Educating residents: the effects of a mock code program.

Housestaff residents are often the primary participants in codes that occur in a hospital setting, yet it is unknown how much confidence and knowledge they possess in the management of these medical emergencies. A study to learn the effect of a mock code program on residents' level of confidence and knowledge regarding code situations was initiated in a children's tertiary care hospital. Thirty-three residents completed a questionnaire before initiation of the study. The questionnaire revealed that codes scare them (79%), and that they felt a need for more knowledge (76%) and more experience (82%) before supervising a code. They did not feel confident in performing certain procedures such as treating dysrhythmias (79%), obtaining i.v. access (64%), and doing intubations (30%). Sixteen residents then participated in mock codes, and the other seventeen residents served as controls. Compared to the pre-study questionnaire, residents who had participated in mock codes had more confidence in their ability to supervise and felt less of a need for more knowledge before supervising a code. The participants also felt more confident in obtaining i.v. access and performing intubations during a code situation. There was no difference in the pre- and post-questionnaires of the control group. Residency programs are not meeting the educational and confidence needs of pediatric residents. A mock code program improves residents' perceived need for more knowledge before supervising a code and improves their confidence in doing many lifesaving procedures.

Routine screening of Halloween candy: helpful or hazardous?

STUDY OBJECTIVES: To determine the frequency of radiopaque items found in radiologic screening of Halloween candy and to determine the possibility of missing a small item. DESIGN: Prospective observational study on Halloween night, 1992. Data were collected from area medical centers that were screening Halloween candy. The ability to detect small sharp items was tested at five centers. SETTING: Five hospitals and three immediate care centers. PARTICIPANTS: Four hundred fifty-four bags of candy were screened. RESULTS: No unknown radiopaque items were discovered. One of five centers tested for accuracy failed to detect a small radiopaque item. Only one hospital required parents to sign a waiver of liability. The immediate care centers recorded patients' names; the other hospitals kept no record of the names of children whose bags were screened. No physicians viewed the radiographs or fluoroscopy. CONCLUSION: The routine radiologic screening of Halloween candy has an extremely low yield in detecting radiopaque items.