Effects of weights applied to the apex of a bag-valve-mask and pinch strength on tidal volume: a prospective simulation study

A bag-valve-mask (BVM) is a first aid tool that can easily and quickly provide positive-pressure ventilation in patients with breathing difficulties. The most important aspect of BVM bagging is how closely the mask adheres to the patient's face when the E-C technique is used. In particular, the greater the adhesion force at the apex of the mask, the greater the tidal volume. The purpose of this study was to investigate the effect of various weights applied to the mask's apex and the pinch strength needed to perform the E-C technique, on tidal volume. In this prospective simulation study, quasi-experimental and equivalent time-series designs were used. A total of 72 undergraduate paramedic student from three universities were recruited using convenience sampling. The tidal volumes according to the weights (0 g, 100 g, 200 g, 300 g) applied to the apical area of the mask, handgrip strength, and pinch strength (tip pinch strength, key pinch strength, and tripod pinch strength) were measured. A linear mixed model analysis was performed. Linear mixed model analyses showed that tidal volume was significantly higher at 200 g (B = 43.38, p = 0.022) and 300 g (B = 38.74, p = 0.017) than at 0 g. Tripod pinch strength (B = 12.88, p = 0.007) had a significant effect on mask adhesion for effective BVM ventilation. Adding weight to the apical area of the mask can help maintain the E-C technique and enable effective ventilation. Future studies are required to develop specific strategies to improve the ventilation skills, which can be an important first-aid activity.

Current Status of Infection Prevention and Control Programs for Emergency Medical Personnel in the Republic of Korea

OBJECTIVES

Emergency medical personnel (EMPs) are pre-hospital emergency responders who are at risk of exposure to infections and may also serve as a source for the transmission of infections. However, few studies of infection control have specifically addressed EMPs in the Republic of Korea (hereafter Korea). The goal of this study was to assess the current status of infection prevention and control programs (IPCPs) for EMPs in Korea.

METHODS

A cross-sectional survey was conducted to quantitatively assess the resources and activities of IPCPs. A total of 907 EMPs in five metropolitan cities completed a structured questionnaire from September 2014 to January 2015. The data were analyzed using descriptive statistics, multi-response analysis, and the chi-square test.

RESULTS

The mean age of the participants was 34.8±15.1 years. IPCPs were found to have weaknesses with regard to the following resources: the assignment of infection control personnel (ICP) (79.5%), hand hygiene resources such as waterless antiseptics (79.3%), the use of paper towels (38.9%), personal protective equipment such as face shields (46.9%), and safety containers for sharps and a separated space for the disposal of infectious waste (10.1%). Likewise, the following activities were found to be inadequately incorporated into the workflow of EMPs: education about infection control (77.5%), post-exposure management (35.9%), and the decontamination of items and spaces after use (88.4%). ICP were found to have a significant effect on the resources and activities of IPCPs (p<0.001). The resources and activities of IPCPs were found to be significantly different among the five cities (p<0.001).

CONCLUSIONS

IPCPs for EMPs showed some limitations in their resources and activities. IPCPs should be actively supported, and specific IPCP activities for EMPs should be developed.

[Health-related quality of life in Korean patients with rheumatoid arthritis: association with pain, disease activity, disability in activities of daily living and depression]

PURPOSE

The purpose of this predictive study was to identify factors affecting health related quality of life (HRQoL) in patients with rheumatoid arthritis (RA).

METHODS

The participants in this study were 131 patients with RA who were recruited from the outpatient clinic of a university hospital in Seoul. Disease activity in rheumatoid arthritis was evaluated by calculating the Disease Activity Score 28. Disability in activities of daily living (ADL) was assessed with the Korean Health Assessment Questionnaire, and depression with The Center for Epidemiologic Studies Depression Scale. HRQoL was evaluated using The Short Form 36 Health Survey. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression.

RESULTS

Pain, disability in ADL, disease activity, and depression correlated negatively with physical and mental dimensions of HRQoL. But hierachical multiple regression analysis revealed that disability in ADL and depression were the only variables negatively influencing physical and mental QoL after adjustment for influences of sociodemographic variables.

CONCLUSION

Results of this study suggest that disability in ADL and depression, rather than disease activity and pain have profound effects on HRQoL in patients with RA. Further studies are needed to assess the predictive ability of disease activity and pain on HRQoL in this population.