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3.
West J Emerg Med ; 21(5): 1095-1101, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32970560

RESUMO

The unprecedented COVID-19 pandemic has resulted in rapidly evolving best practices for transmission reduction, diagnosis, and treatment. A regular influx of new information has upended traditionally static hospital protocols, adding additional stress and potential for error to an already overextended system. To help equip frontline emergency clinicians with up-to-date protocols throughout the evolving COVID-19 crisis, our team set out to create a dynamic digital tool that centralized and standardized resources from a broad range of platforms across our hospital. Using a design thinking approach, we rapidly built, tested, and deployed a solution using simple, out-of-the-box web technology that enables clinicians to access the specific information they seek within moments. This platform has been rapidly adopted throughout the emergency department, with up to 70% of clinicians using the digital tool on any given shift and 78.6% of users reporting that they "agree" or "strongly agree" that the platform has affected their management of COVID-19 patients. The tool has also proven easily adaptable, with multiple protocols being updated nearly 20 times over two months without issue. This paper describes our development process, challenges, and results to enable other institutions to replicate this process to ensure consistent, high-quality care for patients as the COVID-19 pandemic continues its unpredictable course.


Assuntos
Betacoronavirus , Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/terapia , Sistemas de Apoio a Decisões Clínicas , Serviços Médicos de Emergência/métodos , Pneumonia Viral/terapia , Atitude do Pessoal de Saúde , Protocolos Clínicos , Árvores de Decisões , Eficiência , Emergências , Humanos , Internet , Pandemias , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Desenvolvimento de Programas , São Francisco
4.
Tex Med ; 116(7): 42-45, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32872701

RESUMO

The need for improved training on hemorrhage control in emergencies has been building for decades. Physicians say it's just as important to reach out to the community to promote hemorrhage control in the same way CPR and other life-saving methods are promoted.


Assuntos
Educação Médica Continuada , Serviços Médicos de Emergência/métodos , Medicina de Emergência/educação , Hemorragia/terapia , Médicos , Torniquetes , Hemorragia/prevenção & controle , Humanos
5.
Scand J Trauma Resusc Emerg Med ; 28(1): 80, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32799911

RESUMO

BACKGROUND: Rapid access to emergency medical communication centers (EMCCs) is pivotal to address potentially life-threatening conditions. Maintaining public access to EMCCs without delay is crucial in case of disease outbreak despite the significant increased activity and the difficulties to mobilize extra staff resources. The aim of our study was to assess the impact of two-level filtering on EMCC performance during the COVID-19 outbreak. METHODS: A before-after monocentric prospective study was conducted at the EMCC at the Nantes University Hospital. Using telephone activity data, we compared EMCC performance during 2 periods. In period one (February 27th to March 11th 2020), call takers managed calls as usual, gathering basic information from the caller and giving first aid instructions to a bystander on scene if needed. During period two (March 12th to March 25th 2020), calls were answered by a first-line call taker to identify potentially serious conditions that required immediate dispatch. When a serious condition was excluded, the call was immediately transferred to a second-line call taker who managed the call as usual so the first-line call taker could be rapidly available for other incoming calls. The primary outcome was the quality of service at 20 s (QS20), corresponding to the rate of calls answered within 20 s. We described activity and outcome measures by hourly range. We compared EMCC performance during periods one and two using an interrupted time series analysis. RESULTS: We analyzed 45,451 incoming calls during the two study periods: 21,435 during period 1 and 24,016 during period 2. Between the two study periods, we observed a significant increase in the number of incoming calls per hour, the number of connected call takers and average call duration. A linear regression model, adjusted for these confounding variables, showed a significant increase in the QS20 slope (from - 0.4 to 1.4%, p = 0.01), highlighting the significant impact of two-level filtering on the quality of service. CONCLUSIONS: We found that rapid access to our EMCC was maintained during the COVID-19 pandemic via two-level filtering. This system helped reduce the time gap between call placement and first-line call-taker evaluation of a potentially life-threatening situation. We suggest implementing this system when an EMCC faces significantly increased activity with limited staff resources.


