Background: The management of geriatric trauma patients is challenging because of the altered phy... more Background: The management of geriatric trauma patients is challenging because of the altered physiology and co-existent medical conditions. To study the in-hospital mortality profile of geriatric trauma victims and the parameters associated with the mortality, we conducted this retrospective analysis. Methods: In a retrospective review of geriatric trauma admissions (above 60 years) over a 3-year period, we studied the association of age, gender, comorbidities, mechanism of injury (MOI), Glasgow coma score (GCS), injury severity score (ISS), systolic blood pressure, and hemoglobin (Hb) level on admission with hospital mortality. Univariate and Multivariable logistic regression was used to estimate odds and find independent associated parameters. P < 0.05 was considered as statistically significant. Results: Out of 881 patients, 208 (23.6%) patients died in hospital. The most common MOI was fall (53.3%) followed by motor vehicle collision (31.1%) and other mechanisms (14.5%). The...
Objective: The aim of the study was to assess the effectiveness of ultrasound in analyzing topogr... more Objective: The aim of the study was to assess the effectiveness of ultrasound in analyzing topographic relationship of nerve cords with axillary artery at lateral infraclavicular level, their variations, and the distance from the skin and to correlate findings with anthropometric parameters. Materials and Methods: Two hundred patients aged 18–75 years were enrolled for the study after informed written consent. A 7–12 MHz linear ultrasonic transducer was used for scanning of the brachial plexus at lateral infraclavicular fossa. The results of the cord positions were expressed on a 12-section pie chart, and the number of arteries and veins was reported. Measurements included the vertical distance from the upper part of the artery to the skin, diagonal distance to the apical corner of the ultrasound image, and distances from center of cords to the center of artery. Age, sex, weight, height, body mass index, and biceps girth were recorded. Data were expressed as mean with standard deviation or frequency and percentage for categorical variables, and statistical analysis was done using correlation analysis and two-sample t-test. Results: The most frequent positions of the cords were observed in 2–4 sections (92%) for the medial cord, 6–7 sections (92%) for the posterior cord, 10–11 sections (89%) for the lateral cord, and 4–5 sections (95%) for the axillary vein. More than one axillary vein was seen in 12.5% and two axillary arteries were seen in 1.5% of cases. Cord visibility and distance between artery and apical corner of the ultrasound image correlated with anthropometric parameters. Conclusions: A topographical study of brachial plexus at lateral infraclavicular fossa showed anatomical variations and abnormal vascular formations. This sonoanatomic knowledge can be helpful in improving safety and success of nerve blocks.
International journal of applied & basic medical research
Hip fractures are associated with a significant risk of morbidity and mortality in the elderly po... more Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery. In this retrospective study, we reviewed the records of elderly patients with hip trauma operated in the tertiary care trauma center of our institute over a period of 1 year. Out of 120 patients, preoperative echocardiography was done in 30 patients. We compared the patients for whom echocardiography was done with the patients who did not undergo echocardiography. Descriptive statistical methods were used to analyze the results and observations. We observed that preoperative transthoracic echocardiogra...
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2017
Through retrospective review of consecutive charts, we compare the short-term and long-term clini... more Through retrospective review of consecutive charts, we compare the short-term and long-term clinical outcomes after robotic-assisted right colectomy with intracorporeal anastomosis (RIA) (n = 89) and laparoscopic right colectomy with extracorporeal anastomosis (LEA) (n = 135). Cohorts were similar in demographic characteristics, comorbidities, pathology, and perioperative outcomes (conversion, days to flatus and bowel movement, and length of hospitalization). The RIA cohort experienced statistically significant: less blood loss, shorter incision lengths, and longer specimen lengths than the LEA cohort. Operative times were significantly longer for the RIA group. No incisional hernias occurred in the RIA group, whereas the LEA group had 5 incisional hernias; mean follow-up was 33 and 30 months, respectively. RIA is effective and safe and provides some clinical advantages. Future studies may show that, in obese and other technically challenging patients, RIA facilitates resection of a longer, consistent specimen with less mesentery trauma that can be extracted through smaller incisions.
Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or... more Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or any other cause leading to ankylosis of the joint can lead to multiple problems if not detected and treated early. If affected in early years of life, it may cause facial dysmorphism, restricted mouth opening, and difficulty in eating, speech, and sleep. Early surgery and physiotherapy can restore the joint function to a great extent. Anesthetizing a pediatric patient with this disorder is a definite challenge which needs expertise in difficult airway management.
Publication has become a burning issue among Indian medical fraternity owing to certain academic ... more Publication has become a burning issue among Indian medical fraternity owing to certain academic and professional necessities. The large number of submissions to the anaesthesia journals has resulted in accumulation of too much below average scientific material. A properly written manuscript is the dream of every editor and reviewer. The art of preparing a manuscript can be acquired only by following certain basic rules and technical aspects, besides knowledge and skills. Before preparing the manuscript, a target journal should be considered. All the instructions to the authors pertaining to that particular journal should be followed meticulously before preparing the manuscript for submission. The basic structure of the manuscript to be followed can be summarised by the acronym IMRaD (introduction, methods, results and discussion). The current review article aims to highlight all those mandatory and desirable features which should be kept in consideration while preparing a scientific manuscript for publication.
Ultrasound-guided regional anesthesia (UGRA), like other basic skills, should be learnt in a simu... more Ultrasound-guided regional anesthesia (UGRA), like other basic skills, should be learnt in a simulation laboratory before performing on the patient. Cadavers provide an ideal tool for learning sonoanatomy and skills required for performing UGRA. On the basis of preservation technique used, the cadavers can be formalin embalmed cadavers, Thiel cadavers (soft cadavers), and fresh frozen cadavers. We compared three types of cadavers for performing ultrasound-guided upper and lower limb blocks. We observed that fresh frozen and Thiel cadavers were less smelling and had more realistic appearance as compared to formalin embalmed cadavers. It was seen that Thiel cadavers were more flexible and hence, rotation of neck, shoulder and knee was easier. Although images seen in most cadavers were comparable with live subjects but, Thiel cadavers provided more realistic model.
Thirty‐nine years old male, diagnosed case of non‐union subtrochanteric femur fracture was posted... more Thirty‐nine years old male, diagnosed case of non‐union subtrochanteric femur fracture was posted for open reduction and internal fixation (ORIF). After 3 h of subarachnoid blockade (SAB), patient had anaphylactic shock due to the rupture of a cyst in the thigh, which was thought to be chronic collection and turned out to be hydatid cyst. Radiological imaging techniques like ultrasonography (USG), and magnetic resonance imaging (MRI) help in the identification of extra hepatic hydatid cyst, and thereby preventing accidental puncture and rupture of the cyst, while performing neuraxial and peripheral nerve blocks (PNBs).
Journal of Anaesthesiology Clinical Pharmacology, 2020
The Coronavirus SARS- CoV-2 (COVID-19) pandemic has overwhelmed the ability of health care system... more The Coronavirus SARS- CoV-2 (COVID-19) pandemic has overwhelmed the ability of health care systems all over the world. With the spread of the disease, countries have adopted different models to reorganize infrastructure and reallocate the resources to deal with the pandemic. All the nonurgent hospital services have been postponed. But, trauma and emergency services continue to function according to the established protocols with few modifications. During the pandemic, trauma care is based on clinical urgency, safety of the patient as well as health care workers (HCWs) and conservation of resources. The strategies include non-operative management if possible, restricting the number of personnel and utilization of remote consultation or telemedicine. In the present article, we discuss the triage and management of trauma victim during the pandemic, indications for emergency surgery and psychological impact of the pandemic. We also discuss the future challenges during the post-COVID-19 phase.
