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1.
Pan Afr Med J ; 33: 112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489090

RESUMO

Introduction: Animal bite injuries are a common public health concern in Uganda. We sought to characterize animal bite injuries among patients presenting to Mulago National Referral Hospital in Kampala, Uganda. Methods: This was a cross sectional study from 1st September to 30th November 2011. Participants were animal bite injury victims presenting to the accident and emergency (A&E) unit at Mulago hospital and were consecutively enrolled into the study. Socio-demographics, severity and patterns of injury, health seeking and dog handling behaviours were assessed using a standardized questionnaire. Descriptive statistics was used to summarize participant characteristics and the animal bite injuries. Poisson regression model's incident rate ratios (IRR) was used to explore the relationship of the number of days to accessing treatment at Mulago hospital with; a) received prior first aid, b) animal bite injury sustained during day time, c) unknown dog and d) victim resident in Kampala. Data were analyzed using STATA version 12.0 and statistical significance set at P < 0.05. Results: Of 25,420 patients that presented to the A&E unit during the study period, 207 (0.8%) had animal bite injuries, mean age 22.7 years (SD 14.3), 64.7% male, and 40.1% were <18 years. Majority 199 (96.1%) were bitten by a lone unrestrained and un-signaled dog that had bitten someone else in 22.2% of cases, and eight victims (0.4%) were attacked in canine gangs of 2-5 dogs. Rabies vaccination was confirmed in only 23 dogs (11.1%) as 109 (52.7%) were unknown to the victims or the communities. One hundred and eighteen victims (57.0%) sustained the dog bites within Kampala district whilst the rest occurred near or far from Kampala district, and the victims especially referred to access anti-rabies vaccine. Of 207, 189 victims (91.3%) presented within 2.6 days (SD ± 4.3). Two hundred victims (96.6%) sustained extremity injuries while the rest had injuries to other body parts. All injuries were minor and managed on out-patient basis with wound dressing, analgesics, prophylactic antibiotics and anti-rabies vaccination. Victims who received prior first aid had a rate of 1.7 times greater for seeking treatment at Mulago hospital (IRR 1.7, 95% CI 1.4-2.1) compared to those that had no prior first aid. Participants who sustained the animal bite injuries during day time had a rate of 1.6 times greater for seeking treatment at Mulago hospital (IRR 1.6, 95% CI 1.3-2.1) compared to those that sustained injuries at other times. Participants bitten by unknown dog and participants residing in Kampala had IRR 0.7, 95% CI 0.5-0.9 and IRR 0.6, 95% CI 0.5-0.8 respectively of accessing treatment at Mulago hospital compared to bitten by known dog and not residing in Kampala. Conclusion: Dog bites injuries from unrestrained, un-signaled dogs are the commonest source of animal bite injuries especially among children (<18 years). Vaccination against rabies was only confirmed for a very small number of dogs, as majority were unknown and likely stray dogs. Government and public sensitization is urgently required to limit stray dogs, vaccinate dogs and restrain them to prevent a grave probability of a looming canine rabies epidemic.


Assuntos
Mordeduras e Picadas/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Vacinas Antirrábicas/administração & dosagem , Raiva/prevenção & controle , Adolescente , Adulto , Fatores Etários , Animais , Mordeduras e Picadas/terapia , Criança , Estudos Transversais , Doenças do Cão/prevenção & controle , Doenças do Cão/virologia , Cães , Feminino , Primeiros Socorros/estatística & dados numéricos , Acesso aos Serviços de Saúde , Humanos , Masculino , Distribuição de Poisson , Inquéritos e Questionários , Fatores de Tempo , Uganda/epidemiologia , Adulto Jovem
2.
Wiad Lek ; 72(7): 1371-1379, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398172

RESUMO

OBJECTIVE: Introduction: The purpose of educational process in higher educational establishments is to train specialist who has fully mastered the professional competencies for performing daily activities and for action in non-standard situations, which can occur during fulfilling obligations. The aim: Compare the formation of professional competence and practical skills as important part of increasing effectiveness of specialists training; check the correspondence with current legal acts, which regulate the first aid training. PATIENTS AND METHODS: Materials and methods: The bibliography method, info-analytic method, the comparative method, and logical method were used in our research. CONCLUSION: Conclusion: Improvement of complex first aid curriculum for professionals of emergency service is determined the increasing of the level of psychological readiness for performing professional duties.