Assuntos
Betacoronavirus , Comunicação , Infecções por Coronavirus/epidemiologia , Emergências , Sistemas de Comunicação entre Serviços de Emergência/organização & administração , Serviços Médicos de Emergência/métodos , Pneumonia Viral/epidemiologia , Triagem/métodos , Estudos Controlados Antes e Depois , Humanos , Pandemias , Estudos Prospectivos , Telefone
6.
Isr Med Assoc J ; 8(22): 410-416, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32812714

RESUMO

BACKGROUND: The potential excess flow of patients into emergency departments and community clinics for testing and examination during a pandemic poses a major issue. These additional patients may lead to the risk of viral transmission to other patients and medical teams. To contain the spread of coronavirus disease-2019 (COVID-19), the Israeli Ministry of Health initiated a plan spearheaded by Magen David Adom (MDA), Israel's national emergency medical services (EMS) organization. OBJECTIVES: To describe outbreak containment actions initiated by MDA, including a COVID-19 tele-triage center and home testing by paramedics. METHODS: Retrospective analysis was conducted of de-identified data from the call management and command and control systems during the first period of the COVID-19 outbreak in Israel (23 February 2020-15 March 2020). RESULTS: During the study period, the total number of calls to the dispatch centers was 477,321 with a daily average of 21,696, compared to 6000-6500 during routine times. The total number of COVID-19 related calls was 334,230 (daily average 15,194). There were 28,454 calls (8.51% of all COVID-19 related calls, average 1293/day) transferred to the COVID-19 call center. Of the COVID-19 call center inquiries, 8390 resulted in the dispatch of a dedicated vehicle, including a paramedic wearing personal protective equipment, to collect samples for testing (daily average 381). CONCLUSIONS: Maximizing EMS during a pandemic using phone triage, in addition to dispatching paramedics to perform home testing, may significantly distance infected patients from the public and health care system. These steps can further minimize the spread of disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Serviços Médicos de Emergência/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Serviços Médicos de Emergência/organização & administração , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estudos Retrospectivos , Telemedicina/métodos , Telemedicina/organização & administração , Triagem/métodos , Triagem/organização & administração
7.
Am Surg ; 86(8): 937-943, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32762468

RESUMO

INTRODUCTION: There is disagreement in the trauma community concerning the extent to which emergency medical services (EMS) should perform on-scene interventions. Additionally, in recent years the "ABC" algorithm has been questioned in hypotensive patients. The objective of this study was to quantify the delay introduced by different on-scene interventions. METHODS: A retrospective analysis of hypotensive trauma patients brought to an urban level 1 trauma center by EMS from 2007 to 2018 was performed, and patients were stratified by mechanism of injury and new injury severity score (NISS). Independent samples median tests were used to compare median on-scene times. RESULTS: Among 982 trauma patients, median on-scene time was 5 minutes (interquartile range 3-8). In penetrating trauma patients (n = 488) with NISS of 16-25, intubation significantly increased scene time from 4 to 6 minutes (P < .05). In penetrating trauma patients with NISS of 10-15, wound care significantly increased scene time from 3 to 6 minutes (P < .05). Tourniquet use, interosseous (IO) access, intravenous (IV) access, and needle decompression did not significantly increase scene time. CONCLUSION: Understanding that intubation increases scene time in penetrating trauma, while IV and IO access do not, alterations to the traditional "ABC" algorithm may be warranted. Further investigation of prehospital interventions is needed to determine which are appropriate on-scene.


