Effectiveness of virtual training for medical officers and community health officers in the critical care management of COVID-19 patients in the intensive care unit.

BACKGROUND AND AIMS: The coronavirus disease -19 has changed various aspects of education and training in all fields, and e-learning has now become the preferred mode of training and teaching. The aim of this study was to assess the impact of online training and to overcome the limitations of e-learning. METHODS: A total of 176 medical officers (MOs) and 720 community health officers (CHOs) were trained in four batches by using seven training modules with online videos and lecture series. Each batch received two days of training. A pre-test and post-test were conducted which consisted of 25 multiple-choice questions of 4 marks each. There was no negative marking. Candidates obtaining >80 marks were declared as having passed. The results of the pre-test and post-tests were compared. RESULTS: There was remarkable improvement in the knowledge regarding critical care management after virtual training, as evidenced by the test results. None of the MOs scored more than 80% in the pre-test; however, 153 MOs scored more than 80% in the post-test. The average score improved from 47.82 (pre-test) to 89.05 (post-test). The difference was statically significant (P < 0.0001). Similarly, 123 CHOs scored more than 80% in the pre-test, while 378 CHOs scored more than 80% in the post-test. Improvement in average marks was also seen: 90.5 in the post-test as compared to 62.76 in the pre-test. The difference was statically significant (P < 0.0001). CONCLUSION: Online training is beneficial for many candidates from various locations within a short period. The interactive sessions after training are also helpful, and well-designed pre- and post-tests are adequate for assessment.

Effect of Two Different Doses of Dexmedetomidine on the Hemodynamics of "Hypertensive Patients" Undergoing Laparoscopic Cholecystectomy.

CONTEXT: In laparoscopic cholecystectomy, pneumoperitoneum results in tachycardia, hypertension, and increased myocardial oxygen demand. These changes are more pronounced in hypertensive patients. The intravenous administration of dexmedetomidine attenuates sympathoadrenal response and provides better hemodynamic stability intraoperatively. AIMS: To evaluate the hemodynamic stabilizing and sedation properties of two different doses of dexmedetomidine including 0.7 µg.kg-1.h-1 and 0.5 µg.kg-1.h-1 in hypertensive patients undergoing laparoscopic cholecystectomy. SETTINGS AND DESIGN: This was a randomized, prospective, double-blind controlled trial. SUBJECTS AND METHODS: A total of 60 controlled hypertensive patients of either sex, aged 30-60 years, and ASA class 2 without any other serious comorbid conditions who were undergoing laparoscopic cholecystectomy under general anesthesia were randomly assigned into three groups of 20 each. Group A and B received loading dose of dexmedetomidine 1 µg.kg-1 over 10 min and maintenance dose at 0.7 and 0.5 µg.kg-1.h-1, respectively. Group C received normal saline infusion only. Hemodynamic parameters (heart rate and systolic, diastolic, and mean arterial pressure) and sedation score were compared at different time intervals among groups. STATISTICAL ANALYSIS USED: The Chi-square test, ANOVA, and Tukey Post hoc Test. RESULTS: Fluctuations in the hemodynamics of hypertensive patients are effectively attenuated by dexmedetomidine and there is no difference in the attenuation of these hemodynamic changes by maintenance dose of 0.5 or 0.7 µg.kg-1.h-1. However, maintenance dose of 0.5 µg.kg-1.h-1 causes lesser sedation. CONCLUSIONS: Dexmedetomidine administered as infusion in a maintenance dose of 0.5 µg.kg-1.h-1 serves as an ideal anesthetic adjuvant in hypertensive patients undergoing laparoscopic cholecystectomy.