Assuntos
Primeiros Socorros , Competência Profissional , Especialização , Currículo , Humanos
3.
Stud Health Technol Inform ; 262: 126-129, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349282

RESUMO

This paper presents a high-fidelity prototype of a mobile game for teaching children fundamental skills in first aid. The study utilizes expert interviews to define learning scope and evaluate design. The game introduces two situations based on realistic scenarios; a boy who fell on a skateboard, and an elderly man with chest pains. Interactive elements introduce a way for the user to explore and assess a given situation. Gamification keeps motivation for learning high, and choice of graphical elements keeps situations feel familiar but non-frightening. There is a quiz to help children learn how to communicate with emergency services. Experts believe that children can learn essential steps for providing basic first aid, except physically fatiguing techniques, so they found the prototype to be a viable option for learning basic first aid at a young age.


Assuntos
Primeiros Socorros , Aplicativos Móveis , Jogos de Vídeo , Idoso , Criança , Humanos , Aprendizagem , Masculino , Motivação
4.
Washington, D.C.; PAHO; 2019-07-12. (PAHO/NMH/19-015).
em Inglês | PAHO-IRIS | ID: phr-51354

RESUMO

The Pan American Health Organization and the Caribbean Development Bank developed this booklet as a tool to help you take care of yourself and your community during crisis situations. This is achieved through psychological first aid, also known as PFA, a humane, supportive and practical response to a fellow human being who is suffering and may need support. In this booklet, our “PFA helper” will guide you through the three basic principles of PFA: look, listen and link. This will help you to approach affected people, listen and understand their needs, and link them with practical support and information. It will also bring to your attention the needs of specific groups, including men, women, children and adolescents, and people with disabilities, among others. Enjoy the booklet. Read it again from time to time, share it with friends, family and members of your community, and spread the message: “Stronger together”.


Assuntos
Saúde Mental , Técnicas Psicológicas , Primeiros Socorros , Desastres , Segurança , Depressão , Ansiedade , Apoio Social
5.
J Spec Oper Med ; 19(2): 41-47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31201750

RESUMO

BACKGROUND: To investigate questions about application of emergency tourniquets in very young children, we investigated practices of Combat Application Tourniquet (C-A-T) use on a simulated infant-sized limb to develop ways to improve readiness for caregiving. METHODS: This study was conducted as investigations of C-A-Ts used by two individuals in deliberate practice. The practice setup simulating a limb of infants aged 3-5 months included a handrail (circumference, 5.25 in.). This setup needed a specific modification to the instructions for use to adhere the band between the clips. Each user performed 100 practices. RESULTS: With accrual of experience, application time was shorter for each user, on average in a power law of practice, and more ease was associated when less time was taken to apply the tourniquet. The ease of use was associated with accrued experience through deliberate practice of a tourniquet user while under coached learning. A check of tourniquet fit on a 4.25-in. limb also entailed the modification used in the 5.25-in. limb. However, an additional modification of wrapping the band in a figure-8 pattern around the rod was needed because the rod and clip could not meet. The fit on a 3.25-in. limb was impracticable for a workaround. Tourniquet use was harder for smaller limbs (i.e., 4.25 in. and 3.25 in.). A map of tourniquet fit was sketched of which sized limbs were too big, too small, within the fit zone, or at its borders. CONCLUSION: C-A-Ts mechanically fit the simulated limbs of infants aged 3-5 months, and C-A-T use was practicably easy enough to allow experienced users to fit tourniquets to limbs well using a specific modification of the routine technique. The findings and knowledge generated in this study are available to inform researches and developments in best preparation practices for instructing first aid.


Assuntos
Primeiros Socorros , Hemorragia/prevenção & controle , Torniquetes , Simulação por Computador , Desenho de Equipamento , Extremidades , Humanos , Lactente
6.
Graefes Arch Clin Exp Ophthalmol ; 257(8): 1795-1803, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31147840

RESUMO

PURPOSE: There is currently uncertainty about the most efficacious decontamination solution for corrosive chemical eye burns. This 30-year longitudinal study evaluated the relative efficacy of two different decontamination methods. Passive decontamination consists of rinsing with tap water, 0.9% normal saline, isotonic buffered phosphate solution, or Ringer's lactate. Active decontamination adds an amphoteric, polyvalent, and chelating component with Previn® (Diphoterine®) solution (Laboratoire Prevor, Valmondois, France). METHODS: A prospective evaluation of patients treated in two specialized eye clinics for eye burns was begun in 1988. Recorded data included exposure circumstances, type of corrosive, different types of first therapy, and clinical treatment and outcome. Patients were treated from clinic admission and up to 24 h after the corrosive chemical burn with rinsing for 15 min using two different protocols. From 1988 to 2005, sterile 0.9% normal saline or Ringer's lactate was used. Since 2006, sterile, hypertonic, amphoteric Previn® solution was used. Comparative statistical analysis was done with the Fisher contingency tables and Wilcoxon tests. RESULTS: There were a total of 1495 patients with 2194 chemically burned eyes. In 1988-2005, the annual incidence was 66.1/year; in 2006-2017, it was 65.5/year. Similar incidences were noted when initial rinsing was with tap water or isotonic buffered phosphate solutions. There was a significantly more severe outcome of corrosive chemical eye burns with any first aid rinsing solutions other than Previn® solution or tap water was used (p < 0.001). Previn® solution or tap water rinsing in the pre-hospital setting and secondary rinsing with Previn® solution in the hospital decreased lesion severity in comparison with all other rinsing solutions (p < 0.001). CONCLUSION: The frequency of corrosive chemical eye burns was comparatively high despite tightening of occupational health and safety regulations over the past 30 years. The severity of corrosive chemical eye burns has been dramatically decreased since the introduction of Previn® solution for initial and secondary rinsing. A new protocol for immediate Previn® solution use by the Cologne Fire Brigade and secondary Previn® solution rinsing in hospital has reduced the frequency of severe corrosive chemical eye burns to less than 60% as compared to the period of 1988-2005 when other rinsing solutions were utilized.


