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
Thesis (MMed)--Stellenbosch University, 2014.
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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