Background: Trauma in old age is a serious health issue and associated with high fatality. This s... more Background: Trauma in old age is a serious health issue and associated with high fatality. This study details the profile of fatal geriatric trauma at a Level 1 Indian trauma centre. Methods: This is a retrospective study. A total of 779 geriatric patients were admitted to the Jai Prakash Narayan Apex Trauma Centre during 2-year period from January 2014 to December 2015. A retrospective analysis was done of all 194 fatal geriatric trauma patients who underwent autopsy at our centre during this 2-year period. The study has been taken ethical clearance from the institutional review board. Setting: This study was conducted in a 165-bedded Level 1 trauma centre of India. Participants: Hundred and ninety-four fatal geriatric trauma patients were included in the study. Interventions: There were no interventions in this study. Measurements: Data were represented in median (range: minimum–maximum) and frequency (%). Results: The duration of admission of these 194 patients ranged from <1 to 91 days (median 3 days). The causes of trauma were road traffic accidents in 78 (40%), fall from height in 75 (39%), assault in 12 (6%), railway accident in 10 (5%) and unconsciousness in 10 (5%). The autopsy-proven primary cause of death was severe head injury in 89 (46%), septicaemia in 30 (15%), polytrauma in 11 (6%), orthotrauma in 12 (6%), haemorrhagic shock in 9 (5%), spinal injury in 8 (4%), musculoskeletal injury in 3 (2%) and fat embolism in 3 (2%). Conclusion: In our study, while most of the early deaths were due to severe head injuries, late deaths were predominantly due to infections.
Background Basic emergency care at primary, secondary and tertiary health care level in India is ... more Background Basic emergency care at primary, secondary and tertiary health care level in India is in its infancy. Lack of training in emergency care is an important factor. We designed AIIMS basic emergency care course (AIIMS BECC) to address the issue. Objective To improve the knowledge, skill and attitude of healthcare workers and laypersons in basic emergency care and to identify and train instructors. Methods Prospective study conducted over a period of one and half years. The target groups were medical, police, fire fighter, paramilitary forces, teachers, school children of India. Provider AIIMS BECC is of one day duration. The contents of the course are cardio-pulmonary resuscitation, chocking and special scenarios like trauma, electrocution, drowning, hypothermia, pregnancy, etc. Course was disseminated via lectures, audio-visual and hands on training. The participants were evaluated by pre and post test questions. Subjects had to score 80% to be successful and those who scored more than 90% were eligible for instructor course. The confidence levels at baseline and at the end of the course were evaluated in policecourses were evaluated on course clarity, course delivery and trainers quality on a likert scale (1 = worst, 5 = excellent). Results 1614 subjects were trained. 99.81% became providers and 2.6% were trained as instructors. 83.1% were non-medical and16.9% were medical personals. 76.14% were police, paramilitary 0.8%, teachers 1.6%, students 2.1% and mixed groups were 2.6%. The average and modal increase in confidence level among police were 66.14% and 62.49%. Likert scale of ≥ 4 was observed in 90.7% in course clarity, 91.28% in course delivery and 95.26% in trainer quality. Conclusion Knowledge, skill and attitude of healthcare care and laypersons in providing basic emergency care improved by community emergency care initiative. Instructors were identified for further dissemination of the course. The confidence levels increased among police.
There is wide variation in depth of brachial plexus in patient population at supraclavicular regi... more There is wide variation in depth of brachial plexus in patient population at supraclavicular region. We plan to find the depth of the corner pocket and correlate it with age, weight, height and body mass index (BMI). After approval from Ethics Committee, right-sided supraclavicular region of volunteers was scanned. Once an optimal image, which included subclavian artery, pleura, first rib and nerve bundles, was obtained, the corner pocket was kept in the middle of the screen and the image was frozen. Depth of the corner pocket from the skin was measured. Thereafter longest distance (LD) approximating needle trajectory was calculated. The Pearson correlation was used to calculate the relation between these two distances and various predictors such as weight, height, and BMI. Mean shortest distance that is, vertical distance from skin to corner pocket for all volunteers was found to be 1.7 ± 0.8 cm and the mean LD that is, distance traveled by needle entering 1 cm from the edge of foo...
Due to lack of training in emergency care, basic emergency care in India is still in its infancy.... more Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC) to address the issue. To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course. Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated. A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates) and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12(th) standard) and were nonmedicos. BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care.
