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1. Preoperative Pain Management of Patients with Hip Fractures: Blind Fascia Iliaca Compartment Block Compared to Ultrasound Guided Femoral Nerve Block—A Randomized Controlled Trial

Author

Thomas Thougaard, Johanne Bangshoej, Hans Fjeldsøe-Nielsen, and Sandra Viggers

Subjects
medicine.medical_specialty, Preoperative pain, business.industry, Pain management, Ultrasound guided, Femoral nerve block, law.invention, Surgery, Leg raise, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, 030202 anesthesiology, law, medicine, Fascia iliaca, Statistical analysis, 030212 general & internal medicine, business
Abstract

Introduction: Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonly used in preoperative pain management in patients with hip fractures in Danish emergency departments. The aim of this study was to compare the efficacy in pain management of these two types of peripheral nerve blocks in the preoperative period in patients with hip fractures. Method: We performed a randomized controlled study. The primary outcome was the proportion of patients with a numeric rating scale (NRS) pain score equal to three or less at rest and after passive leg raise test three hours after block administration. Results: A total of 88 patients were included in the study and 67 patients in the statistical analysis with 33 in the FICB group and 34 in the FNB group. The results showed a significant reduction in the proportion of patients with an NRS score higher than three, three hours after administration of either FICB or FNB compared to at inclusion. There was no significant difference in pain scores between patients receiving FICB versus patients receiving FNB at rest or after passive leg raise (p = 0.25 and p = 0.86, respectively). Conclusion: Blind FICB and ultrasound guided FNB were effective in preoperative pain management in patients with hip fractures. The results showed that the two types of peripheral nerve blocks were equally efficient in providing pain management in the preoperative period.

Published
2020
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2. Low Incidence of Biphasic Allergic Reactions in Patients Admitted to Intensive Care after Anaphylaxis

Author

Katrin Thormar, Peder Carl, Sofie Elberling, Anders Perner, Peter Søe-Jensen, Sandra Viggers, Lene Heise Garvey, Morten H. Bestle, and Sofie Højlund

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Critical Care, Denmark, MEDLINE, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Intensive care, Hypersensitivity, medicine, Humans, In patient, 0101 mathematics, Anaphylaxis, Retrospective Studies, Inpatients, business.industry, Incidence, Incidence (epidemiology), 010102 general mathematics, Retrospective cohort study, Middle Aged, medicine.disease, Hospitalization, Intensive Care Units, Anesthesiology and Pain Medicine, 030228 respiratory system, Female, business, After treatment
Abstract

Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Biphasic allergic reactions—recurrence of allergy symptoms after a symptom-free period—are reported to occur in 1 to 23% of allergic reactions. Patients admitted to an intensive care unit after anaphylaxis potentially have more severe reactions and a higher risk of biphasic allergic reactions. The purpose of this study was to examine incidence, triggers, symptoms, and treatment of biphasic allergic reactions, in patients admitted to an intensive care unit. Methods Records of patients admitted to intensive care units with anaphylaxis from 2011 to 2014 were reviewed. Only patients with a reaction fulfilling internationally accepted criteria for anaphylaxis were included. Potential biphasic allergic reactions, defined as renewed allergy symptoms 1 to 72 h after initial symptoms had resolved, without further exposure to the trigger, were identified. Results A total of 83 cases of anaphylaxis were identified, and the most frequent triggers were medications (58 of 83 [70%]). Skin symptoms occurred in 69 (83%) cases, and circulatory and respiratory symptoms in 48 (58%) and 45 (54%) cases, respectively. In total, 82 (99%), 80 (96%), and 66 (80%) were treated with antihistamines, corticosteroids, and epinephrine, respectively. Only 10 patients presented with one or more relevant symptoms after the initial allergic reaction. Of these, three were possible, and one was a probable biphasic allergic reaction, giving a total incidence of 4 of 83 (4.8% [95% CI, 1.6 to 12.5]) or 1 of 83 (1.2% [95% CI, 0.1 to 7.46]), respectively. All cases were mild, presenting with skin symptoms only, occurring on average 14 h after initial reactions. Conclusions The authors observed a low incidence of biphasic reactions in patients admitted to an intensive care unit after anaphylaxis, at a rate equivalent to that reported in other patient groups.

Published
2019
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3. The revised Approved Instructional Resources score: An improved quality evaluation tool for online educational resources

