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Introduction: Workplace violence (WPV) toward health‑care workers is increasing. The present study aims to estimate the proportionof resident doctors and interns of a tertiary care hospital who experienced WPV, to find out the perpetrators of WPV, and to ascertain any association between WPV and work‑related stress. Materials and Methods: This observational, institution‑based, cross‑sectional study included resident doctors and interns working in six different departments of a tertiary care hospital. Data collection was done using a predesigned, pretested semi‑structured self‑administered questionnaire adapted and validated from the “WPV in the health sector survey questionnaire” from WHO along with “Perceived occupational stress scale.” Results: Out of 323 participants, 247 (76.47%) experienced some form of WPV, 138 (42.72%) experienced physical violence and 203 (62.85%) experienced psychological violence. Patient relatives were reported as the only perpetrators of physical violence, while seniors of the study subjects were reported as main perpetrators of psychological violence. One hundred and thirty‑four (42%) individuals reported work‑related stress. On multivariate analysis, psychological violence was significantly associated with work‑related stress. Conclusion: WPV was experienced by a high proportion of study subjects. Psychological violence was more frequently experienced, and senior colleagues were deemed responsible in most cases. WPV may be associated with work‑related stress
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Background: Irrational use of prescribing medicines is on the rise due to many factors. The Resident doctors are exposed to variety of prescribing patterns in their daily clinical practice. Aim and Objectives: The study was planned to assess the knowledge, attitude, and practice of rational use of medicine among Resident doctors in a tertiary care teaching hospital. Materials and Methods: A cross-sectional questionnaire-based study was conducted among Resident doctors at a tertiary care teaching hospital. Permission was obtained from the Institutional Ethics Committee. The participants were explained about the study and consent was taken. Identity of the residents was kept confidential. Questionnaire was designed to obtain information about the knowledge, attitude, and practice of Rational Use of Medicines (RUM). The data were recorded and analyzed, and the results are explained in frequency and percentage. Results: About 98% were aware about the term RUM and 96% practiced it, only 9% had National List of Essential Medicines of India available at their work place and 68% were able to correctly name the parts of the prescription slip. 88% respondents were aware about Essential Medicines (EM) and 86% prescribed them. Conclusion: In our study, majority of the Resident doctors were aware about EM and their importance. However, the level of understanding related to P-drug concept and existence of Essential Medicine List was limited. Thus, it is necessary to implement institutional guidelines to achieve more appropriate prescribing patterns, to promote prescription based on the list of EM.
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Background: Promotional drug literature (PDL) seems to be the source of information most commonly used by physicians to update their knowledge on existing and new drugs. Aim and Objectives: The objective of this study was to assess the knowledge and attitude of resident doctors about PDL. Materials and Methods: It was a prospective observational, questionnaire-based study. Approved by institutional Ethics committee. A pre-validated questionnaire (google form) was sent among the resident doctors. A total of 50 residents voluntarily participated in the study. The collected data were analyzed as frequencies and percentage. Results: About 88% of residents were aware about term PDL. Only 50% resident doctors felt that PDL provides adequate drug information. Around 78% participants were aware that both forms of nomenclature should be included in PDL. Almost 92% participants had knowledge regarding complete drug information in PDL. Regarding safety information, 70% resident doctors felt that contraindication should be included in PDL. About 48% participants agreed that PDL might influence prescribing practice. Around 78% participants agreed that doctors’ integrity could compromised by accepting gifts from pharmaceutical representative. Conclusion: However, participants had knowledge about PDL but there is a need to educate students at an early stage about ethical guidelines for assessing PDL.
