Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease

Background: Experience from the Zaire Ebolavirus epidemic in the eastern Democratic Republic of the Congo (2018­2020) demonstrates that early initiation of essential critical care and administration of Zaire Ebolavirus specific monoclonal antibodies may be associated with improved outcomes among patients with Ebola virus disease (EVD). Objectives: This series describes 13 EVD patients and 276 patients with suspected EVD treated during a Zaire Ebolavirus outbreak in Guinea in 2021. Method: Patients with confirmed or suspected EVD were treated in two Ebola treatment centres (ETC) in the region of N'zérékoré. Data were reviewed from all patients with suspected or confirmed EVD hospitalised in these two ETCs during the outbreak (14 February 2021 ­ 19 June 2021). Ebola-specific monoclonal antibodies, were available 2 weeks after onset of the outbreak. Results: Nine of the 13 EVD patients (age range: 22­70 years) survived. The four EVD patients who died, including one pregnant woman, presented with multi-organ dysfunction and died within 48 h of admission. All eight patients who received Ebola-specific monoclonal antibodies survived. Four of the 13 EVD patients were health workers. Improvement of ETC design facilitated implementation of WHO-recommended 'optimized supportive care for EVD'. In this context, pragmatic clinical training was integrated in routine ETC activities. Initial clinical manifestations of 13 confirmed EVD patients were similar to those of 276 patients with suspected, but subsequently non confirmed EVD. These patients suffered from other acute infections (e.g. malaria in 183 of 276 patients; 66%). Five of the 276 patients with suspected EVD died. One of these five patients had Lassa virus disease and a coronavirus disease 2019 (COVID-19) co-infection. Conclusion: Multidisciplinary outbreak response teams can rapidly optimise ETC design. Trained clinical teams can provide WHO-recommended optimised supportive care, including safe administration of Ebola-specific monoclonal antibodies. Pragmatic training in essential critical care can be integrated in routine ETC activities. Contribution: This article describes clinical realities associated with implementation of WHO-recommended standards of 'optimized supportive care' and administration of Ebola virus specific treatments. In this context, the importance of essential design principles of ETCs is underlined, which allow continuous visual contact and verbal interaction of health workers and families with their patients. Elements that may contribute to further quality of care improvements for patients with confirmed or suspected EVD are discussed.

Application research of multi-dimensional interaction combined with PBL teaching in emergency and critical care nursing practice teaching / 中华医学教育探索杂志

Objective:To explore the value of multi-dimensional interaction combined with problem-based learning (PBL) teaching in the nursing practice teaching of emergency and critical care.Methods:A total of 110 nursing students who practiced in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to March 2020 were selected as the control group, and the traditional teaching was adopted. In addition, 89 nursing students who practiced from June 2020 to December 2020 were selected as the research group, and multi-dimensional interaction combined with PBL teaching was adopted. The teaching quality was assessed through the comprehensive scores of the nursing students (departure examination + regular performance assessment) and nursing students' feedback on the teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The comprehensive scores of the nursing students in the research group were higher than those in the control group, and the difference was statistically significant ( P<0.001). Compared with the control group, the nursing students in the research group believed that multi-dimensional interaction combined with PBL teaching could improve nursing knowledge and skills, overall clinical nursing ability, self-management ability, clinical thinking ability, and the ability to analyze, judge and solve clinical nursing problems, group cooperation ability, communication ability between doctors, nurses and patients, emergency ability and rescue ability, and professional quality, with statistically significant differences ( P<0.001). Conclusion:Multi-dimensional interaction combined with PBL teaching can improve the theoretical and clinical practice level of nursing interns, and at the same time help to cultivate nursing talents with excellent comprehensive quality.

Application of flipped classroom in the experiment teaching of emergency and critical care nursing / 中华医学教育探索杂志

Objective To explore the effects of flipped classroom on the experiment teaching of emergency and critical care nursing. Methods The nursing undergraduates in grade 2014 of Shandong University of Traditional Chinese Medicine were randomly divided into the experimental group and the control group. The traditional teaching model was used in the control group, while the experimental group adopted the flipped classroom teaching model. Students in the experimental group watch micro videos for preview before class , carry out review , discussion , answering , group exercise , guidance , displaying , communication and teacher commenting in class, and undergo summarizing and evaluation after class. The theoretical and operational test scores of the two groups were compared, and the evaluation data of the experimental group students on the effect of flipped classroom teaching model were collected. Results The theoretical scores and experimental scores of students in the experimental group were higher than those in the control group respectively [(82.51 ±5.03) vs. (77.36 ±5.48) and (94.35 ±3.16) vs. (88.02 ±4.27), respectively], and the differences were statistically significant (P=0.011, 0.000). A total of 92.1％ of the students in the experimental group said they liked the teaching model, and 90.3％wanted to continue using the flipped classroom teaching mode . Conclusion The flipped classroom teaching model is highly regarded by the students , and the application of it is helpful to improve students' comprehensive performance.

Application of SimMan human body simulator in nursing teaching experiments on emergency and critical care / 现代临床护理

Objective To explore the effect of application of SimMan human body simulator in nursing teaching experiments on emergency and critical care. Methods Forty undergraduate nursing students in 2012 were assigned as the experiment group, where nursing teaching experiments on emergency and critical care were conducted based on SimMan human body simulator. Forty undergraduate nursing students in 2011 were assigned as the control group, where the traditional teaching method was employed. The emergency ability of the nursing students in the two groups was evaluated, and the nursing students′ attitudes towards two teaching methods were investigated. Results The emergency ability was higher in the experiment group than that of the control group (P<0.05). The satisfaction level with teaching method in the experiment group was significantly higher than that of the control group (P<0.05). Conclusions SimMan human body simulator is effective in improving emergency ability of nursing students in nursing teaching experiments of emergency and critical care. It is worth popularizing and applying.

Application and significance of multi-media network-based teaching platform in emergency and critical care medicine teaching / 中华医学教育探索杂志

We created the multi-media network-based teaching platform in emergency and critical care medicine teaching and unified the advantages of the network technique,multimedia technique and information commons,to build up a new place for all kinds of persons to learn the emergency and critical care medicine in any time or any places,and to build up a teaching re-source library of emergency and critical care medicine by the digital image processing technique, streaming media technique and database technique.

Practice and discussion of teaching of Emergency and Critical Care Medicine for foreign students / 中华医学教育探索杂志

In combination with the experience teaching overseas students in Emergency and Critical Care Medicine,we probe into the overseas students' characteristics,the choose of teaching materials and teachers,and how to improve theoretical and practical Emergency and Critical Care Medicine teaching quality etc.