Author

Nadim Lalani, Shelaina Anderson, Jonas Wilmer, Marina Roure, Kristen Weersink, Katherine A. Stuart, Brent Benavides, Wisarut Bunchit, Colleen Sweeney, Robert R. Ehrman, Richard Tang, Kelvin Tran, Gregory Wanner, Drew Kalnow, Christine Roh, Kinjal Patel, Bill Fraser, Therese Mead, Stephen Carroll, Paul Schofield, Caley Flynn, Lindy Buzikievich, Lucy Chen, Tara Stratton, Jan Hansel, Hector C. Singson, Tanner Gronowski, Ali Jamal, Adeeb Saleh, Todd Taylor, Rayan Delbani, Phil Griffith, Michael J. Ward, Miranda Wan, Ashley Kilp, Anna Whalen-Browne, Logan Mills, Ali S. Raja, Perry Menzies, Christine Patterson, Sandra Viggers, Brendan Devine, Vanessa Rogers, Braeden Beaumont, Jennifer Baird, Paula Sneath, Natasha Chatham-Zvelebil, Brandon Herb, Harry Liu, Marie Decock, Sarah Mott, Elise Lovell, Mohammad Ali Jamil, Ken Edwards, Victor Jansen, Maia Dorsett, Jaasmit Khurana, Salim R. Rezaie, Alexander Hart, Fareen Zaver, Manpreet Singh, Ching-Hsing Lee, Suzanne Rannazzisi, Mike McDonnell, Loice Swisher, Rob Carey, Joe Walter, Andrew D. D’Alessandro, Bob Stuntz, James Stempien, Preston Fedor, Kelly Lien, Parisa Shahrabadi, Shauna Regan, Alan Taylor, Nilantha Lenora, Scott Anderson, Calvin H. Yeh, Jason Trickovic, David Calcara, Werner Oberholzer, Catherine Patocka, James Fukakusa, T. Oyedokun, Ivy Liu, Regina Hammock, Steve Liu, Kevin Cullison, Chris Belcher, Teresa Dunphy, Alexis Pelletier-Bui, Zander Laurie, Ashley Lubberdink, James Pearlman, James Huffman, Nikhil Tambe, Carolyn McQuarrie, Gerhard Tiwald, Gregor Prosen, David Lowe, Henry Swoboda, Jennifer Weekes, Kimberly Connors, Aaron Tyagi, Anali Maneshi, Patrick M. Lank, Emina Hajdinjak, Levi Johnston, Eric Chen, Abdulaziz S. Almehlisi, Zach Jarou, Noorin Walji, Alvin Chin, Tanis Quaife, Nikytha Antony, Lawrence Yau, Alexander Zozula, Gregory Costello, Louise Rang, John Mayo, Evan S. Schwarz, Victoria Brazil, P. Mukherj, Taylor Duda, Jaime Jordan, Susan McLellan, Alim Pardhan, Jared Baylis, Allan Mix, Cathy Grossman, Sean Dyer, Emily House, Eric Shappell, Colin Andrews, Mark Woodcroft, William D.T. Kent, Anthony Bryson, Nelson Wong, Pawan Gupta, Diptesh Aryal, Owen Scheirer, Morgan Oakland, Patrick Vallance, Brendan Moore, Mary R C Haas, Kenn Ghaffarian, Steve Montag, Elyse Berger Pelletier, Julianna Deutscher, Nina House, Keith Rosenberg, Sushant Chhabra, Viktor Gawlik, Michael Benham, Andrew Baker, Brent Thoma, Ernest Leber, Larissa Hattin, Casey Lyons, Timothy Chaplin, Kamini Premkumar, Shahbaz Syed, Ivanna Kruhlak, Stephanie Louka, Haakon Lenes, Rene Verbeek, SueLin Hilbert, Joshua Rudner, Julia Nood, Kelly van Diepen, Brian Whiteside, Karthryn T. Eastley, Julia Sheffield, Damjan Gaco, Sam Smith, Quinten S. Paterson, Teresa M. Chan, Jeremy Christensen, Jocelyn Andruko, Youness Elkhalidy, Cory Meeuwisse, Sheena Nandalal, Cara Weessies, Scott Knapp, Sheng Hsiang Ma, Meagan Fu, Veronica Coppersmith, William Denq, Vivian Jia, Kristina Lea, Hugh MacLeod, Simon Huang, Yingchun Lin, Wyatt Warawa, Will Sanderson, Brian Ficiur, Jessica G.Y. Luc, Taylor Nikel, Jessica Yee, Tina Choudhri, Patricia Van den Berg, Andrew Grock, Samantha Lam, Andrew Guy, Keeth Krishnan, Taku Taira, Eric Funk, Rachel Taylor, Ali Mulla, Sebastian Kohler, Kyle Kelson, Nicholas Bouchard, Stanislaw Haciski, Jesse Leontowicz, Paul Trinquero, Charlie Inboriboon, Justin Dueweke, Julian Botta, Emily Brumfield, Kat Butler, Patrick Meloy, Laleh Gharahbaghian, Andrew K. Hall, Maria Rosa Carrillo, Aubrey Powell, Louise Cassidy, Jesse May, Isabelle N. Colmers-Gray, Evelyn Tran, Sarah Batty, Vishal Puri, Randi Ramunno, Luis Vargas, Stephen Miazga, Justin Morgenstern, Michelle Lin, Andrew Griffith, Michael Susalla, Charlotte Alexander, Alex Ireland, Kerstin de Wit, Marcia L. Edmonds, Robert Sobehart, Rob Woods, Kirsty Challen, Dave Slessor, Abby Cosgrove, Eric Chochi, Onyeka Otugo, Amy F. Ho, Alexandra Gustafson, Zlata Vlodaver, Kerry Spearing, Ryan Raffel, Milan L Ridderikhof, Barbra Backus, Saeed Alqahtani, Paul Schunk, Anne Messman, Seth Kelly, Puneet Kapur, Andrew Little, Kathryn Chan, Sean Nugent, Rishi Khakhkhar, Mohammed Alkhalifah, Rachel Wang, Jesse Hill, Marc Phan, Jaroslaw Gucwa, Nick Mancuso, Paxton Ting, Matthew Wagner, Zafrina Poonja, Elisha Targonsky, Britni Sternard, Katherine Yurkiw, Manrique Umana, Jeff Hill, Matthew Willis, and Sherri L. Rudinsky

Subjects
Medical education, education.field_of_study, Intraclass correlation, business.industry, Best practice, Population, MEDLINE, Context (language use), Usability, Original Contribution, Emergency Nursing, Education, Emergency Medicine, Thematic analysis, education, business, Psychology, Quality assurance
Abstract