Assuntos
Queimaduras Químicas/terapia , Descontaminação/métodos , Queimaduras Oculares/terapia , Primeiros Socorros/métodos , Previsões , Acuidade Visual , Adolescente , Adulto , Idoso , Queimaduras Químicas/diagnóstico , Queimaduras Químicas/epidemiologia , Criança , Pré-Escolar , Queimaduras Oculares/diagnóstico , Queimaduras Oculares/epidemiologia , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índices de Gravidade do Trauma , Resultado do Tratamento , Adulto Jovem
7.
BMC Psychol ; 7(1): 37, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31227016

RESUMO

BACKGROUND: Depressive disorder is ranked as the largest contributor to non-fatal health burden. However, with prompt treatment, outcomes can improve. Family and friends are well placed to recognise the signs of depression and encourage early help seeking. Guidelines about how members of the public can provide mental health first aid to someone who is experiencing depression were developed in 2008. A Delphi study was conducted to re-develop these guidelines to ensure they are current and reflect best practice. METHODS: A survey was developed using the 2008 depression mental health first aid guidelines and a systematic search of grey and academic literature. The questionnaire contained items about providing mental health first aid to a person with depression. These items were rated by two international expert panels - a lived experience panel (consumers and carers) and a professional panel. RESULTS: Three hundred and fifty-two items were rated by 53 experts (36 with lived experience and 17 professionals) according to whether they should be included in the revised guidelines. There were 183 items that met the criteria to be included in the updated guidelines. CONCLUSIONS: This re-development has added detail to the previous version of the guidelines, giving more guidance on the role of the first aider and allowing for a more nuanced approach to providing first aid to someone with depression. These guidelines are available to the public and will be used to update the Mental Health First Aid courses.


Assuntos
Transtorno Depressivo/terapia , Primeiros Socorros , Saúde Mental , Adulto , Idoso , Técnica Delfos , Feminino , Primeiros Socorros/normas , Amigos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
8.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(5): 513-527, 2019 05.
Artigo em Chinês | MEDLINE | ID: mdl-31198133

RESUMO

OBJECTIVE: To improve the popularization of the knowledge of the first responders and promote the establishment of the awareness of the first aid, First Aid Professional Committee of Chinese Aging Well Association formulated the Expert consensus on the first responder of the first aid. This consensus aims at the critical and weak link of emergency medical service system (EMSS) in China, providing the public with the first responders action guidance, and guiding the public how to effectively rescue the "first scene", "first time" and "first responder" in the event of sudden injury or illness. Strengthen risk pre-control, environmental control and overall joint control in the "first scene" of different emergencies were emphasized. How to correctly judge, recognize, call for help and give first aid in the "first time" were presented. The first aid skills of the "first responder" should include cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) defibrillation, Heimlich (abdominal impingement), hemostasis, dressing, fixation, and handling. The best place, the best training method and the best communication way to popularize the first aid knowledge and skills were proposed, and the first responder action plan was jointly promoted from various social levels such as policy, law, science and technology, culture and so on. This consensus refers to relevant foreign guidelines and scientific basis and combines with Chinese actual national conditions to provide guidance for the first responders' action and training, aiming to promote the development of first aid in China.


Assuntos
Socorristas , Primeiros Socorros , China , Consenso , Serviços Médicos de Emergência , Humanos
9.
Nurse Educ Today ; 79: 92-97, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31112846

RESUMO

The fast and constant evolution of Massive Open Online Courses (MOOCs) has gained the attention of the educational community, achieving widespread popularity among many universities. However, there is very little research on the use and acceptance of MOOCs by students in disciplines such as health and medicine. The principal focus of this study is to explore the behavior of students from a MOOC on Health Emergencies, analyzing the completion and drop-out rates. The data were collected from three self-administered questionnaires; the first identified general demographic information and the students' learning preferences, the second determined the level of MOOC adoption and the level of identification and satisfaction the students had with the course content, and the third measured the completion and drop-out rates. The MOOC had more than 2114 registered participants. The enrolled students showed high levels of commitment and motivation to learn about this topic through a varied of innovative educational resources, such as videos, learning activities, and interactive animations. In general, the participants expressed their desire to continue learning with this type of methodology. However, the results also showed important issues to be considered in the design and development of a MOOC of these characteristics.