Assuntos
Algoritmos , Tomada de Decisão Clínica/métodos , Serviços Médicos de Emergência/métodos , Hipotensão/terapia , Tempo para o Tratamento/estatística & dados numéricos , Ferimentos e Lesões/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Feminino , Mortalidade Hospitalar , Humanos , Hipotensão/etiologia , Hipotensão/mortalidade , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Transporte de Pacientes , Centros de Traumatologia , Ferimentos e Lesões/complicações , Ferimentos e Lesões/mortalidade
8.
PLoS One ; 15(8): e0237192, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785294

RESUMO

BACKGROUND: Helicopter emergency medical services' (HEMS) effectiveness for pediatric trauma patients remains unclear. We aimed to examine the relation between HEMS and reduced mortality in pediatric trauma patients. METHODS: This retrospective cohort study utilized data from the Japan Trauma Data Bank, a national multicenter clinical trauma database. Participants were aged <18 years, admitted between 2004 and 2015, and transported from the scene to the hospital by HEMS or ground emergency medical services (GEMS). We used a standardized mortality ratio (SMR) weight method, and fitted a marginal structural model to adjust for measured confounders. The SMR weight was calculated using the estimation of the propensity scores. A logistic regression model was used with the baseline independent variables to estimate the propensity score. RESULTS: Overall, 5,947 patients were identified in our study: 453 were transported by HEMS and 5,494 by GEMS. The mean injury severity score in the HEMS group was significantly higher than that in the GEMS group17.0 (Standard deviation = 11.0) vs 12.2 (Standard deviation = 9.2), p < .001. In-hospital mortality was higher in the HEMS group than that in the GEMS group in the unadjusted analysis (3.8% vs 1.3%, respectively; p < .001). After adjusting for covariates, HEMS transport was not associated with reduced hospital mortality. (odds ratio = 0.82, 95% confidence interval = 0.42-1.58). CONCLUSIONS: HEMS was not associated with reduced mortality among pediatric trauma patients compared with GEMS in this nationwide study. Further investigation is necessary to determine who clearly benefits from HEMS as compared to GEMS.


Assuntos
Resgate Aéreo , Aeronaves , Serviços Médicos de Emergência/métodos , Mortalidade Hospitalar , Transporte de Pacientes/métodos , Ferimentos e Lesões/mortalidade , Adolescente , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Lactente , Recém-Nascido , Escala de Gravidade do Ferimento , Japão , Masculino , Mortalidade , Estudos Retrospectivos , Fatores de Tempo
9.
Epidemiol Infect ; 148: e174, 2020 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-32762783

RESUMO

Coronavirus disease 2019 (COVID-19) is a global health threat. A hospital in Zhuhai adopted several measures in Fever Clinic Management (FCM) to respond to the outbreak of COVID-19. FCM has been proved to be effective in preventing nosocomial cross infection. Faced with the emergency, the hospital undertook creative operational steps in relation to the control and spread of COVID-19, with special focuses on physical and administrative layout of buildings, staff training and preventative procedures. The first operational step was to set up triaging stations at all entrances and then complete a standard and qualified fever clinic, which was isolated from the other buildings within our hospital complex. Secondly, the hospital established its human resource reservation for emergency response and the allocation of human resources to ensure strict and standardised training methods through the hospital for all medical staff and ancillary employees. Thirdly, the hospital divided the fever clinic into partitioned areas and adapted a three-level triaging system. The experiences shared in this paper would be of practical help for the facilities that are encountering or will encounter the challenges of COVID-19, i.e. to prevent nosocomial cross infection among patients and physicians.


