1.Paramedics’ Perception on Video Assisted Learning Method in Learning Emergency Skills
Bala Krishnian M ; Ahmad Khaldun I ; Hamidah Y ; Johar MJ ; Ismail MS
Medicine and Health 2016;11(1):47-55
Information technology use in healthcare education has become a popular
medium of instruction. One of the medium of instruction is video assisted learning
(VAL). The use of VAL as an instructional method in the teaching and learning of emergency skills is not new. However, there are lack of studies on the perception of
using this method in learning emergency skills. This qualitative study involved four
focused discussion groups following a VAL instruction on emergency skills. A total
of 20 paramedics were divided into four groups. They were involved in a focussed
discussion after a VAL instruction session. Findings reveal that the paramedics
perceived three major themes which were categorized as : i) advantages of video
as teaching tool, ii) barrier in using video as a teaching tool; and iii) suggestions on
using video as teaching tool. The findings indicate that the paramedics perceived
VAL as a potential tool for learning emergency skills. However, they suggested the
language of instruction should be in their mother tongue for better understanding.
This implies that using English language has disadvantage in technology enhanced
learning for better understanding.
Computer-Assisted Instruction
2.A Study of House Officers in a Teaching Hospital on Knowledge, Perception of Skills and Confidence Level in Performing CPR
Ismail Mohd Saiboon ; Noraliza Mohd Ariffin ; Teodoro Javier Herbosa ; Ahmad Khaldun Ismail ; Nariman Singmamae ; Shamsuriani Md Jamal ; Azhana Hassan ; Ho Siew Eng
Medicine and Health 2007;2(2):110-116
Cardio-pulmonary Resuscitation (CPR) is important and should be mastered by House
Officers (HO). House officers who have just completed their studies are assigned to acute medical and surgical wards. If a patient in the ward has a cardiac arrest (CA), these
doctors are usually the first to attend. Therefore an HO must be confident with CPR skills.
They must be competent in performing CPR. The authors assessed 26 new HOs from
Universiti Kebangsaan Malaysia Hospital (HUKM) with respect to their self-perception
about CPR skills, confidence level in performing CPR and knowledge in performing CPR.
Knowledge was assessed by a questionnaire. We found that 16 of 26 (61.5%) assessed
themselves to have inadequate knowledge and 46.2% had no confidence in performing
CPR. The mean score of the written test was 5.7 ± 1.8. Seven out of 26 (27.0%) HOs had
incorrect hand placement position for CPR. Only 4 and 9 out of 26 HOs had their sternal
paddle and cardiac apex paddle positions correctly placed respectively. In conclusion,
knowledge, perception of skills and confidence levels of HOs on CPR are inadequate and
need further assessment and improvement. Medical schools need to review their CPR
curriculum in order to prepare HOs adequately to work in emergency situations.
3.The Effectiveness Of A Navigation System For Ambulance Service In Kuala Lumpur, Malaysia
Ahmad Khaldun Ismail ; Yap Yah Yun ; Gita Mahardhika ; Ainun Abdul Ghani ; Nurul Saadah Ahmad ; Abdul Karim Mustafa ; Shamsuriani Md Jamal ; Rosdiadee Nordin ; Nasharuddin Zainal
Malaysian Journal of Public Health Medicine 2018;18(Special Volume (1)):166-173
The response and transport intervals of an ambulance dispatch are affected by various factors. The present ambulance
system relies on the driver’s experience, knowledge of local road map and estimations of directions. These may
contribute to delays, misdirection and inefficient utilization of resources. The objectives of this study were to assess the
effects of GPS navigation device on the response and transport time intervals of an ambulance service operating in urban
setting. This was a three-month experimental study involving simulated ambulance dispatch based in a hospital. A total
of 50 simulated cycles were constructed. Travel time, arrival time and distance were documented from each cycle. The
median actual response time using map and GPS navigation device was 11.82 min and 10.47 min respectively. The median
actual transport time using map and GPS navigation device was 11.00 min and 10.74 min respectively. The differences in
response time and transport time between map and GPS navigation were not statistically significant (p= 0.215 and
p=0.710). The application of GPS reduced the error value between estimated and actual response time by 8.73%. It also
reduced the mean error value between estimated and actual transport time by 1.42%. The result shows that the GPS
navigation device allowed for more accurate travel time estimation and its application in an urban setting such as Kuala
Lumpur has the potential to reduce ambulance response time.
Emergency
;
GPS navigation
;
Prehospital care
;
Response time
;
Transport time
4.Training standardized patients for undergraduate Psychiatry examinations: experience of a Malaysian university
Suzaily Wahab ; Rosdinom Razali ; Ahmad Khaldun Ismail ; Mohammad Arif Kamarudin ; Noorlaili Mohd Tohit ; Ruth Packiavathy Rajen Durai ; Nabishah Mohamad ; Harlina Halizah Siraj
Malaysian Journal of Medicine and Health Sciences 2015;11(2):29-34
Simulated/ standardized patients (SPs) have become one of the significant components in today’s
medical education and students’ assessment. Some differences exist in the training method of SPs
for psychiatry examinations compared to other medical disciplines. This brief report highlights the
challenges encountered in the training process and methods to overcome those challenges. A wellstructured,
intensive training remains as one of the most important factors in ensuring standardization of
SPs for psychiatric examinations.