Background Free Open-Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context. It has yet to be evaluated in other populations. Objectives We assessed the AAT's usability in a diverse population of practicing emergency medicine (EM) physicians, residents, and medical students; solicited feedback; and developed a revised tool. Methods As part of the Medical Education Translational Resources: Impact and Quality (METRIQ) study, we recruited medical students, EM residents, and EM attendings to evaluate five FOAM posts with the AAT and provide quantitative and qualitative feedback via an online survey. Two independent analysts performed a qualitative thematic analysis with discrepancies resolved through discussion and negotiated consensus. This analysis informed development of an initial revised AAT, which was then further refined after pilot testing among the author group. The final tool was reassessed for reliability. Results Of 330 recruited international participants, 309 completed all ratings. The Best Evidence in Emergency Medicine (BEEM) score was the component most frequently reported as difficult to use. Several themes emerged from the qualitative analysis: for ease of use-understandable, logically structured, concise, and aligned with educational value. Limitations include deviation from questionnaire best practices, validity concerns, and challenges assessing evidence-based medicine. Themes supporting its use include evaluative utility and usability. The author group pilot tested the initial revised AAT, revealing a total score average measure intraclass correlation coefficient (ICC) of moderate reliability (ICC = 0.68, 95% confidence interval [CI] = 0 to 0.962). The final AAT's average measure ICC was 0.88 (95% CI = 0.77 to 0.95). Conclusions We developed the final revised AAT from usability feedback. The new score has significantly increased usability, but will need to be reassessed for reliability in a broad population.

Published
2021
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4. Impact of blood products on platelet function in patients with traumatic injuries: a translational study

Author

Hanne H. Henriksen, Bryan A. Cotton, Tzu An Chen, Lisa A. Baer, Nena Matijevic, Pär I. Johansson, Sisse R. Ostrowski, Charles E. Wade, Erin E. Fox, Alexandra G. Grand, Jessica C. Cardenas, Jakob Stensballe, Sandra Viggers, John B. Holcomb, and Sacha Sølbeck

Subjects
Adult, Blood Platelets, Male, medicine.medical_specialty, Adolescent, Platelet Function Tests, Blood Component Transfusion, 030204 cardiovascular system & hematology, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Autologous plasma, law, medicine, Humans, In patient, Platelet, Prospective Studies, Aged, Aged, 80 and over, Platelet Count, business.industry, 030208 emergency & critical care medicine, Emergency department, Middle Aged, Intensive care unit, Surgery, Anesthesia, Wounds and Injuries, Injury Severity Score, Female, business
Abstract

Background Reductions in platelet (PLT) count and function are associated with poor outcomes in trauma patients. We proposed to determine if patients expected to receive blood products have a decrease in PLT function higher than expected based on the reduction in PLT count, and if the reduction in function could be associated with the donor plasma/supernatant received. Methods PLT count and function were measured on admission to the emergency department and intensive care unit in severely injured patients expected to receive a transfusion. PLT function was measured by Multiplate aggregometry in response to five agonists. Function was corrected for alterations in count. In vitro studies were conducted in the blood of normal subjects to assess the effect of dilutions with AB donor plasma on PLT function. Results Forty-six patients were enrolled, with 87% requiring a transfusion. Median Injury Severity Score was 23 (13, 29) and mortality 15%. PLT count and function were decreased from emergency department to intensive care unit admission by 25% and 58%, respectively. Decreases in function persisted after adjustment for count. Patients requiring large volumes of blood products had reductions in function that were disproportionately greater. Reductions in PLT function were greatest after transfusion of PLTs. In in vitro studies with a 30% dilution by autologous plasma caused a relational reduction in function, whereas allogenic plasma resulted in greater decreases that were highly variable between donors. Conclusions Within hours of injury a decrease in both PLT count and function occurs, that is aggravated with the administration of blood products, with transfusion of PLTs showing the greatest effect. The effect on PLT function of allogenic transfused plasma appears to be highly donor related.

Published
2017
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5. How to include medical students in your healthcare simulation centre workforce

Author

Sandra Viggers, Peter Dieckmann, and Doris Østergaard

Subjects
Medical education, Healthcare education, business.industry, Health services research, General Medicine, lcsh:Computer applications to medicine. Medical informatics, Education environment, Work (electrical), Faculty development, Human resource management, Health care, Workforce, Peer-to-peer, ComputingMilieux_COMPUTERSANDEDUCATION, lcsh:R858-859.7, Health education, Sociology, Human resources, business, Innovation, Simulation
Abstract

Running simulation centre activities requires a substantial amount of human resources. Here we present ideas on how medical students can be integrated into the simulation centre workforce to support the goal of delivering simulation-based education.The ideas are centred around the many different roles the students can fulfil and how this can be applied in other centres interested in integrating medical students into the workforce. The ideas are based on the experience from a regional Danish simulation centre, the Copenhagen Academy for Medical Education and Simulation (CAMES), where the work of medical students appears to be beneficial for both students, teaching and research faculty, and the growth of the simulation centre.

Published
2019
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6. The Social Media Index as an Indicator of Quality for Emergency Medicine Blogs: A METRIQ Study

