Training interprofessional teams in geriatric emergency medicine: A modified team-based learning approach.

Background: Older adults deserve special healthcare provision in every branch of medicine. Turkey currently does not have geriatric emergency medicine (GEM) subspecialty training. Thus, interprofessional training for healthcare professionals involved in GEM services is required. Team-based learning (TBL) seems suitable to implement such training. We aimed to develop and implement a training program for healthcare professionals engaged with GEM services, and evaluate the program considering teacher and learner satisfaction and knowledge retention. Methods: This was a design-based study in which a one-day GEM training program was developed based on the literature and expert opinions. The program was applied to 54 physicians, 98 nurses, 70 health officers, and 102 paramedics using a modified version of TBL. Teams included at least one representative from each profession. TBL was modified by adding a 1-h lecture and eliminating peer evaluation. Feedback forms, individual and group tests of TBL, and a retention test conducted six months later were used for program evaluation. Results: The mean group test score was higher than that of individual tests in all professions. Physicians' individual test scores were higher than those of other professions, but this difference disappeared in the group test. The retention test mean score was higher than the individual test mean score but lower than that of the group test. Teacher and learner satisfaction was high. Conclusion: We implemented a training program using a modified TBL approach to teach GEM to relevant healthcare professionals; it yielded promising results regarding knowledge gain and retention, as well as teacher and learner satisfaction. The instruction design and method used in this study can be applied to multidisciplinary team training.

Less Exposure for Health Care Workers, More Comfort for Patients During COVID-19 Swab Testing.

BACKGROUND: Nasopharyngeal (NP) and oropharyngeal (OP) swab sampling for coronavirus disease 2019 (COVID-19) diagnosis may lead to release of particles of varying sizes and increase the exposure risk for health care workers (HCWs). However, there is limited evidence for effective methods to reduce occupational exposure from NP and OP swab sampling. This study aimed to reduce droplet-forming responses (DFRs) and the related exposure risk of NP and OP swab sampling by administering 10% lidocaine spray (LS) to the NP and OP areas prior to conducting swab tests. METHODS: This quasi-experimental study was conducted with 100 patients who presented to our tertiary care hospital with symptoms of COVID-19 between December 1 and 15, 2020. First, NP and OP swabbings were performed on each patient. Thereafter, LS was applied to the OP and NP regions, and the swab samples were taken once again. Frequency of DFRs and real-time polymerase chain reaction (RT-PCR) test results before and after LS application were recorded for comparison. In addition, the cycle threshold (Ct) was used as a proxy indicator for SARS-CoV-2 viral load in COVID-19 positive cases. FINDINGS: Significant differences in OP DFR frequencies before and after LS intervention were found (37% and 9%, respectively), as well as before and after NP DFR (31% and 18%, respectively). The mean Ct values for the positive samples did not differ before and after applying LS. CONCLUSION: Our results suggest that applying LS to the OP and NP area prior to swab testing reduces DFR frequencies without affecting (RT-PCR) test results for SARS-CoV-2 and may increase patient and practitioner comfort.

Do Clothing Labels Play a Role for Weight Estimation in Pediatric Emergencies? A Prospective, Cross-Sectional Study.

INTRODUCTION: The aim of this study was to investigate the usability of the age value listed on the labels on children's clothes in the age-based weight estimation method recommended by the Pediatric Advanced Life Support (PALS) guidelines. MATERIAL-METHOD: This prospective, cross-sectional study was organized in Antalya Training and Research Hospital Emergency Department. Children aged between 1-12 years were included in the study. The weight measurements of the children were obtained based on the age-related criteria on the labels of their clothes. The estimated values were compared with the real values of the cases measured on the scale. RESULTS: One-thousand ninety-four cases were included, the mean age of cases in age-based measurements was 6.25 years, which was 6.5 years in label-based measurements. Average weights measured 25.75kg according to age-based measurements, 26.5kg according to label-based measurements, and 26.0kg on the scales, and showed no statistical difference (P <.0001). It was estimated that 741 (67.7%) of age-based measurements and 775 (70.8%) of label-based measurements were within (±)10% values within the normal measurement limits and no significant difference was measured. CONCLUSION: In the emergency department and prehospital setting, children with an unknown age and that need resuscitation and interventional procedures for stabilization, and have no time for weight estimation, checking the age on clothing label (ACL) instead of the actual age (AA) can be safely used for the age-dependent weight calculation formula recommended by the PALS guide.

Ingested Foreign Body Imaging Using Point-of-Care Ultrasonography: A Case Series.

The ingestion of foreign bodies is a common problem in the pediatric population. Emergent treatment of ingested foreign bodies is dependent on the type of foreign body ingested, patient symptoms, timing of ingestion, and the location of the foreign body. Although X-ray and computed tomography are the imaging techniques used most often to assess for foreign bodies, ultrasonography, which lacks ionizing radiation, may also be useful. This case series describes 8 cases of gastrointestinal tract foreign bodies and the utility of point-of-care ultrasonography for their real-time evaluation.