Based University’s Campus Evacuation Plan in Case of Emergencies

Abstract Emergencies are bound to happen anywhere at any time and as such pre-planning is necessary. This study outlined a procedure by which students on a university campus can be evacuated safely, while optimising use of available resources. Applications of optimisation techniques in campus emergency planning studies are not common, especially in developing countries. Collaboration of students is essential for a successful campus emergency evacuation, as such this study examined factors that will predict students’ behaviour in an emergency. The study adopted a location-allocation (L-A) model based decision support system (DSS) to implement the campus evacuation plan. The DSS was implemented within a geographic information system (GIS) environment. A total of 150 students were selected randomly across six faculties at Olabisi Onabanjo University, Nigeria for the study. In the event of an emergency it is proposed that all the students will move to designated assembly areas. The output from the emergency decision support system will be used to direct students from the assembly areas to appropriate evacuation points. The DSS was specifically applied in this study to find the locations of five evacuation points that will minimise travel distances of all students from thirteen assembly areas. The results from the DSS showed the average travel distance is 328.43 metres. This study used the binary logistic regression model to predict factors that will influence students to assist in an emergency. The result of the analysis showed that their level of consciousness of emergencies is the only factor that will significantly influence them to assist in an emergency. The findings from this study showed that for a disaster resilient university it must develop an all-hazards comprehensive plan, conduct regular emergency training and exercises, and develop a partnership with the host community for joint use of emergency resources. Keywords: Decision Support System ; Emergency Preparedness; Evacuation Plan; Location-Allocation Models; University Campus.

The Impacts of Obstetrical Simulation Training for Emergency Medical Service Providers [40G

INTRODUCTION: Obstetrical emergencies in the field require coordinated time-sensitive teamwork between emergency medical services (EMS) and hospital-based teams. Simulation is effective at preparation for emergencies. The study objective was to determine the educational and clinical impacts of simulation training sessions for emergency medical service personnel by obstetrical teams within the same communities. METHODS: A multi-center prospective pre/post educational study design was used to assess the effectiveness of a curriculum designed for emergency medical service providers on obstetrical emergencies. Instructional strategies included team-based checklist review and skills coaching using low-fidelity task trainers, taught by interdisciplinary teams. Outcomes were measured using pre/post educational tests, team performance assessments, course evaluations and clinical impacts. Internal review board exemption was obtained. Paired t-tests were used for data analysis. RESULTS: Over 18 months, 185 EMS personnel participated in the curriculum taught at 2 community hospitals. Instructors included obstetricians, emergency physicians, nurses, and medical students. Significant improvement in knowledge was achieved (pre 47.8%, post 89.6%, P<.0001). Confidence (1=high, 5=low) improved in managing precipitous delivery (pre 3.77, post 1.52, P<.0001), shoulder dystocia (pre 4.0, post 1.48, P<.0001), eclampsia (pre 2.68, post 1.29, P<.0001), breech (pre 4.68, post 2.21, P<.0001), and PPH (pre 3.68, post 1.33, P<.0001). Team performance assessments demonstrated significant improvement (pre 68.54%, post 93.54%, P<.0001). Qualitative clinical impacts included improvements to EMS protocols, transfer of care and communication between teams. CONCLUSION: Simulation training in obstetrical emergencies for emergency medical service providers improves knowledge, skills, and performance. Instruction by obstetrical teams in the same communities enhances communication and collaborative care.

The Nature and Frequency of Medical Emergencies in Dental Offices of Karachi, Pakistan

Background: Medical emergencies are an unfortunate part of the dental practice, to which the dentist must have the required knowledge and means to counter them. In this study, we aimed to determine the nature and frequency of medical emergencies occurring in the dental offices of Karachi, Pakistan. We also aimed to ascertain the awareness and preparedness of dentists and their attitude towards training in management of these medical emergencies. Methods: In this study, 300 questionnaire forms were distributed to dentist at various colleges in Karachi city in the year 2015, out of which 244 complete and valid forms were received and used, giving a response rate of 81%. SPSS version 16.0 was used to compute and analyze the collected data. Results: Out of 244 respondents, 23% were males and 77% were females. Since, 83% of the dentist had faced a medical emergency at least once in their practice. Highest recorded medical emergency was found to be syncope (faints) being reported by 71% of the dentist. Most of the medical emergencies (89%) took place during an extraction procedure. 55% dentist claimed that they were prepared enough to manage an emergency. Irrespective of their perceived abilities, 100% showed keen interest in the field of improvement through continuing education in management of medical emergency. Conclusion: Medical emergencies are common in dental practice and a substantial proportion of dentists feel incompetent in handling such situations. This requires better medical emergency management courses and training in undergraduate dental programs as well as continued dental education and training.

