Effects of peer-education training on cardiopulmonary resuscitation knowledge and skill retention of secondary school students: a feasibility study.

OBJECTIVES: The need for cardiopulmonary resuscitation (CPR) training dissemination in the community could be resolved by mass school training programmes. However, the availability of instructors remains an unsolved problem. Our purpose was to investigate the effects of three different instructor types: healthcare professionals, schoolteachers and peer students, on CPR skills retention of secondary school students 6 months after training. DESIGN: The study was designed as a prospective randomised single-blinded controlled trial. The study ended before reaching the target sample size for the schoolteacher arm. SETTING AND PARTICIPANTS: Students from three different secondary schools in Heraklion, Greece, were recruited to attend CPR training. INTERVENTIONS: All participants received a manual and a digital video disc demonstrating the CPR/automated external defibrillator (AED) algorithm, followed by hands-on training. They were randomly assigned to receive training by either healthcare professionals, schoolteachers or peer students, who had previously been trained appropriately. OUTCOME MEASURES: CPR knowledge and skill retention were evaluated immediately (secondary outcome) and 6 months after training (primary outcome), using a knowledge questionnaire, skill checklists and feedback device. RESULTS: 408 students (199 girls - two non-binary) were enrolled in the study with a median age of 13 (IQR 12-14) years. A total of 255 students (125 girls) were reassessed at 6 months. Preliminary analysis of the data revealed no statistically significant differences between the three groups regarding factual knowledge immediately after training (p=0.226) and at 6 months (p=0.867). Immediately after training, more students trained by healthcare professionals or teachers performed safe defibrillation (p<0.000); however, this finding was dissipated at 6-month reassessment (p=0.202). Compliance with the CPR algorithm and the quality of hands-only CPR were not different (p>0.05) among the groups. CONCLUSIONS: The type of instructor did not affect the CPR knowledge and skill retention of students 6 months after training. Schoolchildren acting as peer instructors could be an effective alternative to healthcare professionals and schoolteachers, although further studies are needed.

Pattern of road traffic injuries in the Rethymnon region, Crete, Greece: a secondary hospital-based study.

INTRODUCTION: Despite the significant progress that has been made during the last decade, Greece still faces the effects of road traffic accidents (RTAs) to a great extent every year. This study represents an epidemiological approach to road traffic injuries (RTIs) presenting to a secondary hospital in a geographical area with very low-quality road network; it aims to indicate possible preventive measures and actions. METHODS: The present study was conducted in Rethymnon General Hospital between January 2018 and February 2020. Data from all trauma patients who presented to the emergency department (ED) after RTAs were retrospectively collected from patient medical records. The severity of injury sustained by road traffic victims was graded using the Injury Severity Score (ISS). RESULTS: During the study period, 1582 trauma patients presented to the ED after RTAs. There were 1079 men and 503 women and the median age was 30 years. In total, 818 motorcycle-related injuries (51.7%), 497 automobile-related injuries (31.4%), 165 bicycle-related injuries (10.4%) and 102 pedestrian injuries (6.4%) were documented. Of the 1582 trauma patients, 58.2% (921) presented with injuries to the extremities, 35.3% (554) presented with thoracic injuries, 34.4% (541) presented with head injuries, 30% (475) presented with spinal column injuries, 17.4% (271) presented with facial injuries, 12.9% (203) presented with abdominal injuries and 10.3% (162) presented with pelvic injuries. A significant increase in the number of incidents was noticed during the tourist season. Median ISS was 2 (IQR=4). 53.7% of patients who were transferred to the hospital by ambulance had an ISS≤4. In 41 cases, transportation to a tertiary hospital was necessary, six patients had emergency operations and 13 others died in the ED. The median length of hospital stay was 3 (IQR=6) days. CONCLUSION: Actions that could possibly mitigate the burden of RTIs in the district of Rethymnon include upgrading the level of law enforcement, implementing educational strategies and information campaigns against inappropriate ambulance use, encouraging facilities to develop trauma registries and ensuring adequate hospital staffing.

Is There a Role for Color Doppler Ultrasonography in Acute Cholecystitis?

OBJECTIVE: The aim of this study was to evaluate the utility of the Pulsatility Index (PI) of the right hepatic artery, measured by color Doppler sonography, in the diagnosis of acute cholecystitis. METHODS: Seventy-five subjects were included in this study and divided into three groups, each consisting of 25 subjects: the cholecystitis group, the asymptomatic cholelithiasis group, and normal controls. Patients with acute cholecystitis fulfilled all the diagnostic criteria as stated in the latest Tokyo Guidelines. In all patients, the right hepatic artery was detected by color Doppler ultrasound and the PI was measured. RESULTS: Patients with acute cholecystitis were found to have significantly higher PI values compared to both normal controls and cholelithiasis patients. Regression analysis revealed a significant positive correlation between the PI and the cholecystitis outcome. CONCLUSION: Measurement of PI by color Doppler ultrasound represents a useful aid in the diagnostic process of acute cholecystitis. More studies are needed before this method is incorporated in the relevant guidelines.

Granisetron: a review of pharmacokinetics and clinical experience in chemotherapy induced - nausea and vomiting.

INTRODUCTION: Chemotherapy induced nausea and vomiting (CINV) are major side effects of chemotherapy and a great burden to patients' quality of life. Serotonin and substance P are the major neurotransmitters involved in the pathophysiology of CINV, but in spite of new antiemetics no completely effective regime exists for its prevention or treatment. Areas covered: In this review the authors provide a detailed description of granisetron's chemistry pharmacokinetics, pharmacodynamics, toxicity and a brief review of clinical trials involving granisetron and the management of CINV. We searched reviews, meta-analysis and randomized controlled trials (Medline, Embase and article reference lists). Expert opinion: According to current literature, granisetron 2 mg orally or 0,01mg/kg (1 mg) intravenously per day, co-administered with dexamethasone and NK-1 antagonists is the recommended regime for highly emetogenic chemotherapy. In the future the role of transdermal and subcutaneous formulations against delayed CINV will be clarified and probably enhance patients' convenience.