Author

Brent Thoma, Teresa M. Chan, Puneet Kapur, Derek Sifford, Marshall Siemens, Michael Paddock, Felix Ankel, Andy Grock, Michelle Lin, Charlotte Alexander, Mohammed Alkhalifah, Abdulaziz S. Almehlisi, Saeed Alqahtani, Scott Anderson, Shelaina Anderson, Colin Andrews, Jocelyn Andruko, Nikytha Antony, Diptesh Aryal, Barbra Backus, Jennifer Baird, Andrew Baker, Sarah Batty, Jared Baylis, Braeden Beaumont, Chris Belcher, Brent Benavides, Michael Benham, Julian Botta, Nicholas Bouchard, Victoria Brazil, Emily Brumfield, Anthony Bryson, Wisarut Bunchit, Kat Butler, Lindy Buzikievich, David Calcara, Rob Carey, Stephen Carroll, Louise Cassidy, Kirsty Challen, Kathryn Chan, Tim Chaplin, Natasha Chatham-Zvelebil, Eric Chen, Lucy Chen, Sushant Chhabra, Alvin Chin, Eric Chochi, Tina Choudhri, Jeremy Christensen, Isabelle Colmers-Gray, Kimberly Connors, Veronica Coppersmith, Abby Cosgrove, Gregory Costello, Kevin Cullison, Andrew D'Alessandro, Kerstin de Wit, Marie Decock, Rayan Delbani, William Denq, Julianna Deutscher, Brendan Devine, Maia Dorsett, Taylor Duda, Justin Dueweke, Teresa Dunphy, Sean Dyer, Karthryn T Eastley, Marcia Edmonds, Ken Edwards, Robert Ehrman, Youness Elkhalidy, Preston Fedor, Brian Ficiur, Caley Flynn, Bill Fraser, Meagan Fu, James Fukakusa, Eric Funk, Damjan Gaco, Viktor Gawlik, Kenn Ghaffarian, Laleh Gharahbaghian, Phil Griffith, Andrew Griffith, Andrew Grock, Tanner Gronowski, Cathy Grossman, Jaroslaw Gucwa, Pawan Gupta, Alexandra Gustafson, Andrew Guy, Mary Haas, Stanislaw Haciski, Emina Hajdinjak, Andrew K. Hall, Regina Hammock, Jan Hansel, Alexander Hart, Larissa Hattin, Brandon Herb, SueLin Hilbert, Jesse Hill, Jeff Hill, Amy Ho, Emily House, Nina House, James Huffman, Charlie Inboriboon, Alex Ireland, Ali Jamal, Mohammad Ali Jamil, Victor Jansen, Zach Jarou, Vivian Jia, Levi Johnston, Drew Kalnow, Seth Kelly, Kyle Kelson, William Kent, Rishi Khakhkhar, Jaasmit Khurana, Ashley Kilp, Scott Knapp, Sebastian Kohler, Ivanna Kruhlak, Nadim Lalani, Samantha Lam, Patrick Lank, Zander Laurie, Kristina Lea, Ernest Leber, Ching-Hsing Lee, Haakon Lenes, Nilantha Lenora, Jesse Leontowicz, Kelly Lien, Yingchun Lin, Andrew Little, Ivy Liu, Harry Liu, Steve Liu, Stephanie Louka, Elise Lovell, David Lowe, Ashley Lubberdink, Jessica Luc, Casey Lyons, Sheng-Hsiang Ma, Hugh MacLeod, Nick Mancuso, Anali Maneshi, Jesse May, John Mayo, Mike McDonnell, Susan McLellan, Carolyn McQuarrie, Julia Nood, Therese Mead, Cory Meeuwisse, Patrick Meloy, Perry Menzies, Anne Messman, Stephen Miazga, Logan Mills, Ken Milne, Allan Mix, Steve Montag, Brendan Moore, Justin Morgenstern, Sarah Mott, P. Mukherj, Ali Mulla, Sheena Nandalal, Taylor Nikel, Sean Nugent, Morgan Oakland, Werner Oberholzer, Onyeka Otugo, Taofiq Segun Oyedokun, Mike Paddock, Alim Pardhan, Kinjal Patel, Quinten Paterson, Catherine Patocka, Christine Patterson, James Pearlman, Elyse Berger Pelletier, Alexis Pelletier-Bui, Marc Phan, Zafrina Poonja, Aubrey Powell, Kamini Premkumar, Gregor Prosen, Vishal Puri, Tanis Quaife, Ryan Raffel, Ali Raja, Randi Ramunno, Louise Rang, Suzanne Rannazzisi, Shauna Regan, Salim R. Rezaie, Milan Ridderikhof, Vanessa Rogers, Christine Roh, Dra. Maria Rosa Carrillo, Keith Rosenberg, Marina Roure, Sherri Rudinsky, Joshua Rudner, Adeeb Saleh, Will Sanderson, Owen Scheirer, Paul Schofield, Paul Schunk, Evan Schwarz, Parisa Shahrabadi, Eric Shappell, Julia Sheffield, Jonathan Sherbino, Manpreet Singh, Hector C Singson, Dave Slessor, Sam Smith, Paula Sneath, Robert Sobehart, Kerry Spearing, James Stempien, Britni Sternard, Tara Stratton, Katherine Stuart, Bob Stuntz, Michael Susalla, Colleen Sweeney, Loice Swisher, Henry Swoboda, Shahbaz Syed, Taku Taira, Nikhil Tambe, Richard Tang, Elisha Targonsky, Rachel Taylor, Alan Taylor, Todd Taylor, Paxton Ting, Gerhard Tiwald, Kelvin Tran, Evelyn Tran, Jason Trickovic, Paul Trinquero, Seth Trueger, Aaron Tyagi, Manrique Umana, Patrick Vallance, Patricia Van den Berg, Luis Vargas, Rene Verbeek, Sandra Viggers, Zlata Vlodaver, Matthew Wagner, Noorin Walji, Joe Walter, Miranda Wan, Rachel Wang, Gregory Wanner, Wyatt Warawa, Mike Ward, Jennifer Weekes, Kristen Weersink, Cara Weessies, Anna Whalen-Browne, Brian Whiteside, Matthew Willis, Jonas Wilmer, Nelson Wong, Mark Woodcroft, Rob Woods, Lawrence Yau, Jessica Yee, Calvin Yeh, Simon York Ming Huang, Katherine Yurkiw, Fareen Zaver, Alexander Zozula, Emergency Department, Graduate School, ACS - Heart failure & arrhythmias, and ACS - Diabetes & metabolism

Subjects
Adult, Male, medicine.medical_specialty, Index (economics), Blogging, Cross-sectional study, media_common.quotation_subject, education, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Social media, Quality (business), 030212 general & internal medicine, media_common, Web site, business.industry, 030208 emergency & critical care medicine, Critical appraisal, Cross-Sectional Studies, Emergency medicine, Emergency Medicine, Gestalt psychology, Female, business, Social Media
Abstract