Whole-Process Emergency Training of Personal Protective Equipment Helps Healthcare Workers Against COVID-19: Design and Effect.

To develop an emergency training program of personal protective equipment (PPE) for general healthcare workers (HCWs) who may be under the threat of Corona Virus Disease 2019 (COVID-19) and evaluate the effect of the program. A three-stage training program was designed. The complete clinical workflow together with infectious disease ward was simulated. To verify the effect of the program, an experimental training with pre- and post-test was conducted before large-scale training. Post-test scores were significantly improved when compared with the pre-test scores. Among all PPE, N95 respirator and protective coverall needed training most. Meanwhile, "proficiency level" and "mutual check & help" also needed to be strengthened as independent scoring points. This training program significantly improved the performances of participants. It may therefore be applied for general HCWs on a larger scale.

The Effectiveness of Simulation-Based Team Training in Obstetrics Emergencies for Improving Technical Skills: A Systematic Review.

This review explores the effectiveness of simulation-based team training in obstetric emergencies for improving technical skills. A literature search was conducted that included all articles to January 2018. A total of 21 articles were included from a potential 1327 articles. Each included study was assessed for impact of the training program using Kirkpatrick's 4-level model. Only the performance of technical skills was evaluated.Five studies reported on acceptance of simulation as an education tool at a level 1. Level 2 outcomes were reported in 7 studies where staff demonstrated improved skills in an educational setting. Three studies reported improved performance in a clinical setting at a level 3. Ten studies were categorized as level 4 and found that simulation learning was translated into improved techniques or maneuvers in reduced time frames in emergency situations of shoulder dystocia and postpartum hemorrhage. There was evidence that neonatal outcomes were improved.

Applying the Ready, Willing, and Able Framework to Assess Agency Public Health Emergency Preparedness: The CDC Perspective.

Public health emergencies in the United States have been complex, frequent, and increasingly costly in the past decade, at times overwhelming government agencies that are primarily resourced for routine, nonemergency health functions. Emergencies are not always predictable, and adequate resources are not always available to prepare staff in advance for emergency response roles and to mobilize them quickly when a new threat emerges. Additionally, real-world data that connect preparedness levels to response outcomes may be difficult to obtain, further limiting continuous quality improvement efforts by public health officials. In this article, we apply the Ready, Willing, and Able (RWA) framework to identify areas for improvement related to organizational and staff readiness, willingness, and ability to respond during a public health emergency. We share emergency response deployment, training, and personnel data collected as part of emergency response activations (2008 to 2018) at the Centers for Disease Control and Prevention to illustrate how the framework may be applied at government agencies to improve response processes and effectiveness. Additionally, we propose potential metrics aligned with the framework constructs that may help emergency managers consistently assess agency preparedness and, over time, be incorporated into broader standardized measurement methods. We conclude that the RWA framework is a practical tool that can complement other preparedness approaches currently in use at government public health agencies.

Training in obstetric and neonatal emergencies in Mexico: effect on knowledge and self-efficacy by gender, age, shift, and profession

BackgroundContinuing education is essential for healthcare workers. Education interventions can help to maintain and improve competency and confidence in the technical skills necessary to address adverse events. However, characteristics of the health provider such as age (related to more critical and reflexive attitude); sex (relationship with gender socialization), profession and work conditions might have an influence on the effect of continuing education efforts.MethodsA training in the management of obstetric and neonatal emergencies (PRONTO, Spanish acronym for Neonatal and Obstetric Rescue Program: Optimal and Timely treatment) was implemented in 14 hospitals in six Mexican states between 2013 and 2014, with a before-after evaluation design. A total of 351 health providers including physicians, interns, nurses and midwives completed the training and were included in the analytic sample. Mixed-effects regression models were fitted to model changes in knowledge and self-efficacy scores after the training for each training topic. Interaction terms of training with age, gender, profession, and shift were included to evaluate possible heterogeneities of effect. All models considered the within-hospital clustering of participants.ResultsAfter training, all participants showed a significant knowledge gain by an average of 19 percentage points for hemorrhage, 23 for neonatal resuscitation, 19 for shoulder dystocia, and 15 for preeclampsia/eclampsia (p < 0.001). Participants who worked night shifts showed lower scores for overall knowledge, compared with morning shift workers. Interns perceived the lowest self-efficacy while they scored very high in knowledge. Self-efficacy in managing obstetric and neonatal emergencies increased significantly by 16 percentage points in average.ConclusionsOur results show that PRONTO is generally successful in increasing knowledge and self-efficacy on all topics but knowledge and self efficacy levels vary greatly by factors such as work shift. Training should be particularly aimed at personnel working during weekends and night shifts, as well as interns and nurses.