Background: The management of geriatric trauma patients is challenging because of the altered phy... more Background: The management of geriatric trauma patients is challenging because of the altered physiology and co-existent medical conditions. To study the in-hospital mortality profile of geriatric trauma victims and the parameters associated with the mortality, we conducted this retrospective analysis. Methods: In a retrospective review of geriatric trauma admissions (above 60 years) over a 3-year period, we studied the association of age, gender, comorbidities, mechanism of injury (MOI), Glasgow coma score (GCS), injury severity score (ISS), systolic blood pressure, and hemoglobin (Hb) level on admission with hospital mortality. Univariate and Multivariable logistic regression was used to estimate odds and find independent associated parameters. P < 0.05 was considered as statistically significant. Results: Out of 881 patients, 208 (23.6%) patients died in hospital. The most common MOI was fall (53.3%) followed by motor vehicle collision (31.1%) and other mechanisms (14.5%). The...
Objective: The aim of the study was to assess the effectiveness of ultrasound in analyzing topogr... more Objective: The aim of the study was to assess the effectiveness of ultrasound in analyzing topographic relationship of nerve cords with axillary artery at lateral infraclavicular level, their variations, and the distance from the skin and to correlate findings with anthropometric parameters. Materials and Methods: Two hundred patients aged 18–75 years were enrolled for the study after informed written consent. A 7–12 MHz linear ultrasonic transducer was used for scanning of the brachial plexus at lateral infraclavicular fossa. The results of the cord positions were expressed on a 12-section pie chart, and the number of arteries and veins was reported. Measurements included the vertical distance from the upper part of the artery to the skin, diagonal distance to the apical corner of the ultrasound image, and distances from center of cords to the center of artery. Age, sex, weight, height, body mass index, and biceps girth were recorded. Data were expressed as mean with standard deviation or frequency and percentage for categorical variables, and statistical analysis was done using correlation analysis and two-sample t-test. Results: The most frequent positions of the cords were observed in 2–4 sections (92%) for the medial cord, 6–7 sections (92%) for the posterior cord, 10–11 sections (89%) for the lateral cord, and 4–5 sections (95%) for the axillary vein. More than one axillary vein was seen in 12.5% and two axillary arteries were seen in 1.5% of cases. Cord visibility and distance between artery and apical corner of the ultrasound image correlated with anthropometric parameters. Conclusions: A topographical study of brachial plexus at lateral infraclavicular fossa showed anatomical variations and abnormal vascular formations. This sonoanatomic knowledge can be helpful in improving safety and success of nerve blocks.
International journal of applied & basic medical research
Hip fractures are associated with a significant risk of morbidity and mortality in the elderly po... more Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery. In this retrospective study, we reviewed the records of elderly patients with hip trauma operated in the tertiary care trauma center of our institute over a period of 1 year. Out of 120 patients, preoperative echocardiography was done in 30 patients. We compared the patients for whom echocardiography was done with the patients who did not undergo echocardiography. Descriptive statistical methods were used to analyze the results and observations. We observed that preoperative transthoracic echocardiogra...
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2017
Through retrospective review of consecutive charts, we compare the short-term and long-term clini... more Through retrospective review of consecutive charts, we compare the short-term and long-term clinical outcomes after robotic-assisted right colectomy with intracorporeal anastomosis (RIA) (n = 89) and laparoscopic right colectomy with extracorporeal anastomosis (LEA) (n = 135). Cohorts were similar in demographic characteristics, comorbidities, pathology, and perioperative outcomes (conversion, days to flatus and bowel movement, and length of hospitalization). The RIA cohort experienced statistically significant: less blood loss, shorter incision lengths, and longer specimen lengths than the LEA cohort. Operative times were significantly longer for the RIA group. No incisional hernias occurred in the RIA group, whereas the LEA group had 5 incisional hernias; mean follow-up was 33 and 30 months, respectively. RIA is effective and safe and provides some clinical advantages. Future studies may show that, in obese and other technically challenging patients, RIA facilitates resection of a longer, consistent specimen with less mesentery trauma that can be extracted through smaller incisions.
Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or... more Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or any other cause leading to ankylosis of the joint can lead to multiple problems if not detected and treated early. If affected in early years of life, it may cause facial dysmorphism, restricted mouth opening, and difficulty in eating, speech, and sleep. Early surgery and physiotherapy can restore the joint function to a great extent. Anesthetizing a pediatric patient with this disorder is a definite challenge which needs expertise in difficult airway management.
Publication has become a burning issue among Indian medical fraternity owing to certain academic ... more Publication has become a burning issue among Indian medical fraternity owing to certain academic and professional necessities. The large number of submissions to the anaesthesia journals has resulted in accumulation of too much below average scientific material. A properly written manuscript is the dream of every editor and reviewer. The art of preparing a manuscript can be acquired only by following certain basic rules and technical aspects, besides knowledge and skills. Before preparing the manuscript, a target journal should be considered. All the instructions to the authors pertaining to that particular journal should be followed meticulously before preparing the manuscript for submission. The basic structure of the manuscript to be followed can be summarised by the acronym IMRaD (introduction, methods, results and discussion). The current review article aims to highlight all those mandatory and desirable features which should be kept in consideration while preparing a scientific manuscript for publication.
Ultrasound-guided regional anesthesia (UGRA), like other basic skills, should be learnt in a simu... more Ultrasound-guided regional anesthesia (UGRA), like other basic skills, should be learnt in a simulation laboratory before performing on the patient. Cadavers provide an ideal tool for learning sonoanatomy and skills required for performing UGRA. On the basis of preservation technique used, the cadavers can be formalin embalmed cadavers, Thiel cadavers (soft cadavers), and fresh frozen cadavers. We compared three types of cadavers for performing ultrasound-guided upper and lower limb blocks. We observed that fresh frozen and Thiel cadavers were less smelling and had more realistic appearance as compared to formalin embalmed cadavers. It was seen that Thiel cadavers were more flexible and hence, rotation of neck, shoulder and knee was easier. Although images seen in most cadavers were comparable with live subjects but, Thiel cadavers provided more realistic model.
Thirty‐nine years old male, diagnosed case of non‐union subtrochanteric femur fracture was posted... more Thirty‐nine years old male, diagnosed case of non‐union subtrochanteric femur fracture was posted for open reduction and internal fixation (ORIF). After 3 h of subarachnoid blockade (SAB), patient had anaphylactic shock due to the rupture of a cyst in the thigh, which was thought to be chronic collection and turned out to be hydatid cyst. Radiological imaging techniques like ultrasonography (USG), and magnetic resonance imaging (MRI) help in the identification of extra hepatic hydatid cyst, and thereby preventing accidental puncture and rupture of the cyst, while performing neuraxial and peripheral nerve blocks (PNBs).
Journal of Anaesthesiology Clinical Pharmacology, 2020
The Coronavirus SARS- CoV-2 (COVID-19) pandemic has overwhelmed the ability of health care system... more The Coronavirus SARS- CoV-2 (COVID-19) pandemic has overwhelmed the ability of health care systems all over the world. With the spread of the disease, countries have adopted different models to reorganize infrastructure and reallocate the resources to deal with the pandemic. All the nonurgent hospital services have been postponed. But, trauma and emergency services continue to function according to the established protocols with few modifications. During the pandemic, trauma care is based on clinical urgency, safety of the patient as well as health care workers (HCWs) and conservation of resources. The strategies include non-operative management if possible, restricting the number of personnel and utilization of remote consultation or telemedicine. In the present article, we discuss the triage and management of trauma victim during the pandemic, indications for emergency surgery and psychological impact of the pandemic. We also discuss the future challenges during the post-COVID-19 phase.