Assuntos
Educação a Distância/métodos , Serviços Médicos de Emergência , Primeiros Socorros/métodos , Educação em Saúde , Aprendizagem , Estudantes/estatística & dados numéricos , Adulto , Avaliação Educacional/estatística & dados numéricos , Feminino , Humanos , Masculino , Inquéritos e Questionários , Universidades
10.
Cochrane Database Syst Rev ; 4: CD013283, 2019 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-30973639

RESUMO

BACKGROUND: Hypoglycaemia is a common occurrence in people with diabetes but can also result from an imbalance in glucose homeostasis in the absence of diabetes. The best enteral route for glucose administration for suspected hypoglycaemia in a first aid situation is unknown. OBJECTIVES: To assess the effects of first aid glucose administration by any route appropriate for use by first-aid providers (buccal, sublingual, oral, rectal) for symptomatic hypoglycaemia. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, CINAHL as well as grey literature (records identified in the WHO ICTRP Search Portal, ClinicalTrials.gov and the EU Clinical Trials Register) up to July 2018. We searched reference lists of included studies retrieved by the above searches. SELECTION CRITERIA: We included studies involving adults and children with documented or suspected hypoglycaemia as well as healthy volunteers, in which glucose was administered by any enteral route appropriate for use by first-aid providers. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, assessed risk of bias, extracted data and evaluated trials for overall certainty of the evidence using the GRADE instrument. We used the Cochrane 'Risk of bias' tool to assess the risk of bias in the randomised controlled trials (RCTs), and the 'risk of bias In non-randomised studies of interventions' (ROBINS-I) tool, in addition to the Cochrane Handbook for Systematic Reviews of Interventions recommendations on cross-over studies, for the non-RCTs. We reported continuous outcomes as mean differences (MD) with 95% confidence intervals (CIs) and dichotomous outcomes as risk ratios (RR) with 95% CIs. All data on glucose concentrations were converted to mg/dL. We contacted authors of included studies to obtain missing data. MAIN RESULTS: From 6394 references, we included four studies evaluating 77 participants, including two RCTs, studying children and adults with hypoglycaemia, respectively, and two non-RCTs with healthy volunteers. The studies included three different routes of glucose administration (sublingual, buccal and a combination of oral and buccal administration). All studies had a high risk of bias in one or more 'Risk of bias' domain.Glucose administration by the sublingual route, in the form of table sugar under the tongue, resulted in a higher blood glucose concentration after 20 minutes compared with the oral route in the very specific setting of children with hypoglycaemia and symptoms of concomitant malaria or respiratory tract infection (MD 17 mg/dL, 95% CI 4.4 to 29.6; P = 0.008; 1 study; 42 participants; very low-quality evidence). Resolution of hypoglycaemia at 80 minutes may favour sublingual administration (RR 2.10, 95% CI 1.24 to 3.54; P = 0.006; 1 study; 42 participants; very low-certainty evidence), but no substantial difference could be demonstrated at 20 minutes (RR 1.26, 95% CI 0.91 to 1.74; P = 0.16; 1 study; 42 participants; very low-certainty evidence). A decrease in the time to resolution of hypoglycaemia was found in favour of sublingual administration (MD -51.5 min, 95% CI -58 to -45; P < 0.001; 1 study; 42 participants; very low-certainty evidence). No adverse events were reported in either group. No data were available for resolution of symptoms and time to resolution of symptoms, and treatment delay.Glucose administered by the buccal route in one study resulted in a lower plasma glucose concentration after 20 minutes compared with oral administration (MD -14.4 mg/dL, 95% CI -17.5 to -11.4 for an imputed within-participants correlation coefficient of 0.9; P < 0.001; 1 trial; 16 participants; very low-quality evidence). In another study there were fewer participants with increased blood glucose at 20 minutes favouring oral glucose (RR 0.07, 95% CI 0.00 to 0.98; P = 0.05; 1 study; 7 participants; very low-certainty evidence). No data were available for resolution of symptoms and time to resolution of symptoms, resolution of hypoglycaemia and time to resolution of hypoglycaemia, adverse events, and treatment delay.For the combined oral and buccal mucosal route (in the form of a dextrose gel) the MD was -15.3 mg/dL, 95%CI -33.6 to 3; P = 0.09; 1 study; 18 participants; very low-quality evidence . No improvement was identified for either route in the resolution of symptoms at 20 minutes or less following glucose administration (RR 0.36, 95% CI 0.12 to 1.14; P = 0.08; 1 study; 18 participants; very low-certainty evidence). No data were available for time to resolution of symptoms, resolution of hypoglycaemia and time to resolution of hypoglycaemia, adverse events, and treatment delay. AUTHORS' CONCLUSIONS: When providing first aid to individuals with hypoglycaemia, oral glucose administration results in a higher blood glucose concentrations after 20 minutes when compared with buccal administration of glucose. A difference in plasma glucose concentration could not be demonstrated, when administering a dextrose gel, defined as "a combined oral and buccal mucosal route" compared to oral administration of a glucose tablet or solution. In the specific population of children with concomitant malaria and respiratory illness, sublingual sugar results in a higher blood glucose concentration after 20 minutes when compared with oral administration.These results need to be interpreted cautiously because our confidence in the body of evidence is very low due to the low number of participants and studies as well as methodological deficiencies in the included studies.