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Objective:To investigate the effectiveness and advantage of visual laryngoscope in the treatment of patients with sudden cardiac arrest who need spontaneous respiration tracheal intubation.Methods:Totally 60 patients who suffered from cardiac arrest and needed spontaneous respiration tracheal intubation were enrolled from June 2020 to February 2021 in the Affilicated Hospital of Chifeng University. Theywere randomlydivided into two groups-traditional laryngoscope (TL) group and visual laryngoscope (VL) group, with30 patients in each group. Then the success rate of glottis exposure, the operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Subgroup assessment between the junior emergency resident doctor (A group) and the senior emergency resident doctor (B group) was conducted.Results:According to Cormack Lehan grades, the success rate of glottis exposure in VL group was higher than that in TL group ( P>0.05), and the success rate of Grade I in VL group was significant higer than that in TL group: 56.70%(17/30) vs. 30.00%(9/30), P<0.05. The trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in TL group (1.30 vs 1.67, P = 0.049) and (56.37 s vs 67.12 s, P<0.05). In the subgroup, the one-time success rate of tracheal intubation in A-TL group was significantly lower than that in B-TL group (4/15 vs. 11/15, P<0.05), while the one-time success rate of tracheal intubation in A-VL group was 60.00%, which is lower than that in B-VL group ( P>0.05). The operative time consumed for successful intubation in A-TL group was significantly longer than that in B-TL group: 78.00 s vs. 55.57 s, P<0.05, while the operative time in A-VL group was a little longer than that in B-VL group ( P>0.05). Conclusions:Visual laryngoscope used in spontaneous respiration tracheal intubation can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation.
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In this study, 15 second-year resident doctors who had standardized training of OBGYN were taken as research subjects to discuss the effect of training resident doctors with obstetrics forceps by using simulation teaching method. The simulation teaching process includes theoretical study, theoretical examination, simulation teaching of forceps skills and Assessment of forceps skills. In theoretical study section: before learning to use forceps, the students acquired the theoretical knowledge by flipped teaching micro-video mode. In theoretical examination section: the mastery of basic clinical knowledge of using forceps was evaluated through online assessment. In simulation teaching of forceps skills: students who scored 8/10 points were admitted to enter the simulation teaching process, and they had practical training of scenario simulation skills in Clinical Skills Center. In assessment of forceps skills: the mastery of forceps skills was evaluated by standardized forceps delivery procedure items. The results showed that the students in the simulation teaching group had excellent teaching assessment results, and the resident doctors had more confidence in operating forceps independently, and the teaching effect was ideal, which could further promote the simulation teaching of obstetric clinical skills.
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Objective:To explore the role of WeChat platform combined with flipped classroom in improving the working ability of resident doctors in the fever clinic.Methods:A total of 118 resident doctors who rotated in the fever clinic of department of emergency medicine were selected as the study subjects, and they were randomized into experimental group and control group, with 59 people in each group. The experimental group used WeChat platform and flipped classroom teaching, and the control group used traditional teaching. The results of theory assessment, operation performance and questionnaire survey were compared between the two groups. SPSS 26.0 statistical software was used for t test and chi-square test. Results:There was no significant difference in theoretical test scores between the experimental group and the control group ( P>0.05). The experimental group scored (91.61±3.01) points and the control group scored (84.52±4.02) points in operational assessment, with significant differences ( t=-10.85, P<0.05). The results of the satisfaction survey showed that there was no significant difference in teaching time distribution between the two groups, and the experimental group was better than the control group in any other aspects. Conclusion:The use of WeChat platform combined with flipped classroom during the COVID-19 epidemic can improve the level of operational skills of the resident doctors to wear or take off the protective clothing and collect nasopharyngeal swabs, help residents to avoid the infections, and improve the level of daily diagnosis and treatment of fever clinic.