Effective maternal, newborn and child health programming among Rohingya refugees in Cox's Bazar, Bangladesh: Implementation challenges and potential solutions.

The health status of Rohingya refugees or Forcibly Displaced Myanmar Nationals (FDMNs), especially women and children, is a significant challenge for humanitarian workers in Bangladesh. Though the Government of Bangladesh, in partnership with other organizations, is offering health care services to FDMNs, a comprehensive understanding of the program implementation is required for continuation in the future. This study explores the challenges and potential solutions for effective implementation of maternal, newborn, and child health (MNCH) programs for FDMNs residing in camps of Cox's Bazar, Bangladesh. We conducted a qualitative study conducted in Cox's Bazar district, Bangladesh, which involved 34 interviews (15 key informant interviews and 19 in-depth interviews) with relevant persons working in organizations responsible for MNCH services to FDMNs. We relied on both inductive and deductive coding and applied the Consolidated Framework for Implementation Research (CFIR) as a guide to our thematic analysis and presentation of qualitative data. Our study identified some key challenges hindering the effective implementation of MNCH service delivery for the FDMNs. High turnover and poor retention of staff, overlapping of service, weak referral mechanism, complex health information system, and lack of security of the front line health providers were some of the key challenges identified. Motivating the health workers, task shifting, capacity building on emergency obstetric care, training CHW & TBA on danger signs, and ensuring the security of the workers are the potential solutions suggested by the respondents. Selecting a few indicators and the introduction of E-tracker can harmonize the health information system. Providing healthcare in an emergency setting has several associated challenges. Considering the CFIR as the base for identifying different challenges and their potential solutions at a different level of the program can prove to be an excellent asset for the program implementers in designing their plans. Two additional domains, context, and security should be included in the CFIR framework for any humanitarian settings.

UPAYA PENINGKATAN KAPASITAS KESIAPSIAGAAN BENCANA GEMPA BUMI DAN TSUNAMI PADA KOMUNITAS SEKOLAH DI SMP NEGERI 13 PADANG

Anak-anak merupakan salah satu kelompok rentan yang paling berisiko terkena dampak bencana. Masih seringnya terjadi gempa berulang di Kota Padang membuat kepanikan pada siswa saat pembelajaran. Hal ini disebabkan masih lemahnya kesiapsiagan bencana pada siswa. Upaya yang dapat dilakukan adalah meningkatkan kesiapsiagaan bencana gempa bumi dan tsunami pada komunitas sekolah melalui pendidikan dan pelatihan siaga bencana. SMP Negeri 13 Padang merupakan salah satu sekolah yang terletak di zona merah gempa dan tsunami yang sudah memiliki komunitas siswa cerdas bencana. Namun, belum pernah mendapatkan pendidikan dan pelatihan siaga bencana. Tujuan kegiatan ini adalah meningkatkan kapasitas kesiapsiagaan bencana gempa bumi dan tsunami pada komunitas sekolah. Metode yang dilakukan adalah melakukan perencanaan dengan sosialisasi program; pelaksanaan kegiatan berupa memberikan pendidikan siaga bencana dan pelatihan kegawatdaruratan melalui ceramah, demonstrasi, dan simulasi, dan menyediakan buku saku siaga bencana kepada lingkungan sekolah; serta evaluasi dengan pretest dan post test hasil kegiatan. Hasil kegiatan adalah terjadinya rata-rata peningkatan pengetahuan siswa yaitu pada komunitas siswa cerdas bencana dari 13,28 menjadi 13,89, terjadinya peningkatan keterampilan kesiapsiagaan bencana gempa bumi dan tsunami pada komunitas siswa cerdas bencana di SMP Negeri 13 Padang, dan tersedianya buku saku siaga bencana. Diharapkan sekolah dapat memberikan dan mengembangkan pendidikan siaga bencana secara berkesinambungan dengan memasukannya dalam kurikulum pendidikan sekolah.

Oil Depot Safety Inspection and Emergency Training System Based on Virtual Reality Technology

An oil depot safety inspection and emergency training system based on VR technology is proposed in this paper for the safety inspection and emergency training with the problems of high cost, high risk, difficulty to repeat, unsatisfactory training effect and single form in hazardous chemical industry such as oil-gas storage. The system utilizes VR development engine, applies 3D Max, Unity 3D and Visual Studio and other development software to complete 3D scenarios building and visualization of the oil depot, furthermore, achieves highly realistic picture effects by HD scriptable render pipeline technology, so as to realize dynamic simulation of various application scenarios such as realistic three-dimensional roaming, knowledge learning, safety inspection and typical fire accident emergency drill. The application results show that the system can effectively improve the pertinence, interesting, operability and implementation effect of oil depot safety inspection and emergency training, so as to achieve the purposes for improving the level of safety knowledge and skill and reducing safety accident.