Assuntos
Glucose/administração & dosagem , Hipoglicemia/tratamento farmacológico , Administração Oral , Adulto , Criança , Complicações do Diabetes , Diabetes Mellitus/sangue , Primeiros Socorros , Glucose/uso terapêutico , Humanos
11.
Int Marit Health ; 70(1): 11-16, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30931512

RESUMO

BACKGROUND: In tropical regions, jellyfish envenomation is a persistent hazard for people who spend time in the sea. Jellyfish stings can be dangerous, and among the people who face the greatest risk are scuba divers. This study therefore sought to determine the level of knowledge divers in Thailand have about the threat of jellyfish envenomation. MATERIALS AND METHODS: In April 2018, a total of 238 divers responded to a questionnaire, thereby providing data for further statistical analysis. RESULTS: The findings revealed that 31.91% of the study participants cited jellyfish stings as their most frequently encountered injury, with 68.09% having personal experience of the problem, or having seen others injured by jellyfish. However, 34.03% of the sample respondents believed their own level of knowledge to be "low" or "none". The mean score was 71%, which can be considered satisfactory, but the scores for items concerning the recognition of signs of envenomation and items about first aid responses (52.74% and 59.13%, respectively) were not acceptable. CONCLUSIONS: Divers frequently experience jellyfish stings, and diving personnel were highly rated for their knowledge in this area. However, very few were fully confident in their first aid capabilities, and therefore it can be argued that it is necessary to improve the level of medical education and to provide training to eliminate this weakness.


Assuntos
Mordeduras e Picadas/diagnóstico , Mordeduras e Picadas/terapia , Cnidários , Mergulho/efeitos adversos , Adolescente , Adulto , Animais , Estudos Transversais , Feminino , Primeiros Socorros/métodos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Tailândia
12.
Int Marit Health ; 70(1): 22-26, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30931514

RESUMO

Jellyfish stings are common in Thailand. Stings can range from mild skin irritation to severe systemic symptoms resulting in death. Jellyfish envenomation is becoming an important public health concern. The lethal box jellyfish and bluebottle jellyfish are found on the Gulf of Thailand and Andaman coasts, but there are still misconception and mismanagement of these types of severe stings. Prevention and awareness of jellyfish stings are important, as well as knowledge and first aid management of severe envenomation. Educational programmes should be provided to locals including school children, teachers, hotel and tour operators, and medical staff. This will greatly reduce the morbidity and mortality associated with fatal stings.


Assuntos
Mordeduras e Picadas/epidemiologia , Cnidários , Animais , Mordeduras e Picadas/prevenção & controle , Mordeduras e Picadas/terapia , Venenos de Cnidários/toxicidade , Primeiros Socorros/métodos , Humanos , Tailândia
13.
Lima; Perú. Ministerio de Salud; 1 ed; 20190400. 38 p. ilus, graf.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1006483

RESUMO

El Manual se enmarca dentro del tercer lineamiento de la Política Sectorial en Salud Mental. Este lineamiento orienta las acciones para el "Cuidado de la Salud Mental de la población con énfasis en condiciones de mayor vulnerabilidad". Los Primeros Auxilios Psicológicos se brindan como parte de la primera respuesta ante una emergencia y/o desastre y sus beneficios radican en reducir el nivel de afectación psicológica tras la vivencia de un evento adverso y promover el fortalecimiento de los recursos personales y colectivos para el afrontamiento y superación de la crisis ocasionada por una emergencia humanitaria o un desastre, por lo que guía al facilitador en los contenidos y metodologías para capacitar en Primeros Auxilios Psicológicos al personal de salud en la primera respuesta frente a contextos de emergencias.