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@#Background: Burnout has become a problem that is increasing among doctors. Burnout syndrome consists of emotional exhaustion, depersonalization, and reduced personal accomplishment, which results from the accumulation of stress in a workplace. Objectives: This study aimed to determine the prevalence and associated factors of burnout among resident doctors in Tabuk, Saudi Arabia. Methods: A cross-sectional study was conducted among 230 resident doctors at King Salman Armed Forces Hospital in Northwestern Region in Tabuk City, Saudi Arabia between September 2020 and January 2021. Data were collected by using a self-administered questionnaire. The Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS (MP)) was used to measure burnout. Sources of stress were assessed by 20 items. Univariate and multivariate analysis were used to examine the factors associated with burnout. Results: The overall prevalence of burnout was 89.1%. This study found that 32.2% of participants scored high on all the subscales. Burnout was associated with gender (p=0.012), chronic disease (p=0.018), level of training (p<0.05), dissatisfaction with work-life balance (p<0.001), work overload (p<0.001), and sources of stress in the workplace (p<0.05). Conclusion: The prevalence of burnout among medical residents in Tabuk was high. Burnout was mainly associated with work-related sources of stress. There is a need for a comprehensive assessment of burnout and stress among medical residents at different levels and specialties. Thus, these findings may help diagnose such problems earlier and trace them to find better solutions,
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Background:Needlestick injuries (NSIs) are percutaneous injuries sustained during delivery of medical care. They are occupational hazards faced by health workers and are a source of transmission of bloodborne pathogens.This study was aimed at determining the prevalence, utilization of post-exposure prophylaxis(PEP) and assessed the association between the sociodemographic, occupational factors, knowledge and attitude towards NSIs to its occurrence among the residents in a Tertiary hospital in Port Harcourt Nigeria.Methods: Descriptive cross-sectional analytical study design Results: The study found a 53.8% prevalence of NSIs. Annual prevalence was 50.9%. The prevalence was significantly higher among senior residents (65.1%) (p=0.006), residents in Paediatrics (75.6%) (p<0.001), and among residents who had worked three years or more (65.7%) (p<0.001). The most frequently reported factors that predisposed to NSIs were excess workload (77.9%), insufficient consumables (72.6%) and long working hours (70.2%). 77.4% of residents recapped needles, 66.1% did not report NSIs. Only 8.9% of the residents utilized PEP after injury. In 51.8% of cases, the needle had been used on a patient prior to the injury. In 25.9% of these cases, the injury involved a high-risk patient (HIV, Hepatitis B or C infected). This study found a risk of transmission of HIV following a needle stick injury to be 0.48%. Conclusion: Needlestick injuries are common among resident doctors. A large number of these injuries go unreported. The attitude toward preventive measures and use of PEP services is sub-optimal necessitating a need for more attention to be drawn to occupational health and safety in the region
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Humans , Male , Female , Adult , Needlestick Injuries , Health Personnel , Post-Exposure Prophylaxis , Physicians , Tertiary Care Centers , NigeriaABSTRACT
Reference manager (RM) also known as reference management software (RMS) are tools used by researchers to organize and manage bibliographic references. They are citation tools that enable researchers to track the scientific papers they have read, sources consulted, cited and used to generate a reference list or bibliography. This study investigated the awareness and pattern of use of RM tools by Resident Doctors (RDs) in Nigeria. Cross-sectional survey design was adopted for the study and semi-structured questionnaire was used for the data collection. Respondents' age was 35.9 ± 5.0, (53.8%) were males. Most of the respondents (92.9%) had heard of RM, 49.1% had ever used any RM with Mendeley topping the list (49.1%). However, many of the respondents (42.8%) did not use RM due to lack of requisite skills, while only (35.1%) respondents had ever received formal training on use of RM. Based on the findings of the study, it was recommended that awareness should be regularly created to encourage resident doctors to apply their knowledge of the tools in the management of their references while training should be conducted for those who do not use the tools.
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Awareness , Database Management Systems , Physicians , Health Personnel , Information LiteracyABSTRACT
Background: Infection control occupies a unique position in the field of patient safety since it is universally relevant to health care workers and patients at every single health-care encounter. Most of the healthcare-associated infections are preventable. Through this study, the awareness, practices, and adherence to standard precautions among the resident doctors were sought. Objectives: The objectives of this study were as follows: (1) To determine the level of awareness, practices, and adherence to standard precautions for infection control among resident doctors and (2) to determine factors affecting infection control. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, an observational study was conducted among the resident doctors in the post-natal care ward (PNC) of a tertiary care hospital. Data collection was done using direct observations, a structured validated interview schedule, and discussions with 21 resident doctors working in the PNC. Results: About 71% of the study population had received a training in standard precautions. Specific infection control protocol as suggested in standard precautions was followed for infection control by 76% of the population. Hepatitis B vaccination coverage with three doses of the vaccine is only 66.6% in the study population. Good awareness in standard precautions considering all five elements together was seen in 57% of respondents. Good practice of standard precautions was seen in 52% of doctors. When the individual elements were considered separately, good practice was seen the least for waste disposal. Most respondents had good practice in hand hygiene and cough hygiene. Conclusion: Deficient adherence to standard precautions among health-care providers warrants new induction and monitoring strategies.
