ABSTRACT
BACKGROUND: Retention of skills and knowledge after neonatal resuscitation courses (NRP) is known to be problematic. The use of cognitive aids is mandatory in industries such as aviation, to avoid dependence on memory when decision-making in critical situations. We aimed to prospectively investigate the effect of a cognitive aid on the performance of simulated neonatal resuscitation. METHODS: Thirty-two anaesthesia residents were recruited. The intervention group had a poster detailing the NRP algorithm and the control group did not. Video recordings of each of the performances were analysed using a previously validated checklist by a peer, an expert anaesthetist, and an expert neonatologist. RESULTS: The median (IQR) checklist score in the control group [18.2 (15.0-20.5)] was not significantly different from that in the intervention group [20.3 (18.3-21.3)] (P=0.08). When evaluated by the neonatologist, none of the subjects correctly performed all life-saving interventions necessary to pass the checklist. A minority of the intervention group used the cognitive aid frequently. CONCLUSIONS: Retention of skills after NRP training is poor. The infrequent use of the cognitive aid may be the reason that it did not improve performance. Further research is required to investigate whether cognitive aids can be useful if their use is incorporated into the NRP training.
Subject(s)
Algorithms , Cardiopulmonary Resuscitation/education , Clinical Competence , Cardiopulmonary Resuscitation/standards , Clinical Protocols , Decision Support Techniques , Education, Medical, Continuing , Female , Humans , Infant, Newborn , Intensive Care, Neonatal/methods , Intensive Care, Neonatal/standards , Male , Ontario , Prospective Studies , Retention, Psychology , Single-Blind MethodABSTRACT
Blood, aqueous humor and cataracts obtained from an Indian population were analyzed for ascorbic acid content. While the concentrations of ascorbic acid in the blood and cataracts were similar in patients with cortical and nuclear cataracts, the level of this nutrient was lower in the aqueous humor of patients with cortical cataracts. This suggests a sluggish transport of ascorbate from the blood to the aqueous humor in the latter group. It is possible that this lower level of ascorbate might be one of the factors participating in cataractogenesis. The lower aqueous ascorbate in the group with the cortical cataracts could not be accounted for by any dietary deficiency of this nutrient. Hence, it appears metabolically related.