Assuntos
Saúde Mental , Assistência Integral à Saúde , Primeiros Socorros , Agentes Comunitários de Saúde
14.
Zhonghua Shao Shang Za Zhi ; 35(3): 198-204, 2019 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-30897866

RESUMO

Objective: To assess the cognitive level of first aid knowledge regarding the small area burn among the child caregivers in Shanghai and improve the level of first aid for small area burn in children. Methods: From November 2017 to March 2018, 7 municipal districts in Shanghai were selected according to the random number table, from which 2 750 students of 4 nurseries, 5 kindergartens, 6 primary schools, and 2 junior middle schools were selected by adopting the convenience sampling method. Each student was limited to one caregiver as the research object. A cross-sectional survey was conducted on the cognitive level of first aid knowledge regarding small area burn among the caregivers with self-designed questionnaire through WeChat and Tencent QQ. The age, burn experience, and scarring after burns in children, the prevalence rate of burn in children of different age groups, the educational background of caregivers and their social relationship with their children, and the measures taken by caregivers firstly after small area burn occurred among their children were recorded. The choices of applying the folk prescription drugs to the wounds of their children made by caregivers and those with different educational backgrounds were recorded. The choices of applying daily necessities to the wound of their children made by caregivers were recorded. The caregivers' knowledge of standard first aid measures for small area burn, and the knowledge of caregivers with different educational backgrounds of all standard first aid measures for small area burn were recorded. The caregivers' choices of hospitals for treatment the first time, and the choices of going to the Grade Ⅲ Level A hospital with burn specialty for treatment made by caregivers with different knowledge levels about first aid measures for small area burn and those by caregivers whose children did or didn't have burn experience were recorded. The caregivers' choices of different types of medical institutions with burn specialty or specialized in burn treatment, and choices of going to burn department of comprehensive Grade Ⅲ Level A hospital for treatment made by caregivers with different knowledge levels about first aid measures for small area burn were recorded. Data were processed with Pearson chi-square test and partitions of chi-square test. Results: The effective recovery rate of questionnaire was 99.0% (2 723/2 750). The ages of children were mainly 6-11 years [64.7% (1 762/2 723)]The prevalence of burn in children was 19.4% (527/2 723). There was no statistically significant difference in the overall comparison of burn prevalence of children among the age groups (χ(2)=1.424, P>0.05). The percentage of scar formation after burn in children was 27.3% (144/527). The education backgrounds of caregivers were mainly undergraduate [40.2% (1 094/2 723)], and their social relationships with children were mainly children's mothers [74.6% (2 030/2 723)]. Assuming that their children suffered from minor burns, the measures firstly taken by 74.0% (2 016/2 723) of the caregivers was to immediately access cool running water and remove clothing on the wound of children. Totally 19.2% (523/2 723) of the caregivers chose to apply folk prescription drugs for their burn children by themselves, and the percentage of caregivers with education background of junior middle school choosing to apply folk prescription drugs for their burn children by themselves was significantly higher than that of caregivers with education background of junior college, undergraduate, or graduate (χ(2)=18.502, 20.642, 13.319, P<0.05). Totally 49.2% (1 340/2 723) of caregivers chose to daub many kinds of daily necessities for their burn children by themselves. Totally 39.2% (1 068/2 723) of caregivers knew all standard first aid measures for small area burn, the percentage of caregivers with education background of undergraduate knowing all standard first aid measures for small area burn was significantly higher than that of caregivers with education background of senior high school and secondary specialized school (χ(2)=11.234, P<0.05). Assuming that their children suffered from minor burns, 39.0% (1 063/2 723) of the caregivers chose to go to the nearest hospital for treatment the first time, the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment the first time was similar with that of caregivers who did not know/did not fully know (χ(2)=3.528, P>0.05), and the percentage of caregivers whose children had burn experience choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment in the first time was similar with that of caregivers whose children didn't have burn experience (χ(2)=3.521, P>0.05). Among all medical institutions with burn specialty or specialized in burn treatment, 28.0% (762/2 723) of the caregivers chose to go to comprehensive Grade Ⅲ Level A hospital for treatment, and the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to comprehensive Grade Ⅲ Level A hospital for treatment was significantly higher than that of caregivers who did not know/did not fully know (χ(2)=4.890, P<0.05). Conclusions: The caregivers of children are mainly children's mothers with education background of undergraduate in Shanghai, and caregivers' cognitive levels of first aid knowledge regarding the small area burn are low. Only a few caregivers know all standard first aid measures for small area burn, and there are still some caregivers who have the wrong idea of applying folk prescription drugs or daily necessities for children by themselves. The publicity and education of basic first aid knowledge of burn should be strengthened through various channels such as burn simulation exercise and network, and caregivers should be guided to take their children to hospitals with burn specialty for treatment after occurrence of burn in children, so as to obtain more professional medical treatment.