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Background: The main objective of the Maharashtra Health Systems Development Project (MHSDP) is to enhance the quality of care by improving health care; in the hospitals, in the state. Improvement in the prescribing practice of resident doctors working in the hospitals is one of the initiatives taken up, to improve the rationalizing service delivery. A prescription audit may become an important tool for sensitizing resident doctors for rational prescription and utilization of drug.Methods: An observational study was carried out during the period of March 2017 to May 2017 in tertiary care teaching hospital, Kolhapur. Total 247 first prescriptions written by resident for in-door-patient department were collected, scrutinized and analysed. Prescriptions were evaluated for completeness of prescription format while legibility was graded. Prescriptions were also analysed as per World Health Organization prescribing indicators.Results: In study 247 prescriptions with 1091 drugs with average 4.42% drugs per prescription, 49.8 % prescriptions wrote the drugs by generic name. We found that 44.1 % prescriptions written with drugs included in essential medicines list while antibiotics prescribed were 27.1%. In prescription format 34% had incorrect dosage, 67% of prescriptions omitted the duration of treatment. Direction for drug use was not mentioned in 25% of prescriptions. Weight was not mentioned on any prescriptions even for paediatric group.Conclusions: Through prescription auditing, sensitizing resident doctors for rational prescription and utilization of drug can be done to achieve the goal of the MHSDP of enhancing the quality of care by improving health care; in the hospitals, in the state.
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Background: The pillar of doctor patient relationship is the bond of mutual trust. This pillar is strengthened by effective communication between doctor and patient/relatives. It has been widely accepted that a doctor needs to have very good communication skills in addition to clinical knowledge and skills required for effective healthcare. Every doctor duly needs to demonstrate humanity, healthy behaviour, as well as sensible communication with patients which can build the sustainable ‘trust’ in the treatment offered by that doctor. However, the current curriculum of medical courses is enormously focused on providing competent medical knowledge but lacking the focus on inculcating communication skills.Methods: A cross sectional study was carried out amongst 377 resident doctors of first to third year, from randomly selected medical colleges of Maharashtra having postgraduate courses in clinical subjects and affiliated to Maharashtra University of Health Sciences, Nashik, Maharashtra, India during the period of February 2017 to January 2019. Data was entered in MS Excel sheet and analyzed using percentages and proportions wherever appropriate.Results: Highest study respondents were from General Medicine with 13% of total and having 17.4% males and 8% females among respective genders followed by General surgery and Pediatrics residents with 12.5% each specialty.Conclusions: The study has shown that there was varied knowledge about the communication skills among the resident doctors. The residents have shown fair attitudes and behaviours towards mindfulness and basic communication skills.
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Background: The mutual trust between doctor and patient, an indispensable part of the healthcare, is weakening day by day. This has resulted in unwanted incidences of violence and attacks on doctors. Communication between doctors and patients is an integral part of the relationship and is one of the major determinants of mutual trust. Apart from the knowledge and skills required to treat a disease, communication skill is an indispensable part of a doctor’s professional life. The resident doctors do not get a chance to learn and implement the communication skills required for the doctor patient relationship. Methods: An interventional study was carried out amongst 377 resident doctors of first to third year, from randomly selected medical colleges of Maharashtra having postgraduate courses in clinical subjects and affiliated to Maharashtra University of Medical Sciences, Nashik, Maharashtra during the period of February 2017 to January 2019. Results: There was significant difference in the pre and post test scores for quantified knowledge in relation to training in communication skills (p<0.0001), and also significant difference in the pre and post test scores for quantified knowledge in relation to basic doctor patient relationship, suggesting that the intervention was effective in improving the communication skills. Conclusions: The study has shown that there was significant difference in the pre and post test scores for quantified knowledge in relation to being doctor, basics of communication skills, doctor patient relationship, communication in special situation, and training in communication skills.