Demographic characteristics and recombinant tissue plasminogen activator treatment in patients with acute ischemic stroke

Aim: Intravenous recombinant tissue plasminogen activator (IV rt-PA) has revolutionized the treatment of acute ischemic stroke (AIS). The use of IV rt-PA in the treatment of AIS is still not at the expected level. Data regarding utilization rate in Turkey is inadequate. In this study, we aimed to present the clinical and demographic characteristics of AIS patients and to share IV rt-PA application data. Material and Methods: 224 patients diagnosed with AIS between January 2017 and January 2019 were included in the study. Among these, 17 patients received IV rt-PA treatment after informed consent was obtained. Clinical and laboratory findings, risk factors and demographic characteristics of the patients were recorded from our database. Statistical significance level was accepted as p < 0.05. Results: In this study, the rate of IV rt-PA administration was 7.6% (17 of 224 patients) among all AIS patients. However, in all AIS patients (n = 224), the rate of patients (n = 57) who could application IV rt-PA clinically (National Institutes of Health Stroke Scale [NIHSS] of ≥5 or aphasia or homonymous hemianopsia) was 25.4%. The most common reason for not applying IV rt-PA (72.5%) was that the onset of symptoms was uncertain or the therapeutic time was over 4.5 hours (3 hours in patients over 80 years of age and wide middle cerebral artery infarction). Conclusion: There are many patients who can benefit from IV rt-PA, which has proven efficacy in the treatment of AIS. In order to increase the number of patients who can benefit from this treatment, multi-faceted studies are needed, including awareness raising activities for the population and training of emergency and ambulance health personnel.

Design and Implementation of Petrochemical 3D Model Database Platform

In order to meet the demands of petrochemical engineering enterprises for 3D digitalization management of production equipment, and realize rapid building of accident site environment, a set of 3D model database platform facing petrochemical engineering industry is designed and developed aiming at characteristics of standard, regular and repeated model of petrochemical engineering. The 3D model platform is comprised of 3D model data sub-module, interactive editing sub-module, and 3D product application sub-module. It realizes multi-dimensional and integrated information management, and effectively serves equipment management, accident emergency and employee training. With expansion of petrochemical engineering production scale, strengthening of safety requirements, ceaseless improvement of technical grade and gradual increase and complexity of production equipment and facilities, it is necessary to establish a digitalization management system for production facilities and equipment in the petrochemical engineering industry to meet demands of petrochemical enterprises for 3D digitalization management, further dig potentials of petrochemical enterprises in production and management, improve automatic information level, and make information development better serve safety production and accident emergency.

Optimalisasi UKS dalam Penanganan Kegawatdaruratan Dasar di Sekolah melalui Pelatihan Kegawatdaruratan Dasar bagi PMR di SMP Bayt Al-Hikmah Kota Pasuruan

OPTIMIZING SCHOOL HEALTH (UKS) IN HANDLING BASIC EMERGENCY IN SCHOOLS THROUGH BASIC EMERGENCY TRAINING FOR RED CROSS TEEN IN BAYT AL-HIKMAH MIDDLE SCHOOL, PASURUAN CITY. Accidents and emergency conditions can occur anywhere, anytime and attack anyone. Errors or delays in initial treatment can result in the deterioration of the victim’s condition which can result in disability or other complications, not infrequently even to the point of death. At present the incidence of cardiac arrest and respiratory arrest patients is greatly increased and requires immediate assistance in rescue. Objectives of Community Service Optimization in the School Health Efforts in Handling Emergency in Schools Through Basic Emergency Training is expected that PMR members will be able to do first aid to the surrounding community who experience accidents or emergency conditions. This activity was carried out at Bayt Al-Hikmah Middle School in Pasuruan City on 29 and 31 August 2019. Community service activities consisted of theoretical training in class and skills training with a total number of participants of 50 people. The results of community service activities showed that there was a significant increase in the ability of PMR members, this was indicated by an increase in the average value of knowledge before and after the training which was 55.4 to 85.6. Participants are able to do basic first aid in cases of broken bones with splint dressing, cases of bleeding with compressive pressure, as well as handling foreign body obstruction properly. This basic first aid training activity should be carried out routinely especially for refreshing, updating and developing and fostering PMR members in schools and communities.