Study objective Online educational resources such as blogs are increasingly used for education by emergency medicine clinicians. The Social Media Index was developed to quantify their relative impact. The Medical Education Translational Resources: Indicators of Quality (METRIQ) study was conducted in part to determine the association between the Social Media Index score and quality as measured by gestalt and previously derived quality instruments. Methods Ten blogs were randomly selected from a list of emergency medicine and critical care Web sites. The 2 most recent clinically oriented blog posts published on these blogs were evaluated with gestalt, the Academic Life in Emergency Medicine Approved Instructional Resources (ALiEM AIR) score, and the METRIQ-8 score. Volunteer raters (including medical students, emergency medicine residents, and emergency medicine attending physicians) were identified with a multimodal recruitment methodology. The Social Media Index was calculated in February 2016, November 2016, April 2017, and December 2017. Pearson's correlations were calculated between the Social Media Index and the average rater gestalt, ALiEM AIR score, and METRIQ-8 score. Results A total of 309 of 330 raters completed all ratings (93.6%). The Social Media Index correlated moderately to strongly with the mean rater gestalt ratings (range 0.69 to 0.76) and moderately with the mean rater ALiEM AIR score (range 0.55 to 0.61) and METRIQ-8 score (range 0.53 to 0.57) during the month of the blog post's selection and for 2 years after. Conclusion The Social Media Index's correlation with multiple quality evaluation instruments over time supports the hypothesis that it is associated with overall Web site quality. It can play a role in guiding individuals to high-quality resources that can be reviewed with critical appraisal techniques.

Published
2018

7. Students' Society for Anaesthesiology and Traumatology

Author

Monika Afzali, Lasse Lykkebo Olsen, and Sandra Viggers

Subjects
medicine.medical_specialty, Medical education, Anesthesiology and Pain Medicine, business.industry, education, Medicine, Traumatology, Critical Care and Intensive Care Medicine, business
Abstract

• Medical student's societies may be beneficial in recruiting the best candidates to specialties.

Published
2015
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8. Full-scale simulation may be used to train medical students in disaster medicine

Author

Sandra Viggers and Monika Afzali

Subjects
medicine.medical_specialty, Medical education, business.industry, Traumatology, Critical Care and Intensive Care Medicine, Basic skills, Anesthesiology and Pain Medicine, Resource (project management), ComputingMilieux_COMPUTERSANDEDUCATION, medicine, Postgraduate training, business, Disaster medicine, Curriculum
Abstract

Summary The international medical community has identified medical students as a viable resource to be used in response to national and international disasters. However today there is still no formal pre- or postgraduate training in disaster medicine for medical students in Denmark. The Students' Society of Anaesthesiology and Traumatology (SATS) in Copenhagen developed a three-day disaster medicine course called Trauma Days 2013. The course curriculum was designed to give participants insight in and the basic skills required during a disastrous event and consisted of lectures, workshops, and full-scale simulations. The course may be useful as an educational introduction to the topic of disaster medicine. A formalized curriculum in medical schools, eventually as an elective course, may educate medical students in disaster medicine.

Published
2015
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9. Intraosseous access can be taught to medical students using the four-step approach

Author

Ask D. Kvisselgaard, Tobias Stenbjerg Lyngeraa, Monika Afzali, and Sandra Viggers

Subjects
Medical education, medicine.medical_specialty, Students, Medical, Objective structured clinical examination, Resuscitation, Denmark, education, Vascular access, Anaesthesiology, Pilot Projects, 030204 cardiovascular system & hematology, OSCE and checklist validity, Education, 03 medical and health sciences, 0302 clinical medicine, medicine, Cadaver, Humans, Intraosseous access, Students medical, Human cadaver, Medicine(all), business.industry, Reproducibility of Results, 030208 emergency & critical care medicine, General Medicine, Infusions, Intraosseous, Medical students, Checklist, Surgery, Traumatology, Physical therapy, Emergency Medicine, Clinical Competence, Clinical competence, business, Kappa, Research Article
Abstract

Background The intraosseous (IO) access is an alternative route for vascular access when peripheral intravascular catheterization cannot be obtained. In Denmark the IO access is reported as infrequently trained and used. The aim of this pilot study was to investigate if medical students can obtain competencies in IO access when taught by a modified Walker and Peyton’s four-step approach. Methods Nineteen students attended a human cadaver course in emergency procedures. A lecture was followed by a workshop. Fifteen students were presented with a case where IO access was indicated and their performance was evaluated by an objective structured clinical examination (OSCE) and rated using a weighted checklist. To evaluate the validity of the checklist, three raters rated performance and Cohen’s kappa was performed to assess inter-rater reliability (IRR). To examine the strength of the overall IRR, Randolph’s free-marginal multi rater kappa was used. Results A maximum score of 15 points was obtained by nine (60%) of the participants and two participants (13%) scored 13 points with all three raters. Only one participant failed more than one item on the checklist. The expert rater rated lower with a mean score of 14.2 versus the non-expert raters with mean 14.6 and 14.3. The overall IRR calculated with Randolph’s free-marginal multi rater kappa was 0.71. Conclusion The essentials of the IO access procedure can be taught to medical students using a modified version of the Walker and Peyton’s four-step approach and the checklist used was found reliable.