Assuntos
Queimaduras/terapia , Cuidadores , Cognição , Primeiros Socorros , Conhecimentos, Atitudes e Prática em Saúde , Criança , China , Estudos Transversais , Humanos , Inquéritos e Questionários
15.
J Nurses Prof Dev ; 35(4): 210-214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30829740

RESUMO

Given the current professional behavioral health workforce shortage, nursing professional development practitioners require educational resources to fully support registered nurses across settings in responding to patients with behavioral health symptoms. Mental Health First Aid is an 8-hour training to help nonprofessional bystanders assess a mental health crisis, provide initial help, and connect to supports and self-help resources in the local community. Mental Health First Aid was acceptable and useful to 60 RNs and can be supplemented with additional content.


Assuntos
Competência Clínica/normas , Primeiros Socorros/enfermagem , Programas de Rastreamento/enfermagem , Transtornos Mentais , Enfermeiras e Enfermeiros/provisão & distribução , Enfermagem Psiquiátrica/educação , Adulto , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Desenvolvimento de Pessoal
16.
Behav Neurol ; 2019: 5048794, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30863463

RESUMO

Purpose: To measure fidelity with which a group seizure first aid training intervention was delivered within a pilot randomized controlled trial underway in the UK for adults with epilepsy who visit emergency departments (ED) and informal carers. Estimates of its effects, including on ED use, will be produced by the trial. Whilst hardly ever reported for trials of epilepsy interventions-only one publication on this topic exists-this study provides the information on treatment fidelity necessary to allow the trial's estimates to be accurately interpreted. This rare worked example of how fidelity can be assessed could also provide guidance sought by neurology trialists on how to assess fidelity. Methods: 53 patients who had visited ED on ≥2 occasions in prior year were recruited for the trial; 26 were randomized to the intervention. 7 intervention courses were delivered for them by one facilitator. Using audio recordings, treatment "adherence" and "competence" were assessed. Adherence was assessed by a checklist of the items comprising the intervention. Using computer software, competence was measured by calculating facilitator speech during the intervention (didacticism). Interrater reliability was evaluated by two independent raters assessing each course using the measures and their ratings being compared. Results: The fidelity measures were found to be reliable. For the adherence instrument, raters agreed 96% of the time, PABAK-OS kappa 0.91. For didacticism, raters' scores had an intraclass coefficient of 0.96. In terms of treatment fidelity, not only were courses found to have been delivered with excellent adherence (88% of its items were fully delivered) but also as intended they were highly interactive, with the facilitator speaking for, on average, 55% of course time. Conclusions: The fidelity measures used were reliable and showed that the intervention was delivered as attended. Therefore, any estimates of intervention effect will not be influenced by poor implementation fidelity.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Epilepsia/terapia , Primeiros Socorros , Convulsões/terapia , Adolescente , Adulto , Idoso , Epilepsia/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Convulsões/diagnóstico , Resultado do Tratamento , Adulto Jovem
17.
J Spec Oper Med ; 19(1): 35-43, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30859524

RESUMO

BACKGROUND: A tourniquet's readiness during emergencies depends on how it is configured. We investigated configuration so ways of improving readiness can be developed. METHODS: This study was conducted at the Institute of Surgical Research in 2018 as sequential investigations by one user of Combat Application Tourniquets (C-A-Ts) in a band-and-rod design. RESULTS: Each tourniquet comes packaged with paper instructions for use, which include directions on how to configure it in preparation for caregiving. The paper and video instructions for use omit tensioning of the tourniquet in configuration, and the video misconfigured a time strap over the rod. In first-aid classrooms, we saw unwitting learners troubleshoot that misconfiguration. Problems with configuration were also seen in caregiving and with tourniquets stowed in kits. In deliberate practice, we self-applied a tourniquet to a thigh. In configuration after each of 100 uses, tourniquet elongation due to tensioning averaged 2.4 in was important for restoring the tourniquet to its full length. During configuration, if the C-A-T's stabilization plate slid along the band, out of position, the user slid the plate back into position. In various ways of testing other C-A-Ts, elongations averaged from 0.4 in to 0.9 in, depending on whether the tourniquet was self-applied or applied to a firm manikin. Elongation increments accrued as the tourniquet's band flattened. Configuration time averaged 22 seconds, and accrued experience improved the compactness of configuration. CONCLUSION: People are too often unreliable at putting C-A-Ts into the optimal configuration for use. That ready-to-use configuration includes the tourniquet being at its full length, having the stabilization plate positioned correctly along the band, and having the strap fastened to its clip of origin. When used, tourniquets had normal, small elongations in part due to band flattening. This tourniquet study showed the importance of optimal configuration to first-aid readiness practices.


