The Effectiveness and Benefits of Disaster Simulation Training for Undergraduate Medical Students in Saudi Arabia.

Background: There is a growing recognition of the need for disaster management training for medical students in Saudi Arabia, but there is limited research on its effectiveness. Thus, this study evaluated the effectiveness of a disaster simulation training program for undergraduate medical students in Saudi Arabia. Methods: A disaster management simulation activity was conducted for 32 medical students. The students attended a 30-minute lecture about mass casualty incidents (MCIs) and completed a pre-simulation survey. They were then randomly assigned to one of three groups (performer, actor, observer) and asked to apply their skills to triage patients after a Level C MCI. A debriefing session was conducted using the plus/delta debriefing method. Then, the students completed a post-simulation survey. Results: The results showed that after the simulation training the students' self-confidence in their ability to respond to a disaster increased from 40.7% to 59.4% (p value < 0.01), to utilize incident command structure increased from 37.9% to 62.5% (p value < 0.01), to demonstrate START triage for victims of a disaster increased from 28.2% to 65.7% (p value < 0.01), and to apply safe search and rescue techniques increased from 40.7% to 59.4% (p value < 0.01). The students' self-confidence in their ability to perform basic first aid skills also increased after the simulation. Conclusion: The study findings suggest that disaster management simulation training can be an effective way to increase medical students' self-confidence and preparedness for disaster response.

Camping-related carbon monoxide poisoning: Knowledge and risk behaviours among young Saudi campers.

OBJECTIVE: To evaluate the Saudi campers' knowledge and the applied safety practices regarding carbon monoxide poisoning during camping activities. METHODS: The cross-sectional questionnaire-based study was conducted from December 1, 2018, to February 1, 2019, in Riyadh, Saudi Arabia, and comprised young male campers from recreational camps in the northern parts of the city. Data was collected from the participants regarding socio-demographic characteristics, knowledge regarding carbon monoxide poisoning, the applied safety measures to prevent carbon monoxide poisoning and the dealing with carbon monoxide poisoning during camping activities. Data was analysed using SPSS 22. RESULTS: There were 235 male subjects with mean age 24.47±1.139 years (range: 21-32 years). Of the total, 50(21.3%) participants had received civil defence education or training. Overall, 137(58.3%) participants had a good mean knowledge score, and 157(66.8%) participants had a good mean practice score for applying healthy measures in preventing and managing carbon monoxide poisoning. As a preventive measure against carbon monoxide poisoning, the use of carbon monoxide detectors was valued by 107(45.5%) participants. Having civil defence training, having a monthly income >10,000 Saudi Riyals, and having a good knowledge score were the elements that had significant association with the choice related to carbon monoxide detector usage. CONCLUSIONS: The campers had relatively high knowledge regarding carbon monoxide poisoning, but this knowledge was not fully translated into good health practice.

Recurrent hypoglycemia secondary to metformin toxicity in the absence of co-ingestions: a case report.

BACKGROUND: Metformin toxicity is well known to cause lactic acidosis. Multiple cases of hypoglycemia due to isolated metformin overdose have been reported. Increased glucose consumption secondary to anaerobic metabolism has been reported as a possible explanation. CASE PRESENTATION: A 23-year-old Arabic woman took 30 g of metformin. In the emergency department, 4 hours after of the event, she was fatigued but vitally stable. During her hospitalization, she had severe lactic acidosis, hypotension corrected with fluid boluses and vasopressors, and multiple episodes of hypoglycemia (6.3 mg/dL, 38 mg/dL, and 42 mg/dL), requiring multiple 50% dextrose-water boluses. The three hypoglycemic episodes occurred coincident with severe lactic acidosis. She improved after 24 hours of continuous renal replacement therapy. CONCLUSIONS: Hypoglycemia can be induced by metformin toxicity in the absence of co-ingestants. A possible explanation of metformin-induced hypoglycemia is increased glucose consumption due to anaerobic metabolism, decreased oral intake, decreased liver glucose production, and decreased glucose absorption.