Published
2017

10. Meeting abstracts from the first European Emergency Medical Services congress (EMS2016)

Author

Alexander White, Han Xian Ng, Wai Yee Ng, Eileen Kai Xin Ng, Stephanie Fook-Chong, Phek Hui Jade Kua, Marcus Eng Hock Ong, Alvilda Thougaard Steensberg, Lars Bredevang Andersen, Mette Mølby Eriksen, Ole Mazur Hendriksen, Thomas Thougaard, Andreas Claesson, J. Lennartsson, L. Svensson, M. Ringh, J. Hollenberg, P. Nordberg, M. Rosenqvist, T. Djarv, S. Österberg, D. Fredman, Y. Ban, Anne-Sophie Löwe, Jacob Nielsen, Martin Zimling, Jakob Schmidt, Freddy Lippert, Annette K. Ersbøll, Thea Palsgaard Møller, Mikkel D. Jørgensen, Annika Hamilton, Jacob Steinmetz, Mads Wissenberg, Christian Torp-Pedersen, Lars Hove, Nicolai Lohse, Bodil Thorsager, Hanne Bonde, Maria Birkvad Rasmussen, Doris Østergaard, Camilla Schade Hansen, Mikkel Brabrand, Annmarie Lassen, Cilia Kjer, Mathias Holgersen, Sandra Viggers, Claus Kjær Pedersen, Morten Thingemann Bøtker, Ingunn Skogstad Riddervold, Christian Juhl Terkelsen, Dag S. Nystøyl, S. Hunskaar, E. Zakariassen, David Fredman, Leif Svensson, Yifang Ban, Martin Jonsson, Jacob Hollenberg, Per Nordberg, Mattias Ringh, Mårten Rosenqvist, Margareta Lundén, Jan Haas, Filipe Ribeiro, Mark Newton, Paulo Freitas, Dario Rocha, Emilio Leal, Nuno Santos, Tania Cortez, Stephanie Allmark, Janet Marsden, Gitte Linderoth, Grethe Thomas, Anne Møller Nielsen, Gertrud Øllgaard, Hideo Inaba, Akira Yamashita, Testuo Maeda, Håkon Kvåle Bakke, Tine Steinvik, Johan Angell, Torben Wisborg, Håkon Ruud, Ingunn Anda Haug, Tonje S. Birkenes, Helge Myklebust, Jo Kramer-Johansen, Kamilia S. Funder, Lars S. Rasmussen, Rasmus Hesselfeldt, Volkert Siersma, Asger Sonne, Sandra Wulffeld, amilia S. Funde, Frants Pedersen, Ole M. Hendriksen, Freddy K. Lippert, Kim Sol-A, Sand Do Shin, Kyungwon Lee, Eui Jung Lee, Young Sun Ro, Ki Jeong Hong, Yu Jin Kim, Joo Jeong, Park Jeong Ho, Lars Grassmé Binderup, Søren Mikkelsen, Caroline Schaffalitzky de Muckadell, Hans Morten Lossius, Palle Toft, Annmarie Touborg Lassen, Lee Thompson, Michael Hill, Maren Ranhoff Hov, Thomas Lindner, Eirik Franer, Andreas Monstad, Christian G. Lund, Martin Betzer, Rasmus Malmberg Lyngby, Milla Jousi, Jouni Nurmi, Nanna Kruse, Charlotte Barfod, Nikolaj Raaber, Morten T. Bøtker, Sophie-Charlott Seidenfaden, Ingunn S. Riddervold, Paul Simpson, Liz Thyer, Ben van Nugteren, Hans Kirkegaard, Niels Juul, T. Zwisler, Camilla Rønnov, Hanne B. Mieritz, Gitte Jørgensen, Susanne Ångerman-Haasmaa, Sami Länkimäki, Søren Viereck, Josephine Philip Rothman, Fredrik Folke, Teodora Filipescu, Alasdair Gray, Teresa A Williams, Kwok M. Ho, Hideo Tohira, Daniel Fatovich, Deon Brink, Paul Bailey, Gavin D. Perkins, Judith Finn, Annette Kjær Ersbøll, Thora Majlund Kjærulff, Janne Shurmann Tolstrup, Jon Trærup Andersen, Jerry Overton, Theo Walther Jensen, Jens Roland, Jens Flensted Lassen, Tuukka Puolakka, Jyrki Puolakka, Juhana Hallikainen, Kirsi Rantanen, and Markku Kuisma

Subjects
medicine.medical_specialty, business.industry, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Family medicine, Emergency Medicine, medicine, Helicopter emergency medical service, Emergency medical services, 030212 general & internal medicine, Meeting Abstracts, business
Published
2017
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11. Ambulance technician trainee's performance in adherence to anaphylaxis guidelines after 'rapid cycle deliberate practice' compared to standard after event debriefing

Author

Jesper Petersen, Sandra Viggers, David Olsen, Morten Lindkvist, and Anne Lippert

Subjects
business.industry, Debriefing, Technician, Event (relativity), Emergency Medicine, medicine, Medical emergency, Emergency Nursing, Cardiology and Cardiovascular Medicine, medicine.disease, business, Anaphylaxis
Published
2019
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12. Individual Gestalt Is Unreliable for the Evaluation of Quality in Medical Education Blogs: A METRIQ Study