Background: Trauma in old age is a serious health issue and associated with high fatality. This s... more Background: Trauma in old age is a serious health issue and associated with high fatality. This study details the profile of fatal geriatric trauma at a Level 1 Indian trauma centre. Methods: This is a retrospective study. A total of 779 geriatric patients were admitted to the Jai Prakash Narayan Apex Trauma Centre during 2-year period from January 2014 to December 2015. A retrospective analysis was done of all 194 fatal geriatric trauma patients who underwent autopsy at our centre during this 2-year period. The study has been taken ethical clearance from the institutional review board. Setting: This study was conducted in a 165-bedded Level 1 trauma centre of India. Participants: Hundred and ninety-four fatal geriatric trauma patients were included in the study. Interventions: There were no interventions in this study. Measurements: Data were represented in median (range: minimum–maximum) and frequency (%). Results: The duration of admission of these 194 patients ranged from <1 to 91 days (median 3 days). The causes of trauma were road traffic accidents in 78 (40%), fall from height in 75 (39%), assault in 12 (6%), railway accident in 10 (5%) and unconsciousness in 10 (5%). The autopsy-proven primary cause of death was severe head injury in 89 (46%), septicaemia in 30 (15%), polytrauma in 11 (6%), orthotrauma in 12 (6%), haemorrhagic shock in 9 (5%), spinal injury in 8 (4%), musculoskeletal injury in 3 (2%) and fat embolism in 3 (2%). Conclusion: In our study, while most of the early deaths were due to severe head injuries, late deaths were predominantly due to infections.
Background Basic emergency care at primary, secondary and tertiary health care level in India is ... more Background Basic emergency care at primary, secondary and tertiary health care level in India is in its infancy. Lack of training in emergency care is an important factor. We designed AIIMS basic emergency care course (AIIMS BECC) to address the issue. Objective To improve the knowledge, skill and attitude of healthcare workers and laypersons in basic emergency care and to identify and train instructors. Methods Prospective study conducted over a period of one and half years. The target groups were medical, police, fire fighter, paramilitary forces, teachers, school children of India. Provider AIIMS BECC is of one day duration. The contents of the course are cardio-pulmonary resuscitation, chocking and special scenarios like trauma, electrocution, drowning, hypothermia, pregnancy, etc. Course was disseminated via lectures, audio-visual and hands on training. The participants were evaluated by pre and post test questions. Subjects had to score 80% to be successful and those who scored more than 90% were eligible for instructor course. The confidence levels at baseline and at the end of the course were evaluated in policecourses were evaluated on course clarity, course delivery and trainers quality on a likert scale (1 = worst, 5 = excellent). Results 1614 subjects were trained. 99.81% became providers and 2.6% were trained as instructors. 83.1% were non-medical and16.9% were medical personals. 76.14% were police, paramilitary 0.8%, teachers 1.6%, students 2.1% and mixed groups were 2.6%. The average and modal increase in confidence level among police were 66.14% and 62.49%. Likert scale of ≥ 4 was observed in 90.7% in course clarity, 91.28% in course delivery and 95.26% in trainer quality. Conclusion Knowledge, skill and attitude of healthcare care and laypersons in providing basic emergency care improved by community emergency care initiative. Instructors were identified for further dissemination of the course. The confidence levels increased among police.
There is wide variation in depth of brachial plexus in patient population at supraclavicular regi... more There is wide variation in depth of brachial plexus in patient population at supraclavicular region. We plan to find the depth of the corner pocket and correlate it with age, weight, height and body mass index (BMI). After approval from Ethics Committee, right-sided supraclavicular region of volunteers was scanned. Once an optimal image, which included subclavian artery, pleura, first rib and nerve bundles, was obtained, the corner pocket was kept in the middle of the screen and the image was frozen. Depth of the corner pocket from the skin was measured. Thereafter longest distance (LD) approximating needle trajectory was calculated. The Pearson correlation was used to calculate the relation between these two distances and various predictors such as weight, height, and BMI. Mean shortest distance that is, vertical distance from skin to corner pocket for all volunteers was found to be 1.7 ± 0.8 cm and the mean LD that is, distance traveled by needle entering 1 cm from the edge of foo...
Due to lack of training in emergency care, basic emergency care in India is still in its infancy.... more Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC) to address the issue. To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course. Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated. A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates) and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12(th) standard) and were nonmedicos. BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care.
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Papers by Chhavi Sawhney