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Background: Bio-ethics i.e. health care ethics is a set of moral principles, beliefs and values that guide us in making choices about medical care. This novel study was carried out with an objective of assessment of knowledge regarding the medical ethics among the resident doctors of Indira Gandhi Medical College, Shimla Himachal Pradesh.Methods: This descriptive analytical cross-sectional study was conducted at Indira Gandhi Medical College (IGMC), Shimla, Himachal Pradesh among the resident doctors using predesigned, structured, self-administered anonymous close-ended questionnaire. We analyzed the data using Stata software version 12.Results: There were a total of 61 study participants, who consented to participate, of which more than half were females (52.5%). The mean age of the study participants was 28.6±0.63 years. Regarding the source of knowledge about medical ethics most of the study participants had acquired the information during their experience at their workplace (42.6%). A majority of the male participants disagreed that confidentiality while providing the health care services should be abandoned (54.3%). More than 90% of the study participants agreed that incorporation of medical ethics is necessary in undergraduate curriculum.Conclusions: Incorporation of a formal structured teaching on medical ethics in the undergraduate curriculum is the need of the hour. Besides research work, the medical ethics committee in the institution should also act as the guiding hands to address the grievances faced by the doctors during medical practice.
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Background: Hepatitis B is global infectious diseases with estimated two billions of the world population have contracted the infection, of them there are 350 million with chronic infection. Hepatitis B disease may lead to state of chronic carrier, liver cirrhosis and failure or hepatocellular carcinoma.Methods: This was a cross-sectional study which involved 100 intern, 100 resident doctors, and 100 paramedical staff; data collection was performed by a suitable self-administered, close-ended questionnaire.Results: Medical staff members had better knowledge about hepatitis B than the paramedical staff in the study. More than 50% of the paramedical staff didn’t know the correct mode of hepatitis b transmission. Attitude towards vaccination was seen significantly high in interns and resident doctors, as more than 88% had taken hepatitis b vaccine as compared to only 57% from paramedical staff had taken vaccine. Only 55% of paramedical staff had strictly followed universal precautions which was statistically significant in medical and paramedical staff.Conclusions: This study highlights the dissimilarities in knowledge, attitude as well as practices amongst different categories of healthcare personnel regarding hepatitis B infection. The most distressing situation was of paramedical staff that was at the lowest strata in terms of both knowledge and practices and therefore was at highest risk of hepatitis B infection.
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Background: Perceived stress and burnout are by-products of powerless responsibility imposed on resident doctors. Emotional intelligence (EI) works as an adapting and coping tool. Objective: The objective of this study is to find out the role of work-related perceived stress on burnout and influence of EI on it. Methods: A descriptive cross-sectional study was conducted from February to April 2016 among 63 resident doctors of different departments of Bankura Sammilani Medical College and Hospital. Data were collected through a self-administered questionnaire for background characteristics and work-related variables. Cohen perceived stress scale, Trait EI, and Shirom-Melamed burnout questionnaire were applied for measuring perceived stress, EI, and burnout, respectively. Statistical analysis was done with of SPSS version 22.0, and for mediation analysis, Andrew F. Hyne抯 SPSS macro was adopted. Nonparametric bootstrapping was done assuming small sample. Results: Out of complete responses, 67%, 22.9%, and 9.8% were from clinical, paraclinical, and preclinical specialties, respectively. Burnout had a significant positive correlation with perceived stress and in negative correlation with EI-well-being and positive correlation with EI-self-control and sociability. Physical fatigue factor of burnout had a significant positive correlation with EI-emotionality. Perceived stress had a negative correlation with EI-well-being. On mediation analysis, assuming EI as a mediator, total, direct, and indirect effects of perceived stress on burnout were significant (<0.05). Mediation was proved to act with percent mediation of 0.07. Conclusion: There was definite mitigating effect of EI on burnout by perceived stress among resident doctors. This necessitates more attention by decision-makers toward this burning problem for the sake of care of caregivers.