Author

Brent Thoma, Stefanie S. Sebok-Syer, Keeth Krishnan, Marshall Siemens, N. Seth Trueger, Isabelle Colmers-Gray, Rob Woods, Emil Petrusa, Teresa Chan, Charlotte Alexander, Mohammed Alkhalifah, Saeed Alqahtani, Scott Anderson, Shelaina Anderson, Colin Andrews, Jocelyn Andruko, Felix Ankel, Nikytha Antony, Diptesh Aryal, Barbra Backus, Jennifer Baird, Andrew Baker, Sarah Batty, Jared Baylis, Braeden Beaumont, Chris Belcher, Brent Benavides, Michael Benham, Elyse Berger Pelletier, Julian Botta, Nicholas Bouchard, Victoria Brazil, Emily Brumfield, Anthony Bryson, Wisarut Bunchit, Kat Butler, Lindy Buzikievich, David Calcara, Rob Carey, Stephen Carroll, Casey Lyons, Louise Cassidy, Kirsty Challen, Tim Chaplin, Natasha Chatham-Zvelebil, Eric Chen, Lucy Chen, Sushant Chhabra, Alvin Chin, Eric Chochi, Tina Choudhri, Jeremy Christensen, Kimberly Connors, Veronica Coppersmith, Abby Cosgrove, Gregory Costello, Kevin Cullison, Andrew D'Alessandro, Kerstin de Wit, Marie Decock, Rayan Delbani, William Denq, Julianna Deutscher, Brendan Devine, Maia Dorsett, Taylor Duda, Justin Dueweke, Teresa Dunphy, Sean Dyer, Kathryn T. Eastley, Marcia Edmonds, Ken Edwards, Robert Ehrman, Youness Elkhalidy, Preston Fedor, Brian Ficiur, Caley Flynn, Bill Fraser, Meagan Fu, James Fukakusa, Eric Funk, Damjan Gaco, Viktor Gawlik, Kenn Ghaffarian, Laleh Gharahbaghian, Phil Griffith, Andrew Griffith, Andrew Grock, Tanner Gronowski, Cathy Grossman, Jaroslaw Gucwa, Pawan Gupta, Alexandra Gustafson, Andrew Guy, Mary Haas, Stanislaw Haciski, Emina Hajdinjak, Andrew K. Hall, Regina Hammock, Jan Hansel, Alexander Hart, Larissa Hattin, Brandon Herb, SueLin Hilbert, Jesse Hill, Jeff Hill, Amy Ho, Emily House, Nina House, James Huffman, Charlie Inboriboon, Alex Ireland, Mohammed Ali Jamal, Victor Jansen, Zach Jarou, Vivian Jia, Levi Johnston, Drew Kalnow, Puneet Kapur, Seth Kelly, Kyle Kelson, William Kent, Rishi Khakhkhar, Jaasmit Khurana, Ashley Kilp, Scott Knapp, Sebastian Kohler, Ivanna Kruhlak, Nadim Lalani, Samantha Lam, Patrick Lank, Zander Laurie, Kristina Lea, Ernest Leber, Ching-Hsing Lee, Haakon Lenes, Nilantha Lenora, Jesse Leontowicz, Kelly Lien, Yingchun Lin, Michelle Lin, Andrew Little, Ivy Liu, Harry Liu, Steve Liu, Stephanie Louka, Elise Lovell, David Lowe, Ashley Lubberdink, Jessica Luc, Sheng-Hsiang Ma, Hugh MacLeod, Nick Mancuso, Anali Maneshi, Dra. Maria Rosa Carrillo, Jesse May, John Mayo, Mike McDonnell, Susan McLellan, Carolyn McQuarrie, Julia Nood, Therese Mead, Cory Meeuwisse, Patrick Meloy, Perry Menzies, Anne Messman, Stephen Miazga, Logan Mills, Ken Milne, Allan Mix, Steve Montag, Brendon Moore, Justin Morgenstern, Sarah Mott, P. Mukherj, Ali Mulla, Sheena Nandalal, Taylor Nikel, Sean Nugent, Morgan Oakland, Werner Oberholzer, Onyeka Otugo, Taofiq Segun Oyedokun, Mike Paddock, Alim Pardhan, Kinjal Patel, Quinten Paterson, Catherine Patocka, Christine Patterson, James Pearlman, Alexis Pelletier-Bui, Marc Phan, Zafrina Poonja, Aubrey Powell, Kamini Premkumar, Gregor Prosen, Vishal Puri, Tanis Quaife, Ryan Raffel, Ali Raja, Randi Ramunno, Louise Rang, Suzanne Rannazzisi, Shauna Regan, Milan Ridderikhof, Vanessa Rogers, Christine Roh, Keith Rosenberg, Marina Roure, Sherri Rudinsky, Joshua Rudner, Adeeb Saleh, Will Sanderson, Owen Scheirer, Paul Schofield, Paul Schunk, Evan Schwarz, Parisa Shahrabadi, Eric Shappell, Julia Sheffield, Jonathan Sherbino, Manpreet Singh, Hector C. Singson, Dave Slessor, Sam Smith, Paula Sneath, Robert Sobehart, Kerry Spearing, James Stempien, Britni Sternard, Tara Stratton, Katherine Stuart, Bob Stuntz, Michael Susalla, Colleen Sweeney, Loice Swisher, Henry Swoboda, Shahbaz Syed, Taku Taira, Nikhil Tambe, Richard Tang, Elisha Targonsky, Rachel Taylor, Alan Taylor, Todd Taylor, Paxton Ting, Gerhard Tiwald, Kelvin Tran, Evelyn Tran, Jason Trickovic, Paul Trinquero, Seth Trueger, Aaron Tyagi, Manrique Umana, Patrick Vallance, Patricia Van den Berg, Luis Vargas, Rene Verbeek, Sandra Viggers, Zlata Vlodaver, Matthew Wagner, Noorin Walji, Joe Walter, Miranda Wan, Rachel Wang, Gregory Wanner, Wyatt Warawa, Mike Ward, Jennifer Weekes, Kristen Weersink, Cara Weessies, Anna Whalen-Browne, Brian Whiteside, Matthew Willis, Jonas Wilmer, Nelson Wong, Mark Woodcroft, Lawrence Yau, Jessica Yee, Calvin Yeh, Simon York Ming Huang, Katherine Yurkiw, Fareen Zaver, Alexander Zozula, Graduate School, Emergency Department, ACS - Heart failure & arrhythmias, and ACS - Diabetes & metabolism

Subjects
Adult, Male, Students, Medical, Blogging, Intraclass correlation, media_common.quotation_subject, education, MEDLINE, Likert scale, 03 medical and health sciences, 0302 clinical medicine, Evaluation methods, Medicine, Humans, Quality (business), Generalizability theory, 030212 general & internal medicine, Reliability (statistics), media_common, Medical education, Education, Medical, business.industry, Internship and Residency, Reproducibility of Results, 030208 emergency & critical care medicine, Gestalt Theory, Emergency Medicine, Gestalt psychology, Female, Clinical Competence, Educational Measurement, business, Social Media
Abstract