Assuntos
Infecções por Coronavirus/terapia , Serviços Médicos de Emergência/métodos , Arquitetura Hospitalar/métodos , Pneumonia Viral/terapia , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Surtos de Doenças , Serviços Médicos de Emergência/organização & administração , Serviços Médicos de Emergência/normas , Febre/diagnóstico , Febre/etiologia , Febre/terapia , Arquitetura Hospitalar/normas , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Ensino , Fatores de Tempo , Triagem/métodos , Ventilação/normas , Fluxo de Trabalho , Recursos Humanos/organização & administração , Recursos Humanos/normas
10.
Emergencias (Sant Vicenç dels Horts) ; 32(4): 258-268, ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193946

RESUMO

El presente documento de consenso se ha desarrollado con el fin de proporcionar una herramienta útil para el manejo del paciente asmático que acude al servicio de urgencias (SU) con una crisis asmática. Incluye recomendaciones para tomar la decisión de alta o ingreso, así como indicaciones de derivación para el posterior seguimiento. Un equipo multidisciplinar, constituido por tres especialistas en medicina de urgencias, tres especialistas en neumología y tres especialistas en alergología, se encargó de elaborar una lista de preguntas clínicas que respondieron mediante la ayuda tanto de guías de práctica clínica, como de literatura disponible. Los contenidos y el reparto de tareas en diferentes grupos de trabajo se consensuaron en una reunión presencial. Los materiales resultantes se pusieron en común y sirvieron para la preparación del manuscrito final. Las recomendaciones y los algoritmos incluidos en el mismo van dirigidos a identificar y diagnosticar correctamente las exacerbaciones asmáticas en el SU y a establecer los criterios de hospitalización o alta. Se incluyen también las pautas para el tratamiento de los pacientes y para su derivación al ámbito de atención especializada en caso de alta, incluyendo los criterios de priorización para dicha derivación. El documento ha sido avalado por la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Sociedad Española de Alergología e Inmunología Clínica (SEAIC), y la Sociedad Española de Urgencias y Emergencias (SEMES)


This consensus paper's purpose is to provide a tool for managing emergency asthma exacerbations that require a decision to admit or discharge the patient. The paper also addresses where to refer the discharged patient for follow up. A multidisciplinary team of 3 emergency physicians, 3 specialists in respiratory medicine, and 3 allergy specialists were charged with drafting a list of clinical questions to answer by consulting practice guidelines and other resources in the literature. The specialists held a face-to-face meeting to distribute tasks and topics to working groups. The groups shared their reports, which provided the basis for drafting the final paper. The recommendations and flow charts included in the paper provide guidance for identifying and correctly diagnosing asthma exacerbations in the emergency department. Criteria for admission or discharge are incorporated. Treatment protocols and recommendations for referring discharged patients to specialists are addressed, along with criteria for priority referrals. The final consensus paper has been endorsed by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), the Spanish Society of Allergology and Clinical Immunology (SEAIC), and the Spanish Society of Emergency Medicine (SEMES)


Assuntos
Humanos , Asma/epidemiologia , Serviços Médicos de Emergência/métodos , Encaminhamento e Consulta/normas , Índice de Gravidade de Doença , Indicadores de Qualidade em Assistência à Saúde/normas , Encaminhamento e Consulta/organização & administração , Exacerbação dos Sintomas , Hospitalização , Anamnese , Comunicação Interdisciplinar , Fatores de Risco
14.
Emergencias (Sant Vicenç dels Horts) ; 32(4): 269-277, ago. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-190943

RESUMO

La investigación es una de las labores inalienables al ejercicio de la profesión médica. En el ámbito de la medicina de urgencias y emergencias (MUE), durante las últimas décadas se ha producido un aumento progresivo de esta actividad, liderada por los propios profesionales que trabajan en servicios de urgencias hospitalarios (SUH) y en los sistemas médicos de emergencias. No obstante, su producción científica se ha fundamentado más en la actividad de grupos unicéntricos que en redes de colaboración entre centros. Los últimos años, no obstante, han aparecido líneas de investigación exclusivamente dedicadas a la MUE en diversos institutos de investigación sanitaria españoles, reconocidos por el Instituto de Salud Carlos III, y también grupos de investigación de procesos específicos con una producción mantenida en el tiempo, muchos de ellos vinculados a la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES). En el contexto de la pandemia de COVID-19 generada por el SARS-CoV-2, ha surgido la necesidad de que estos elementos investigadores unan sus fuerzas para hacer frente a los principales retos investigadores que supone esta pandemia desde la perspectiva de los SUH. Ello ha conducido a la fundación de la red de investigación SIESTA (Spanish Investigators on Emergency Situacions TeAm), cuyo primer reto es la realización del macroproyecto UMC-19 (Unusual Manifestations of Covid-19) en el plazo de un mes. A continuación se describen los pasos seguidos y los principales hitos de esta experiencia primigenia


