RESUMO
The volume of hemopericardium requiring hemodynamic changes in the trauma patient is not well understood. We performed a study using autopsy data from trauma patients who died with hemopericardium (>20 mL). Of 1848 traumatic deaths, 54 had hemopericardium at autopsy. The median pericardial blood in this group was 150 mL, which is more than the previously assumed volume to be lethal in trauma patients. Therefore, it may be appropriate to redefine the estimated volume required to cause lethal hemopericardium in trauma patients.
Assuntos
Tamponamento Cardíaco , Derrame Pericárdico , Autopsia , Tamponamento Cardíaco/etiologia , Médicos Legistas , Humanos , Derrame Pericárdico/etiologiaRESUMO
Being chosen for the Board of Governors of The Ottawa Hospital is as tough as being chosen for the board of a major bank. The hospital knows that a high-performing board can add immense value.
Assuntos
Conselho Diretor/normas , Seleção de Pessoal/organização & administração , Administração Hospitalar , Humanos , Seleção de Pessoal/métodosAssuntos
Prevenção de Acidentes/instrumentação , Acidentes de Trânsito/prevenção & controle , Traumatismos em Atletas/prevenção & controle , Esportes , Acidentes de Trânsito/estatística & dados numéricos , Automóveis , Engenharia , Humanos , Escala de Gravidade do Ferimento , Motocicletas , Equipamentos de Proteção/estatística & dados numéricos , Fatores de Risco , SegurançaRESUMO
BACKGROUND: Medical students are required to retain vast amounts of medical knowledge on the path to becoming physicians. To address this challenge, multimedia Web-based learning resources have been developed to supplement traditional text-based materials. The Picmonic(®) Learning System (PLS; Picmonic, Phoenix, AZ, USA) is a novel multimedia Web-based learning platform that delivers audiovisual mnemonics designed to improve memory retention of medical sciences. METHODS: A single-center, randomized, subject-blinded, controlled study was conducted to compare the PLS with traditional text-based material for retention of medical science topics. Subjects were randomly assigned to use two different types of study materials covering several diseases. Subjects randomly assigned to the PLS group were given audiovisual mnemonics along with text-based materials, whereas subjects in the control group were given the same text-based materials with key terms highlighted. The primary endpoints were the differences in performance on immediate, 1 week, and 1 month delayed free-recall and paired-matching tests. The secondary endpoints were the difference in performance on a 1 week delayed multiple-choice test and self-reported satisfaction with the study materials. Differences were calculated using unpaired two-tailed t-tests. RESULTS: PLS group subjects demonstrated improvements of 65%, 161%, and 208% compared with control group subjects on free-recall tests conducted immediately, 1 week, and 1 month after study of materials, respectively. The results of performance on paired-matching tests showed an improvement of up to 331% for PLS group subjects. PLS group subjects also performed 55% greater than control group subjects on a 1 week delayed multiple choice test requiring higher-order thinking. The differences in test performance between the PLS group subjects and the control group subjects were statistically significant (P<0.001), and the PLS group subjects reported higher overall satisfaction with the material. CONCLUSION: The data of this pilot site demonstrate marked improvements in the retention of disease topics when using the PLS compared with traditional text-based materials. The use of the PLS in medical education is supported.