Assuntos
Primeiros Socorros/instrumentação , Hemorragia/terapia , Torniquetes , Desenho de Equipamento , Humanos , Manequins , Coxa da Perna
18.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(3): 257-263, 2019 03.
Artigo em Chinês | MEDLINE | ID: mdl-30914082

RESUMO

OBJECTIVE: To promote the clinical treatment technical training and popularization of traumatic shock and cardiac arrest, Health Emergency Committee of Chinese Research Hospital Association, Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association, Cardiopulmonary Resuscitation Specialized Committee of Henan Hospital Association jointly established "Chinese expert consensus on the clinical application of innovative first-aid resuscitation technology for traumatic shock in 2019". This consensus has solved the problem of volume resuscitated gel mix and ratio in the emergency situation of pre-hospital transfusion and blood products unable to be used in traumatic shock. Hypertonic gel compound liquid can treat traumatic shock with small dosage and good effect of stabilizing blood pressure, which can replace whole blood and other blood products, improve the safety of transport to hospital, and provide an opportunity for life-saving surgery. At the same time, abdominal lifting and compression cardiopulmonary resuscitation (CPR) has solved the difficulty of treating patients with post-traumatic cardiac arrest who cannot perform traditional chest compressive CPR, and greatly improved the success rate of pre-hospital treatment for patients with traumatic shock. In view of the actual demand of emergency medical treatment in China and the contraband of chest CPR for chest trauma, the combination of "administration, production, study, research and application" was adopted, and the abdominal lifting and compression CPR was successfully developed and popularized. This expert consensus summarized the scientific evidence on traumatic shock and traumatic cardiac arrest published at home and abroad so far, and put forward the expert consensus on the clinical application of innovative first-aid resuscitation technology for traumatic shock based on Chinese national conditions. This consensus incorporated the wisdom and philosophy of Chinese and foreign scholars in the training of traumatic shock and CPR, and would certainly make the training of traumatic shock and cardiac arrest in China entering a new stage with strong pertinence, quick onset, few side effects and high treatment rate.


Assuntos
Reanimação Cardiopulmonar/métodos , Primeiros Socorros/métodos , Parada Cardíaca/terapia , Choque Traumático/terapia , Reanimação Cardiopulmonar/educação , China , Consenso , Difusão de Inovações , Humanos
19.
Aerosp Med Hum Perform ; 90(4): 405-408, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30922429

RESUMO

BACKGROUND: Handling cases of chest pain aboard commercial flights is challenging for crewmembers, onboard medical volunteers, and ground-based doctors providing remote advice. Obtaining an electrocardiogram (ECG) in-flight could help in dictating the management of such cases. The ability to diagnose or rule out ST-segment elevation myocardial infarction (STEMI) would have clinical and prognostic implications. The feasibility of obtaining good quality ECG tracings by flight attendants in flight is not known.METHODS: A series of 200 consecutive ECG tracings transmitted to a ground-based medical support provider were independently reviewed by four observers who ranked the ECG tracings according to a quality score (QS) criteria, as well as trying to identify or rule-out cases of STEMI.RESULTS: ECG quality was considered good enough to extract useful information in 170 of 200 tracings (85%). Seven cases of STEMI were identified. A STEMI was confidently ruled out in 104 cases. Additional abnormalities of variable clinical importance were also detected.DISCUSSION: ECGs are essential in the prehospital management of chest pain cases. ECGs obtained in flight by airline flight attendants were mostly of diagnostic quality, allowing confirmation or ruling out of STEMI, as well as detecting arrhythmias of clinical significance in case management.Alves PM, Lindgren JA, Streitwieser DR, Anzola E, Ahmed N, Nerwich N. Quality of electrocardiograms obtained in flight by airline flight attendents. Aerosp Med Hum Perform. 2019; 90(4):405-408.


Assuntos
Aeronaves , Dor no Peito/diagnóstico , Eletrocardiografia/métodos , Primeiros Socorros/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Dor no Peito/etiologia , Estudos de Viabilidade , Humanos , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações
20.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(1): 34-36, 2019 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-30707866

RESUMO

OBJECTIVE: Medical big data is a hot research topic in China, and it is also the main research direction in the field of emergency medicine. The current situation of the construction of the first-aid big data platform and the construction of the first-aid clinical decision support system were analyzed, the problems existing in the development of the first-aid big data research field were enumerated, to explore the theoretical methods for promoting the development of domestic first-aid big data, so as to provide references for the research in related fields.


Assuntos
Big Data , Sistemas de Apoio a Decisões Clínicas , Primeiros Socorros , China , Medicina de Emergência , Humanos
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