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Guidewire-Assisted Nasogastric Tube Insertion in Intubated Patients in an Emergency Center
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Jin Go, Hyunjong Kim, Seunghwan Kim, Je Sung You, Min Joung Kim, Hyun Soo Chung, Sung Phil Chung, Hahn Shick Lee
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Korean J Crit Care Med. 2013;28(4):287-292.
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DOI: https://doi.org/10.4266/kjccm.2013.28.4.287
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 Abstract
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- BACKGROUND
The purpose of this study is to identify the usefulness of guidewire-assisted nasogastric tube insertion in intubated patients with cervical spine immobilization or unstable vital signs in an emergency center.
METHODS
Thirty-four intubated patients in an emergency center were enrolled in the study. Patients were randomly allocated to the control group or the guidewire group. All patient necks were kept in neutral position during the procedure. In the control group, the nasogastric tube was inserted with the conventional method. A guidewire-supporting nasogastric tube was used in the guidewire group. The success rates of the first attempts and overall were recorded along with complications.
RESULTS
The first attempt success rate was 88.2% in the guidewire group compared with 35.2% in the control group (p < 0.001). The overall success rate was 94.2% in the guidewire group and 52.9% in the control group (p = 0.017).
Five cases of self-limiting nasal bleeding were reported in the guidewire group, and two cases occurred in the control group. No statistical differences were identified between groups.
CONCLUSIONS
Guidewire-assisted nasogastric tube insertion is a simple and useful method in intubated patients with cervical spine immobilization or unstable vital signs.
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Assessment and Training of Teamwork and Leadership for Critical Care Nurses: A Pilot Study
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Hyun Jin Kim, Sang Mo Je, Hyun Soo Chung, Sung Phil Chung, Hahn Shick Lee
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Korean J Crit Care Med. 2012;27(2):75-81.
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DOI: https://doi.org/10.4266/kjccm.2012.27.2.75
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Abstract
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- BACKGROUND
Teamwork and leadership training have been shown to improve subsequent resuscitation performance in a variety of clinical situations. Critical care nurses, in addition to those who may be part of resuscitation team leaders and members, have also the need for such training. This study examines the teamwork and leadership skills of critical care nurses and their perceptions of the need for teamwork and leadership training.
METHODS
We developed a pilot, interactive 3-hour teamwork, and the leadership training program based on the objectives and teaching methods of the Advanced Life Support (ACLS) course. Participants completed a 1-hour lecture, and discussion for team roles and obstacles, 30 min of script-based role play in resuscitation team training, and finally, a 2-hour simulation-based team training program.
Before the completion of the course, participants were anonymously surveyed on the perceived educational value of the teamwork and leadership program. Expert raters reviewed videos of simulated resuscitation events in the course, and scored each video by two existing checklist for the team dynamic.
RESULTS
Fifty-one nurses voluntarily participated and six videotaped simulation were rated by an expert rater. Most of the students believed the course was delivered at an appropriate level for them, and that it is a necessary training in their continuing professional education. The video rated average scores were from 68.5 to 72.9 according to the checklists.
CONCLUSIONS
Critical care nurses can learn teamwork and leadership skills from appropriately designed programs, and believe it is a necessity in their training.
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Effect of Cardiac Arrest Team Training Using Script on the Quality of Simulated Resuscitation
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Mao Lung Sun, Hyun Jong Kim, Sung Phil Chung, Hahn Shick Lee, Wen Joen Chang
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Korean J Crit Care Med. 2012;27(1):5-9.
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DOI: https://doi.org/10.4266/kjccm.2012.27.1.5
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Abstract
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- BACKGROUND
The purpose of this study was to compare the quality of simulated resuscitation between the conventional simulation training group and the script based training group.
METHODS
This was a retrospective analysis of video clips from a previous study of cardiopulmonary resuscitation (CPR) team simulation training. A total of eighty-four video clips were analyzed. Each video clip belonged to either the conventional group or the script group, of either pre-training or post-training. One of the authors analyzed all the video clips. The qualities of resuscitation team plays were compared in terms of the hands-on compression time, the interval to meaningful measures and the number of utterances of the team leader and members.
RESULTS
The hands-on time of the conventional group improved after training whereas that of the script group deteriorated (22.2 vs -7.0 sec, p = 0.009). The time to defibrillation also improved in the conventional group whereas that of the script group deteriorated (-24.0 vs 33.0 sec, p = 0.002). There were no differences in the utterances of team leaders and members between groups and between pre- and post-training.
CONCLUSIONS
This study suggested that the effect of script-based training on quality of CPR was less useful than that of conventional training using simulation and debriefing. Therefore, CPR team training using a script alone should not be recommended.
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