Masters Degrees (Emergency Medicine)

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Browsing Masters Degrees (Emergency Medicine) by browse.metadata.advisor "Louw, Pauline"

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    Arterial blood gases in emergency medicine: how well do our registrars and consultants currently enrolled in the Western Cape Division of Emergency Medicine interpret them
    (Stellenbosch : Stellenbosch University, 2014-12) Xafis, Paul; Cloete, Flip; Louw, Pauline; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Family and Emergency Medicine. Emergency Medicine.
    ENGLISH SUMMARY : Intro: Arterial blood gas (ABG) analysis is a useful tool in point-of‐care testing for patients presenting to an emergency center (EC). Emergency Medicine (EM) doctors need to be equipped with sufficient skills to interpret ABGs in order to effectively manage patients. This prospective descriptive cross-sectional study assessed ABG theoretical knowledge, interpretation skills and confidence in analysing ABGs amongst EM registrars (trainees) and consultants currently enrolled in the Division of Emergency Medicine in the Western Cape. Methods: Thirty EM registrars and twenty-three EM consultants responded to the ABG interpretation questionnaire. Scores were compared to validated expert scores. Confidence with ABG interpretation and satisfaction with current registrar teaching methods was analysed using a 10-point visual analogue scale. Results: The average ABG questionnaire score for the group was 63%. No candidates achieved expert scores. Senior registrars (3rd and 4th years of training) scored highest, followed by consultants and junior registrars (1st and 2nd years of training). There was no significant difference between registrar and consultants scores (21.1 vs. 22 respectively; p=0.72). There was no significant difference in overall and individual test scores between consultants and registrars at different levels of training (h=10.85; p=0.28). Registrars’ self-rated ABG accuracy improved with increasing level of training, although satisfaction with ABG training did not. Registrars preferred future methods of ABG learning were focused EM teaching sessions, ‘on the floor’ ABG teaching in ECs, and access to online resources and case-based tutorials. Conclusion: Mediocre levels of theoretical knowledge and interpretation skills in ABG analysis were evident. Registrars reported dissatisfaction with current registrar ABG teaching. There is scope to improve the current EM curriculum with regards to ABG training, with the potential to reinforce existing registrar teaching sessions, enhance ‘on the floor’ ABG training in ECs, and to investigate and incorporate social media platforms and computer-assisted learning (CAL) techniques into existing teaching modalities. Consultant continuing education (CME) should focus on reinforcing existing ABG knowledge and interpretation skills.
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    Routine drug screening in patients with intentional drug overdose : appropriate or not?
    (Stellenbosch : Stellenbosch University, 2024-12) Ferreira, Yolandi; Van Hoving, Daniel J.; Louw, Pauline; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Family and Emergency Medicine.
    ENGLISH SUMMARY: Introduction: Intentional drug overdose is a common presentation to Emergency Centres. However, various management strategies exist for these patients due to the lack of evidenced based guidelines. Performing routine drug screens on all intentional overdose patients may not be cost-effective; besides, it may not even change decisions related to patient management. The aim of this study is to determine the significance of a routinely performed limited drug screen on asymptomatic patients presenting to an Emergency Centre after an intentional drug overdose. Methodology: In this retrospective chart review, all patients who presented with a history of an intentional drug overdose will be identified from patient registers for a six month period. Patients will be excluded if less than 12 years of age, ingestion of non-drug chemicals occurred and where folders are either missing or contains incomplete documentation. The pre-hospital record, nursing triage record, and doctor’s notes will be reviewed. Data collected will include patient demographics, the presence of clinical toxicity and the results of drug screens performed. Conclusion: Significant results could be used to guide the development of both local and national protocols. This should improve the cost related to the treatment of intentional drug overdose patients and lessen the burden of this disease.