Knowledge and skills regarding adult carodio-pulmonary resuscitation among doctors and nurses

Objectives: to assess the knowledge and skills regarding adult carodio-pulmonary resuscitation (CPR) among doctors and nurses working in Kegalle district, Sri Lanka.Methods: To asses core knowledge regarding CPR, a self administered questionnaire was used. For skills assessment each candidate was asked to perform CPR on Laderal Resuci Anne skill trainer manikin. Performance was video recorded and evaluated for correct CPR steps while manikin data was analyzed to check the effectiveness of chest compressions and ventilation. 100 doctors and 284 nurses were included in the study.Results: Only 45.08% of doctors and 36.75% of nurses had adequate core knowledge on CPR and the knowledge deteriorate with time. A good core knowledge on CPR was associated with a good perceived level of competency regarding CPR. One third of doctors and 70.08% nurses have never received an update on CPR. The use of Ambu bag was the most preferred way to deliver ventilations but 83.5% of the time rescue breaths were inadequate, the average volume of ventilation being 392 ml. Only 36.84% of doctors were confident regarding their endotracheal intubation skills while 84.68% had never performed a cricothyrotomy. Only 20.6% of chest compressions had adequate depth while 14.7% were performed at a correct rate. The mean value of a duty cycle was 52.13%. Almost all the respondents did not adhere to the correct CPR steps. The positive aspect was that emergency treatment units (ETUs) were adequately equipped to resuscitate patients.Conclusions: Core knowledge and skills regarding adult CPR is inadequate among doctors and nurses working at government hospitals in Kegalle district. Therefore it is recommended to arrange training programs on CPR based on latest guidelines and conducted by an expert panel.

Analysing the Time of Bed Availability in Intensive Care Unit of Accident and Orthopaedic Department Using Survival Analysis.

PurposeOptimizing the available resources in a hospital helps to improve the capacity utilization in the respective divisions. Predicting the length of stay (LoS) of patients admitted to Intensive Care Unit (ICU) gives a clear vision to the physicians and the administrative level to improve the productivity and to plan its staffing policy. MethodThe study was carried out for all the patients admitted to the ICU in Accident and Orthopaedic Service to estimate their LoS in ICU using survival analysis. Data obtained were identified as censored or non-censored data and were categorized based on their gender, age and the type of injury. Kaplan-Meier estimates were used to predict the LoS of patients based on the above categories. Finally, the best-fitted survival model, the logistic model was used to identify the significance of gender, age and the type of injury of the patients on their LoS. ResultsThe probability of discharging a female patient within less number of days was higher than that of male patients. Senior adults recorded the highest LoS. When patients were categorized based on the type of injury, highest LoS was recorded by the patients with facial injuries. According to the log-rank test only the levels of age (p value = 0.04) and injuries (p-value = 0.04) show a statistical difference between the respective variable levels. Gender does not show a significance relation with the LoS. ConclusionThe patients' age and the type of injury were significantly related to LoS of ICU patients.