Evaluation of a Multimodal Resuscitation Program and Comparison of Mouth-to-Mouth and Bag-Mask Ventilation by Relatives of Children With Chronic Diseases.

Children with chronic critical illness are at higher risk for cardiopulmonary arrests. Before chronically ill children are discharged from hospital, family members receive training in basic life support at many institutions. We evaluated whether a multimodal training program is able to teach adherence to current resuscitation guidelines and whether laypersons can be trained to perform both bag-mask ventilation and mouth-to-mouth ventilation equally effective in infants. Prospective observational study. Pediatric critical care unit of a tertiary referral center. Relatives of children with chronic illness prior to discharge from hospital. Multimodal emergency and cardiopulmonary resuscitation training program. Following participation in our cardiopulmonary resuscitation training program 56 participants performed 112 simulated cardiopulmonary resuscitations (56 with mouth-to-mouth ventilation, 56 with bag-mask ventilation). Nearly all participants checked for consciousness and breathing. Shouting for help and activation of the emergency response system was only performed in half of the cases. There was almost full adherence to the resuscitation guidelines regarding number of chest compressions, chest compression rate, compression depth, full chest recoil, and duration of interruption of chest compression for rescue breaths. The comparison of mouth-to-mouth ventilation and bag-mask ventilation revealed no significant differences regarding the rate of successful ventilation (mouth-to-mouth ventilation: 77.1% ± 39.6%, bag-mask ventilation: 80.4% ± 38.0%; p = 0.39) and the cardiopulmonary resuscitation performance. A standardized multimodal cardiopulmonary resuscitation training program for family members of chronically ill children is effective to teach good cardiopulmonary resuscitation performance and adherence to resuscitation guidelines. Laypersons could be successfully trained to equally perform mouth-to-mouth and bag-mask ventilation technique.

Evaluating preparedness of emergency trainees to triage victims of mass casualty incidents

Background: Triage of victims in mass casualty incidents (MCI) is crucial in prioritizing care and allocating resources1. Triage skills are important to be evaluated for training and better preparedness. Using clinical vignettes is a well-known approach to evaluate clinicians’ knowledge and decision-making2. This study aims to evaluate preparedness of emergency residents and fellows to triage victims of MCI. Methods: Emergency Medicine (EM) residents and fellows at Hamad General Hospital, Emergency Department (HGH-ED) were invited to the study. Each participant filled a questionnaire followed by triaging of 15 vignette-based victims of MCI. Descriptive statistics elaborated on participants’ training and relevant exposures (Table 1). It also showed the degree of agreement in their triage results and rates of under-triage and over-triage. Cohen's kappa coefficient showed inter-rater agreement and internal consistency in triage results. Results: Participants included 63 emergency trainees, 27 residents, and 36 fellows. Only 28.3% (n = 17) of them participated in an MCI drill over the past two years. 51.7% (n = 31) attended training on triage in MCI. 73.3% (n = 44) indicated that they have rarely or never triaged victims in a real MCI or a drill. Only 3.3% (n = 2) perceived themselves as highly confident in triaging victims of MCI. A total of 904 triage outcomes resulted from this exercise (Table 2). The overall rate of agreement among the triage outcomes is 73% (660 times in 904 triage outcomes). The rate of over-triage was 36.8% and 23% under-triage. Conclusion: Better triage results was associated with previous triage training. The rate of over-triage was as the literature recommends. However, the rate of under triage was alarmingly higher than the literature recommendation as < 5%3. The higher rate of under-triage imposes a risk of missing seriously injured victims, which may lead to higher mortality or poor patients’ outcomes. Further training and exercises may be the key to saving more lives and resources.

Safety Assessment of Emergency Training for Industrial Accident Scenarios Based on Analytic Hierarchy Process and Gray-Fuzzy Comprehensive Assessment

To evaluate the safety of emergency training for industrial accident scenarios, an approach combining analytic hierarchy process (AHP) and gray-fuzzy evaluation is proposed. According to the characteristics of industrial emergency training scenarios, a safety evaluation index system for this training is constructed from four aspects: human, machine, environment, and management. The index weight is established using the AHP and the evaluation model is established base of the gray-fuzzy evaluation method. Based on the combination of the two methods, the quantitative results on training safety was obtained and the most important factor that have the greatest impact on training safety was found. Using this new assessment method, the safety of an industrial accident training scenario for a domestic emergency training facility are assessed, the defects in its emergency capacity are determined, and measures and suggestions are recommended to provide scientific and effective basis for improving emergency capacity.