ABSTRACT
UNLABELLED: Management of in-hospital cardiac arrest is now considered as a hospital quality indicator. Such management actually requires training health care workers (HCWs) for basic life support (BLS). OBJECTIVE: To assess the usefulness and efficacy of a short mandatory BLS training course amongst general ward HCWs in a 1,200 bed teaching hospital. STUDY DESIGN: The in-hospital medical emergency team (MET) established a 45-min BLS training course comprising 10 goals for basic CPR and preparing for the arrival of the MET. Assessment was based on satisfaction questionnaires, cross-sectional evaluation of knowledge and skills of HCWs before and 1 year after the start of the training course. Efficacy of BLS performed on ward was assessed by the MET on scene. RESULTS: One year after, 68 training sessions had been fulfilled and 522 HCWs had been trained (46.27% of total HCWs). HCWs were satisfied with the teaching course. Instant retention of objectives was over 90%. Cross-sectional surveys showed an improvement of BLS knowledge and skills. The knowledge of initial clinical assessment remained low. Knowledge and skills were significantly higher amongst HCWs who had been trained than amongst those who had not. Unfortunately, general ward BLS performance showed no improvement. CONCLUSION: Short mandatory training courses are stimulating and well appreciated amongst HCWs. Although basic knowledge and skills improve dramatically, no improvement of on-scene BLS performance occurs.
Subject(s)
Cardiopulmonary Resuscitation/economics , Heart Arrest/therapy , Clinical Competence , Cross-Sectional Studies , Emergency Medical Services , Hospitals , Humans , Inservice Training , Life Support Care , Quality Assurance, Health Care , Surveys and Questionnaires , Treatment OutcomeABSTRACT
We report two cases of myocardial infarction, in young HIV positive patients seen in the Emergency Department. These patients were under treatments: for one, an association of nucleosidic inhibitors, and for the other one, the combination of nucleosic analogue inhibitor with a non nucleosic analogue; in the last case, the patient underwent, few months before, a treatment containing a protease inhibitor. In both cases, the pain wasn't typical and didn't refer to a coronary heart disease. Lipid tests were normal. The diagnosis has been made quickly and allows a coronary angioplasty with a favourable issue. Authors are arguing the characteristics of this cardiac pathology, recently discovered in HIV positive patients, and do insist on the need to think at a coronary heart disease in front of any chest pain symptom even unusual.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Myocardial Infarction/etiology , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Anti-HIV Agents/adverse effects , Anti-HIV Agents/therapeutic use , Chest Pain/etiology , Electrocardiography , Emergency Medical Services , Female , HIV Protease Inhibitors/adverse effects , HIV Protease Inhibitors/therapeutic use , Humans , Male , Myocardial Infarction/surgeryABSTRACT
BACKGROUND: Present knowledge of the consequences of mass gatherings for the health of the community is scant. Our objective was to determine the impact of the 1998 World Football Cup on general community health. METHODS: We set up an electronic sentinel disease surveillance, before, during and after the World Football Cup tournament held in France from June 10 to July 12, 1998. Medical activity, and the daily number of cases of communicable, environmental, and societal diseases relating to mass gatherings were surveyed. The incidence of the pathologies surveyed in real time during and after the World Cup versus the pre-Cup reference period was the main outcome measure. Five sentinel networks participated, comprising 553 general practitioners, 60 hospital adult emergency departments, 19 private emergency community services, 4 community health centres, and the medical centre of the Paris airports. RESULTS: Throughout the 66-day study period, physicians reported 558,829 medical encounters via 21,532 connections to the computer. Compared to the reference period, the level of medical activity reflected by the pathological items surveyed remained stable during the study period. CONCLUSION: The 1998 World Football Cup had no epidemiological impact on general community health, as observed by sentinel networks located downstream of the specific health services provided by the French authorities to ensure high standards of safety.