Education, Medical
;
Psychiatry
5.The Effectiveness of a Navigation System for Ambulance Service in Kuala Lumpur, Malaysia
Ahmad Khaldun ISMAIL ; Yap Yah YUN ; Ainun Abdul GHANI ; Nurul Saadah AHMAD ; Abdul Karim MUSTAFA ; Shamsuriani Md JAMAL
Malaysian Journal of Public Health Medicine 2018;Special Volume(1):166-173
The response and transport intervals of an ambulance dispatch are affected by various factors. The present ambulance system relies on the driver’s experience, knowledge of local road map and estimations of directions. These may contribute to delays, misdirection and inefficient utilization of resources. The objectives of this study were to assess the effects of GPS navigation device on the response and transport time intervals of an ambulance service operating in urban setting. This was a three-month experimental study involving simulated ambulance dispatch based in a hospital. A total of 50 simulated cycles were constructed. Travel time, arrival time and distance were documented from each cycle. The median actual response time using map and GPS navigation device was 11.82 min and 10.47 min respectively. The median actual transport time using map and GPS navigation device was 11.00 min and 10.74 min respectively. The differences in response time and transport time between map and GPS navigation were not statistically significant (p= 0.215 and p=0.710). The application of GPS reduced the error value between estimated and actual response time by 8.73%. It also reduced the mean error value between estimated and actual transport time by 1.42%. The result shows that the GPS navigation device allowed for more accurate travel time estimation and its application in an urban setting such as Kuala Lumpur has the potential to reduce ambulance response time.
6.A case of cough induced rib fracture with subcutaneous emphysema and pneumothorax
Wan Nor Aida Wan Mohd Shukri ; Ng Von How ; Ahmad Khaldun Ismail
The Medical Journal of Malaysia 2019;74(6):551-552
Coughing is an important reflex mechanism which enhances
the clearance of secretions and particulates from the
airways, however repetitive muscle strain due to prolonged
coughing may cause the uncommon complication of stress
fracture of the ribs. The following is an unusual case of
cough induced multiple rib fractures associated with
subcutaneous emphysema and pneumothorax which was
missed in the emergency setting. Delayed diagnosis and
treatment would have been avoided if this uncommon
condition was considered as a possibility
7.The Prevalence of Hypersensitivity Reactions to Snake Antivenoms Administered in Sultanah Nur Zahirah Hospital From 2013 To 2016
Nur Aizahakiki Shafie ; Hamid Fauzi ; Mohd Shahezwan Abd Wahab ; Mohd Zaki Fadzil Senek ; Ahmad Khaldun Ismail
The Medical Journal of Malaysia 2020;75(3):216-220
Introduction: Snakebite is an important medical emergency.
Antivenoms remain the only proven treatment for snake
envenoming. However, the use of antivenom is associated
with hypersensitivity reactions. The aims of this study were
to determine the prevalence and types of hypersensitivity
reactions and types and outcomes of pharmacological and
non-pharmacological treatments for antivenom reactions
among snakebite patients that received antivenoms.
Methods: This was a 4-year cross-sectional study of
snakebite patients from January 2013 to December 2016 in
Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. Data
was extracted from the Pharmacy Record on the usage of
antivenom and patients of snakebites treated with
antivenom were identified. Data of patients were then
obtained from the electronic medical records.’ Demographic
details, clinical features and characteristics of antivenom
reactions of patients were recorded in standardized data
collection forms and analyzed using chi-square or MannWhitney U tests.
Results: Of the 44 patients who received antivenom, 24
(54.5%) developed hypersensitivity reaction. All patients
developed reaction early. No patient developed delayed
(serum-sickness) reaction. Of the 24 patients, 14 (58.3%) had
moderate to severe hypersensitivity reaction and 9 (37.5%)
patients had mild reactions. Only one (4.2%) patient
presented with bradycardia.
Conclusion: The prevalence of early hypersensitivity
reaction to snake antivenom in HSNZ was relatively high.
Healthcare providers should be aware of the appropriate
method of preparing and administering antivenom, and the
management for acute hypersensitivity reactions. This will
optimize the management of snakebite and ensure patient
safety
8.Naja species Bite Injury- Pathophysiology of Envenomation and Multidisciplinary Approach in Management.
Nor Safiahani Mhd Yunin ; Keshvinder Singh ; Mohd Noor Nashriq Umar Othman ; Vikneswaran Govindasamy ; Ahmad Khaldun Ismail
Malaysian Journal of Medicine and Health Sciences 2023;19(No.5):435-437
Cobra bite envenomation is one of the commonest causes of snake related injuries in Malaysia. Local tissue injury following a cobra bite is a complex sequalae of envenomation that is attributed to various peptides and enzymes including cytotoxin, metalloproteases, phospholipase A2 and hyaluronidase. This case involves a young construction worker who was bitten by an unidentified snake on the dorsum of his left foot. He presented with typical features of local and systemic envenomation of a Naja species. Remote Envenomation Consultancy Services was consulted and the appropriate antivenom was administered. The patient underwent wound debridement and subsequent skin
grafting. Follow up at outpatient clinic showed good skin graft uptake and recovery. Managing a significant Naja species bite envenomation can be a lengthy process requiring expertise from various subspecialties. Timely and seamless multidisciplinary approach in managing a Naja species envenomation ensures a favorable outcome with minimal complication..