Research is an inalienable part of medicine. The last few decades have seen a steady increase in research relevant to emergency medicine, led by professionals working in hospital emergency departments and related medical services. Most of the work has been done by groups in individual rather than networked centers. However, several Spanish institutions recognized by the Carlos III Health Institute (ISCIII) have developed lines of research that focus exclusively on emergency medicine. In addition, stable research groups - many of them associated with the Spanish Society of Emergency Medicine (SEMES) - have been engaged in ongoing studies of processes specific to our field. The coronavirus disease 2019 (COVID-19) pandemic caused by the acute respiratory syndrome coronavirus 2 (SARSCoV-2) created a need to focus all our efforts on the main challenges facing emergency departments. In response, the SIESTA (Spanish Investigators in Emergency Situations TeAm) network was created. The network's first challenge has been to complete the UMC-19 (Unusual Manifestations of COVID-19) macroproject within a single month. This paper describes the steps SIESTA followed and the main goals of this pioneering experience


Assuntos
Humanos , Colaboração Intersetorial , Serviços Médicos de Emergência/organização & administração , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Serviços Médicos de Emergência/ética , Serviços Médicos de Emergência/métodos , Planos e Programas de Saúde/organização & administração , Formulação de Projetos , Espanha/epidemiologia
15.
PLoS One ; 15(7): e0235315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32634172

RESUMO

BACKGROUND: The effect of paramedic crew size in the resuscitation of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. We hypothesised that teams with a larger crew size have better resuscitation performance including chest compression fraction (CCF), advanced life support (ALS), and teamwork performance than those with a smaller crew size. METHODS: We conducted a randomized controlled study in a simulation setting. A total of 140 paramedics from New Taipei City were obtained by stratified sampling and were randomly allocated to 35 teams with crew sizes of 2, 3, 4, 5, and 6 (i.e. 7 teams in every paramedic crew size). A scenario involving an OHCA patient who experienced ventricular fibrillation and was attached to a cardiopulmonary resuscitation (CPR) machine was simulated. The primary outcome was the overall CCF; the secondary outcomes were the CCF in manual CPR periods, time from the first dose of epinephrine until the accomplishment of intubation, and teamwork performance. Tasks affecting the hands-off time during CPR were also analysed. RESULTS: In all 35 teams with crew sizes of 2, 3, 4, 5, and 6, the overall CCFs were 65.1%, 64.4%, 70.7%, 72.8%, and 71.5%, respectively (P = 0.148). Teams with a crew size of 5 (58.4%, 61.8%, 68.9%, 72.4%, and 68.7%, P<0.05) had higher CCF in manual CPR periods and better team dynamics. Time to the first dose of epinephrine was significantly shorter in teams with 4 paramedics, while time to completion of intubation was shortest in teams with 6 paramedics. Troubleshooting of M-CPR machine decreased the hands-off time during resuscitation (39 s), with teams comprising 2 paramedics having the longest hands-off time (63s). CONCLUSION: Larger paramedic crew size (≧4 paramedics) did not significantly increase the overall CCF in OHCA resuscitation but showed higher CCF in manual CPR period before the setup of the CPR machine. A crew size of ≧4 paramedics can also shorten the time of ALS interventions, while teams with 5 paramedics will have the best teamwork performance. Paramedic teams with a smaller crew size should focus more on the quality of manual CPR, teamwork, and training how to troubleshoot a M-CPR machine.


Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , Reanimação Cardiopulmonar/métodos , Serviços Médicos de Emergência/métodos , Parada Cardíaca Extra-Hospitalar/prevenção & controle , Adulto , Cuidados Críticos/métodos , Auxiliares de Emergência , Medicina de Emergência/métodos , Epinefrina/administração & dosagem , Feminino , Humanos , Intubação/métodos , Masculino , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/patologia , Fibrilação Ventricular/fisiopatologia , Fibrilação Ventricular/prevenção & controle
18.
Ann Hematol ; 99(9): 1967-1977, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32621178

RESUMO

Thalassemia is characterized by a defect in the synthesis of one or more of the globin subunits of hemoglobin. This defect results in imbalance in the α/ß-globin chain ratio, ineffective erythropoiesis, chronic hemolytic anemia, and iron overload. With advances in diagnosis, treatment, and transfusion support, the prognosis of patients with thalassemia has improved over the past few decades. An increasing number of patients with thalassemia is living with long-term complications, including cardiomyopathy, chronic liver disease, endocrinopathy, and infections. In this paper, we review common complications that bring the patient with thalassemia to urgent or emergent medical attention. We also discuss the aspects of emergency care that are most relevant while caring for the patient with thalassemia in the emergency department.


Assuntos
Serviços Médicos de Emergência/tendências , Serviço Hospitalar de Emergência/tendências , Doenças Raras/diagnóstico por imagem , Doenças Raras/terapia , Talassemia/diagnóstico por imagem , Talassemia/terapia , Betacoronavirus , Transfusão de Sangue/métodos , Transfusão de Sangue/tendências , Cardiomiopatias/diagnóstico por imagem , Cardiomiopatias/epidemiologia , Cardiomiopatias/terapia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Diagnóstico Diferencial , Serviços Médicos de Emergência/métodos , Humanos , Hepatopatias/diagnóstico por imagem , Hepatopatias/epidemiologia , Hepatopatias/terapia , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Doenças Raras/epidemiologia , Talassemia/epidemiologia
19.
Arch Gynecol Obstet ; 302(3): 585-593, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32661755

RESUMO

PUPROSE: An emergency caesarean section is a potentially life-threatening situation both for the mother and the newborn. Non-technical skills can be improved by simulation training and are necessary to manage this urgent situation successfully. The objective of this study was to investigate, if training of emergency caesarean section can be transferred into daily work to improve the outcome parameters pH an APGAR of the newborn. METHODS: In this pre-post study, 141 professionals took part in a training for emergency caesarean section. Participants received a questionnaire, based on the tools "Training Evaluation Inventory" and "Transfer Climate Questionnaire" 1 year after training. Outcome data of the newborn were collected from the hospitals information system. RESULTS: Except the scale "extinction", Cronbach's alpha was higher than 0.62. All scales were rated lower than 2.02 on a 5-point Likert Scale (1 = fullest approval; 5 = complete rejection). "Negative reinforcement" was rated with 2.87 (SD 0.73). There were no significant differences in outcome data prior. The questionnaire fulfils criteria for application except the scale "extinction". CONCLUSION: The presented training course was perceived as useful by the professionals and attitudes toward training were positive; the content was positively reinforced in practice 1 year after training. Parameters of the newborn did not change. It is conceivable that other outcome parameters (e.g. posttraumatic stress disorder) are addressed by the training. The development of relevant outcome parameters for the quality of emergency sections needs further investigation.


Assuntos
Cesárea/educação , Serviços Médicos de Emergência/métodos , Capacitação em Serviço/métodos , Comunicação Interdisciplinar , Adulto , Cesárea/estatística & dados numéricos , Avaliação Educacional , Emergências , Tratamento de Emergência , Feminino , Alemanha , Humanos , Recém-Nascido , Equipe de Assistência ao Paciente , Gravidez , Inquéritos e Questionários , Adulto Jovem
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