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Objective:To understand the current situation of medical humanistic quality of standardized trainees for hospitalizations in Chongqing, and put forward the corresponding educational countermeasures and suggestions. Methods: According to the method of convenient sampling, 5 resident doctors standardized training base were selected with half a random, then 110 trainees were randomly selected to conduct a cognition investigation about the medical humanistic quality. EpiData 3. 0 was adopted for double entry data and SPSS22. 0 software was used for analyzing data. Results:There were 98. 06% of standardized trainees for hospitalizations paid more attention to medical humanistic quality. In the selection of medical humanistic quality courses, 81. 55% of the trainees chose The Doctor-patient Relationship, 77. 67% of the trainees chose The Medical Psychology. In the evaluation of the importance of medical humanistic quality to the clinical work, 96. 12% of the standardized trainees for hospitalizations believed that it was important. Conclusion: In order to improve the medical humanistic quality of the standardized trainees for hospitalizations, all aspects should be taken seriously:it should make efforts from the trai-nees' self-awareness, the teaching teachers' attention to the medical humanistic quality and the medical humanis-tic quality environment provided by the training base.
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Objective The quality management method was introduced into the teaching of pediatric cardiopulmonary resuscitation(CPR),and to improve the quality of training and realize teaching objectives. Methods Quality management team analyzed the examination results of CPR by Plato method,and cleared the risk factors associated with quality problem. A standard operating procedure was used in teaching and assessment of the CPR,and doctors′examination results of CPR would be analyzed by a statistical approach. Results Platonic analysis showed that heart compressions and artificial ventilation were risk factors associat-ed with quality problem in CPR. In the total frequency of deductions,the proportion of the heart compressions was 36. 8% and artificial ventilation was 15. 7%. According to the standard operating procedure,the quality of heart compressions in CPR was improved. In the total frequency of deductions,the proportion was only 3. 5%. Conclusion The quality management method can be applied in the teaching of cardiopulmonary resuscitation,which can improve the teaching quality.
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The standardized resident training is an important part of continuing medical education in China,which plays a vital role in the cultivation and development of doctors.At present,the standardized resident training system in our country is at an exploratory stage and different from those advanced countries.This paper contrastively analyzed the domestic and foreign standardized resident training modes from the perspectives of education patterns,training years,training organizations,training contents,assessments,and financial sources.By learning from the advanced experience of those foreign countries,it provided the reference for the standardized resident training system in China.
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Objective To investigate the usefulness of HC visual laryngoscope designed for unskilled junior emergency resident doctors in respect of increasing the efficiency and success rate of emergency tracheal intubation.Methods A total of 80 patients needed the emergency tracheal intubation were at first divided into two groups randomly (random number).Patients in group A were operated by junior emergency resident doctors and patients in group B were operated by well experienced attending doctors.Then,the two groups of patients above were divided into two groups randomly (random number).Patients in group N were operated with conventional laryngoscope and patients in group HC were managed with HC visual laryngoscope.Then comparisons of the success rate of glottis exposure,the one-time success rate of tracheal intubation,the success rate of tracheal intubation,the complications,the number of attempt in successful intubation cases and the operative time consumed for successful intubation cases among the groups were done.Results (1)The success rate of glottis exposure,the one-time success rate and the success rate of tracheal intubation in group A-HC were 90%,70% and 90%,respectively which were significantly higher than those (50%,20% and 45%)in group A-N (P 0.05 ). Conclusions HC visual laryngoscope used by unskilled junior emergency resident doctors for emergency tracheal intubation,could increase success rate of glottis exposure,decrease the number of attempt of intubation,decrease rate of complication,shorten operative time required for intubation thus improving efficiency and success rate of emergency tracheal intubation,and maybe narrow the skill gap between unskilled junior resident doctors and well experienced attending doctors in respect of emergency tracheal intubation.