Study objective Open educational resources such as blogs are increasingly used for medical education. Gestalt is generally the evaluation method used for these resources; however, little information has been published on it. We aim to evaluate the reliability of gestalt in the assessment of emergency medicine blogs. Methods We identified 60 English-language emergency medicine Web sites that posted clinically oriented blogs between January 1, 2016, and February 24, 2016. Ten Web sites were selected with a random-number generator. Medical students, emergency medicine residents, and emergency medicine attending physicians evaluated the 2 most recent clinical blog posts from each site for quality, using a 7-point Likert scale. The mean gestalt scores of each blog post were compared between groups with Pearson's correlations. Single and average measure intraclass correlation coefficients were calculated within groups. A generalizability study evaluated variance within gestalt and a decision study calculated the number of raters required to reliably (>0.8) estimate quality. Results One hundred twenty-one medical students, 88 residents, and 100 attending physicians (93.6% of enrolled participants) evaluated all 20 blog posts. Single-measure intraclass correlation coefficients within groups were fair to poor (0.36 to 0.40). Average-measure intraclass correlation coefficients were more reliable (0.811 to 0.840). Mean gestalt ratings by attending physicians correlated strongly with those by medical students (r=0.92) and residents (r=0.99). The generalizability coefficient was 0.91 for the complete data set. The decision study found that 42 gestalt ratings were required to reliably evaluate quality (>0.8). Conclusion The mean gestalt quality ratings of blog posts between medical students, residents, and attending physicians correlate strongly, but individual ratings are unreliable. With sufficient raters, mean gestalt ratings provide a community standard for assessment.

Published
2016

13. Early introduction of intraosseous access ought to be emphasized

Author

Sandra Viggers, Ask D. Kvisselgaard, and Monika Afzali

Subjects
medicine.medical_specialty, Early introduction, Denmark, Resuscitation, Advanced Cardiac Life Support, 03 medical and health sciences, 0302 clinical medicine, Cadaver, Medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Infusions, Intravenous, Societies, Medical, Education, Medical, business.industry, Internship and Residency, 030208 emergency & critical care medicine, General Medicine, American Heart Association, Infusions, Intraosseous, United States, Europe, Practice Guidelines as Topic, Emergency Medicine, Clinical Competence, business
Published
2016

14. The teaching of pediatric emergency procedures to medical students - a pilot study

Author

Camilla B Sørensen and Sandra Viggers

Subjects
Pediatric emergency, medicine.medical_specialty, ComputingMilieux_THECOMPUTINGPROFESSION, business.industry, education, Alternative medicine, Psychological intervention, Emergency department, Pediatric emergencies, Critical Care and Intensive Care Medicine, medicine.disease, Local structure, Meeting Abstract, ComputingMilieux_COMPUTERSANDEDUCATION, Emergency Medicine, medicine, Medical emergency, InformationSystems_MISCELLANEOUS, business, Curriculum, Clinical skills
Abstract

Background Junior doctors are often first on scene in the emergency department. It is therefore crucial that they are capable of performing life-saving interventions (LSI’s). Pediatricians and anesthesiologists handle pediatric emergencies. However, depending on hospital location, local structure, and resources junior doctors can be compelled to perform these LSI’s. Many junior doctors will not learn additional pediatric skills after the end of the assigned curriculum in medical school. We designed a four-hour workshop-based course to introduce Danish medical students to clinical skills needed to manage pediatric emergencies.

Published
2015
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16. Improving self perceived competence in medical students using simulation

Author

Sandra Viggers and Tobias Stenbjerg Lyngeraa

Subjects
Medical education, business.industry, media_common.quotation_subject, Debriefing, Cornerstone, Emergency Nursing, Terminology, Simulation training, Likert scale, Interdependence, Emergency Medicine, Self perceived, Medicine, Cardiology and Cardiovascular Medicine, business, Competence (human resources), media_common
Abstract

(2.76 vs. 3.59) improved by nearly one EQF-level, competencies also improved from 3.24 to 3.70 on the 8-point likert scale. All differences are statistically significant (p 90% state that simulation is an appropriate tool to teach pharmacology, 100% said that structured debriefing was a cornerstone and >90%would like to havemore simulation sessions during their education. Conclusions: Full-scale simulation is an appropriate method to teach pharmacology. Results are positive even in multiprofessional groups and seem to have sustainable effects. Students enjoy simulation training which may has interdependent positive effects with overall learning. Literature: CEDEFOP [2008]: Terminology of European education and training policy. A selection of 100 key terms. Luxembourg

Published
2013
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17. Medical students can easily acquire intraosseous cannulation skills

Author

Sandra Viggers, Tobias Stenbjerg Lyngeraa, Monika Afzali, and Ask D. Kvisselgaard

Subjects
Human cadaver, Resuscitation, business.industry, Bioinformatics, medicine.disease, Critical Care and Intensive Care Medicine, Meeting Abstract, medicine, Emergency Medicine, Intravascular volume depletion, Medical emergency, Peripheral vascular shutdown, business, Intraosseous cannulation, Venous cannulation
Abstract

Background In life-threatening emergencies with intravascular volume depletion, shock, or even cardiac arrest, obtaining conventional intravascular access can be difficult due to peripheral vascular shutdown. Intraosseous (IO) access is recommended during resuscitation when conventional intravenous access is difficult and is a fast and safe method for administration of fluids, blood products, and medications. However, lack of training in the procedure may be a reason why the use of the IO access is still limited in resuscitation. The goal of this study was to investigate if medical students can obtain competencies in IO access taught on a human cadaver course.

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