E-learning can be Helpful for Mastering Basic Life Support Skills on Public

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.

E-learning can be Helpful for Mastering Basic Life Support Skills on Public

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.

Ultrasonographic Measurements of Abdominal Aortic Diameter in Elderly Patients

BACKGROUND: Researchers have reported that the prevalence of abdominal aortic aneurysm(AAA) is 1~4% in the entire population and 4~9% in the population older than 65 years. 40 to 50% of AAA patients die before arrival at a hospital; and mortality from a ruptured AAA is greater than 90%. Moreover, diagnosis is frequently delayed because the majority of patients are asymptomatic. Even if AAA is quickly diagnosed(ruptured or symptomatic) and operated on, survival rate is less than 50%. Recently, trials have been done to detect asymptomatic AAA by ultrasonography in the elderly population with a subsequent increase in the number of surgeries of asymptomatic AAA. Method: We measured the diameter of the abdominal aorta in all patients aged 65 years and older seen in the emergency room at Chuncheon Sacred Heart Hospital, Hallym University. We investigated the correlations between risk factors and prevalence of AAA and the diameter of the abdominal aorta. We also screened for age, gender, and history of smoking, hypertension, coronary heart disease, and CVA. RESULTS: 444 cases were enrolled in this study with 185 being male(41.7%) and 259 female(58.3%). Mean age was 73.91+/-7.02 years. Mean maximum diameter of the abdominal aorta was 2.08+/-0.37cm. Comparing maximum diameters, men averaged 2.17+/-0.37cm and women 2.01+/-0.35 cm (p<0.001); smokers 2.16+/-0.39cm and nonsmokers 2.05+/-0.35cm(p=0.007); hypertension history 2.10+/-0.42 cm and no hypertension history 2.06+/-0.33cm(p=0.246); coronary heart disease history 2.35+/-0.84cm and no coronary heart disease 2.07+/-0.35 cm(p=0.01); and CVA history 2.08+/-0.37 cm and no CVA history 2.08+/-0.37cm(p=0.997). CONCLUSION: There were notable differences in the maximum abdominal aortic diameter with gender and histories of smoking, hypertension, and coronary heart disease. Ultrasound screening of AAA should be strongly recommended in male smokers 65 years and older with a history of coronary heart disease. Overall, ultrasound screening of AAA for elderly patients should be carefully considered.

The Clinical Usefulness of Halo Sign on CT Image of Trauma Patients

PURPOSE: The management of hemorrhagic shock is critical for trauma patients. To assess hemorrhagic shock, the clinician commonly uses a change in positional blood pressure, the shock index, an estimate of the diameter of inferior vena cava based on sonography, and an evaluation of hypoperfusion complex shown on a CT scan. To add the finding for the hypoperfusion complex, the 'halo sign' was introduced recently. To our knowledge, this 'halo sign' has not been evaluated for its clinical usefulness, so we designed this study to evaluate its usefulness and to find the useful CT signs for hypoperfusion complex. METHODS: The study was done from January 2007 to May 2007. All medical records and CT images of 124 patients with trauma were reviewed, of which 103 patients were included. Exclusion criteria was as follows: 1) age or = 5. RESULTS: The value of kappa, to assess the inter-observer agreement, was 0.51 (p < 0.001). The variables of the halo-sign-positive group were statistically different from those of the halo-sign-negative group. The rate of transfusion for the halo-sign-positive group was about 10 times higher than that of the halo-sign-negative group and the rate of mortality was about 6 times higher. CONCLUSION: In the setting of trauma, early abdominal CT can show diffuse abnormalities due to hypoperfusion complex. Recognition of these signs is important in order to prevent an unwanted outcome in hemorrhagic shock. We conclude that the halo sign is a useful one for hypoperfusion complex and that it is useful for assessing the degree of hemorrhagic shock.

A Case of Pulmonary Thromboem-bolism associated with Protein C Deficiency

A pulmonary thromboembolism usually results from a serious complication of deep venous thrombosis (DVT). However, several prothrombotic genetic risk factors are known to predispose a patient to thrombotic events, with manifestation at a young age. Protein C and S deficiencies are known to increase the risk of venous thrombosis and pulmonary thromboembolism. We report a case of a young patient with protein C and S deficiencies suffering from a massive pulmonary thromboembolism.

Clinical Review In Geriatric Trauma Patients

PURPOSE: This study was conducted to examine various clinical factors for their ablity to predict mortality in geriatric patients following trauma. METHODS: In this retrospective study, medical records from Chun Cheon Sacred Heart hospital were reviewed for patients 65 years and older who sustained trauma. The following variables were extracted and examined, independently and in combination, for their ablity to predict death: age, gender, mechanism of injury, blood pressure, and respiration, pulse rate, as well as Glasgow Coma Score, Revised Trauma Score, and Injury Severity Score. These patients had entered the hospital following trauma during a 2-year period (1999-2000). RESULTS: the Injury Severity Score (more than 28), the Glasgow Coma Score (less than 9), and the Revised Trauma Score (less than 8) were variables that correlated with mortality. Mortality rates were higher for men than for women. Admission variables associated with the highest risks of death included hypotension (mean blood pressure < 78 mmHg); pedestrian and motorcycle traffic accident; skull fracture, subdural hemorrhage, and diffuse axonal injury; and hemothorax and lung contusion. CONCLUSION: Admission variables in geriatric trauma patients can be used to predict the outcome and may also be useful in making decisions about triage, and treatment of the patient.