A skills acquisition study on ECMOjo: a screen-based simulator for extracorporeal membrane oxygenation.

BACKGROUND: Extracorporeal membrane oxygenation relies heavily on didactic teaching, emphasizing on essential cognitive skills, but overlooking core behavioral skills such as leadership and communication. Therefore, simulation-based training has been adopted to instill clinical knowledge through immersive experiences. Despite simulation-based training's effectiveness, training opportunities are lessened due to high costs. This is where screen-based simulators come into the scene as affordable and realistic alternatives. AIM: This article evaluates the educational efficacy of ECMOjo, an open-source screen-based extracorporeal membrane oxygenation simulator that aims to replace extracorporeal membrane oxygenation didactic instruction in an interactive and cost-effective manner. METHOD: A prospective cohort skills acquisition study was carried out. A total of 44 participants were pre-assessed, divided into two groups, where the first group received traditional didactic teaching, and the second used ECMOjo. Participants were then evaluated through a wet lab assessment and two questionnaires. RESULTS: The obtained results indicate that the two assessed groups show no statistically significant differences in knowledge and efficacy. Hence, ECMOjo is considered an alternative to didactic teaching as per the learning outcomes. CONCLUSION: The present findings show no significant dissimilarities between ECMOjo and didactic classroom-based teaching. Both methods are very comparable in terms of the learner's reported self-efficacy and complementary to mannequin-based simulations.

Transthoracic echocardiography visualization of bicaval dual lumen catheters for veno-venous extracorporeal membrane oxygenation.

Bicaval dual lumen catheters improve the efficiency of veno-venous extracorporeal membrane oxygenation by minimizing recirculation with an innovative design, which requires precise placement of three catheter ports in the superior vena cava, right atrium, and inferior vena cava, respectively. However, the exact position of these catheter ports is usually not known during placement because they cannot be visualized with conventional radiography. We performed a retrospective review of our experience over the past year using transthoracic echocardiography to evaluate the position of the catheter ports. From a subcostal, sagittal imaging approach, we were able to identify all three catheter ports in 11 of 11 studies. At least one of the catheter ports was incorrectly positioned in 5 of 11 studies. Further prospective evaluation is necessary to determine if catheter repositioning based on transthoracic echocardiography findings can further improve the clinical efficiency of veno-venous extracorporeal membrane oxygenation.

Pediatric Code Blue: How Prepared Are We? A Self-Efficacy Assessment Project.

Pediatric advanced life support (PALS) recertification every two years is inadequate to maintain proficiency. The authors hypothesized that a standardized, recurring curriculum may enhance retention of cardiopulmonary resuscitation (CPR) skills. Monthly in situ mock code training and an annual online self-directed learning module were implemented for pediatric intensive care unit nurses, pediatric residents, and respiratory therapists at a women and children's hospital. The in situ mock codes were linked to PALS training self-efficacy (pre- and post-mock code) and feedback related surveys. CPR knowledge was assessed using an online module with pre- and post-tests. A total of 82 in situ mock code surveys and 137 online modules were completed over a 20-month period. Medical knowledge (P < .05 for 7/10 questions) and self-confidence improved (P < .001. Several staff reported a negative impact on their patient care assignments in order to participate in the mock code. However, a significant number of participants (65%) concurred with the benefits of monthly mock codes. The curriculum improved CPR efficacy by improving knowledge-based retention as well as self-confidence in their skills.

A day in the life of PubMed: analysis of a typical day's query log.

OBJECTIVE: To characterize PubMed usage over a typical day and compare it to previous studies of user behavior on Web search engines. DESIGN: We performed a lexical and semantic analysis of 2,689,166 queries issued on PubMed over 24 consecutive hours on a typical day. MEASUREMENTS: We measured the number of queries, number of distinct users, queries per user, terms per query, common terms, Boolean operator use, common phrases, result set size, MeSH categories, used semantic measurements to group queries into sessions, and studied the addition and removal of terms from consecutive queries to gauge search strategies. RESULTS: The size of the result sets from a sample of queries showed a bimodal distribution, with peaks at approximately 3 and 100 results, suggesting that a large group of queries was tightly focused and another was broad. Like Web search engine sessions, most PubMed sessions consisted of a single query. However, PubMed queries contained more terms. CONCLUSION: PubMed's usage profile should be considered when educating users, building user interfaces, and developing future biomedical information retrieval systems.

A Case of Escherichia coli Hemolytic Uremic Syndrome in a 10-Year-Old Male With Severe Neurologic Involvement Successfully Treated With Eculizumab.

Hemolytic uremic syndrome (HUS) can be classified as typical and atypical, and the treatment recommendations currently differ between the 2 types. Eculizumab is recommended as first-line treatment for atypical HUS; however, its use in typical HUS has been controversial. We report a case of a 10-year-old male with severe neurologic impairment who was successfully treated with eculizumab, which was started 4 days after onset of neurologic symptoms. Our case supports the use of eculizumab in typical HUS with neurologic involvement, even when given later in the course, as the pathophysiology of typical HUS has been shown to involve activation of the complement pathway, similar to atypical HUS. Further studies are required to establish the efficacy and duration of eculizumab use in this patient population.