Intraosseous access can be taught to medical students using the four-step approach.

BACKGROUND: The intraosseous (IO) access is an alternative route for vascular access when peripheral intravascular catheterization cannot be obtained. In Denmark the IO access is reported as infrequently trained and used. The aim of this pilot study was to investigate if medical students can obtain competencies in IO access when taught by a modified Walker and Peyton's four-step approach. METHODS: Nineteen students attended a human cadaver course in emergency procedures. A lecture was followed by a workshop. Fifteen students were presented with a case where IO access was indicated and their performance was evaluated by an objective structured clinical examination (OSCE) and rated using a weighted checklist. To evaluate the validity of the checklist, three raters rated performance and Cohen's kappa was performed to assess inter-rater reliability (IRR). To examine the strength of the overall IRR, Randolph's free-marginal multi rater kappa was used. RESULTS: A maximum score of 15 points was obtained by nine (60%) of the participants and two participants (13%) scored 13 points with all three raters. Only one participant failed more than one item on the checklist. The expert rater rated lower with a mean score of 14.2 versus the non-expert raters with mean 14.6 and 14.3. The overall IRR calculated with Randolph's free-marginal multi rater kappa was 0.71. CONCLUSION: The essentials of the IO access procedure can be taught to medical students using a modified version of the Walker and Peyton's four-step approach and the checklist used was found reliable.

[A three-day course can increase knowledge and interest in disaster medicine for medical students]. / Medicinstuderendes viden om og interesse for katastrofemedicin kan øges med et tredages kursus.

The incidence of disasters increases and the need for physicians with an interest in disaster medicine is essential. As an early introduction of disaster medicine, medical students from Denmark, members of the Students' Society for Anesthesiology and Traumatology, participated on a three-day course, Trauma Days 2013, with full-scale simulations. The students underwent debriefings and questionnaires were handed out. 94% of the students increased their interest in disaster medicine.

[A research training module as a part of the anaesthesiology education programme].

This article describes the structure of the research training module, as a part of the education programme for anaesthesiologists in the eastern region of Denmark. The module consists of courses, independent work on a project, guidance and evaluation. In a period of about four years a total of 56 anaesthesiologists have completed the programme. A questionnaire revealed that 59% felt their abilities to read and interpret research had been improved and 30% reported an increasing interest in research. 40% had presented their project at scientific meetings and 25% had published their project.

A helicopter emergency medical service may allow faster access to highly specialised care.

INTRODUCTION: Centralization of the hospital system entails longer transport for some patients. A physician-staffed helicopter may provide effective triage, advanced management and fast transport to highly specialized treatment for time-critical patients. The aim of this study was to describe activity and possible beneficial effect of a physician-staffed helicopter in a one-year trial period in eastern Denmark. MATERIAL AND METHODS: This was a prospective observational study of all missions related to a daylight operating, physician-staffed helicopter. We recorded information about the activity during 12 months, focusing on dispatchment, diagnoses, medical interventions, admission patterns and 30-day mortality. RESULTS: There were a total of 574 missions resulting in 609 patient contacts. Activity ranged from 22 to 76 missions per month. The helicopter was grounded 6% of its operating time, mainly due to weather conditions. The primary patient categories were trauma (43.5%) and cardiac disease (26.1%). The physician acted as Medical Incident Officer at three major incidents. A total of 53 endotracheal intubations, 13 intraosseous cannula insertions and four tube thoracostomies were performed. The median hospital length-of-stay was four days, 30-day mortality was 6.1% and 86 patients were transferred to intensive care units. CONCLUSION: The physician-staffed helicopter had approximately two missions per day the first year, mainly in relation to trauma and cardiac patients needing specialized treatment. Advanced medical interventions were commonly performed. FUNDING: Funded by Trygfonden. TRIAL REGISTRATION: not relevant.

[Health professional operators at dispatch centres shall ensure identification of cardiac arrest and initiate counselling by telephone]. / Sundhedsfaglige operatører på vagtcentralen skal erkende hjertestop og starte telefonisk rådgivning.

Denmark has introduced health professional operators (HPO) at the dispatch centres to ensure early identification of cardiac arrest and earlier initiation of cardiopulmonary resuscitation (CPR) to improve survival. Communicative skills and personal competences are important, and the HPOs' medical background will probably lead to better triage of patients. Their use of a protocol, leads to a more frequent recognition of cardiac arrest and contributes to better CPR guidance. A common national training for all the HPOs' has been implemented and future guidance might include video-transmission.