Abstract
The aim of the present project was the development of a system supporting on-line Guideline-based training in Emergency Medicine. The developed Windows application is built on Visual C++ 6.0, in Greek language, and is based on widely accepted Emergency Medical Guidelines, employed to define the minimum standard of care provided to patients by the First Responders.
INTRODUCTION
Continuing Medical Education (CME) constitutes a specific kind of education, and nowadays it is a requirement among practicing physicians to promote continuous enhancement of clinical knowledge to reflect new developments in medical care. Lifelong learning is critical to current physicians who are being held to high levels of accountability to patients, health-care payers, and society at large. The developed application, built on Visual C++ 6.0, aims to support emergency health-care personnel training, through the on-line display of the appropriate medical guidelines for the treatment of a patient in the Emergency department of a hospital, according to the patient’s condition.
METHODS
Commonly accepted European and American Emergency Medical Guidelines are employed in this that define the minimum standard of care provided to patients by the First Responders. These protocols define the minimum standard of care to be provided in the Emergency department of a Greek hospital, since there is a lack of generally accepted Emergency Medical guidelines. The user interacts with the program through its main menu, which gives him the ability to switch to up to thirteen different screens, each one of which reflects a distinct emergency aspect. The first six screens represent following major emergency categories:
| Cardiopulmonary | Obstetric-Neonatal |
| Medical | Pediatric |
| Trauma | Behavioral-Environmental |
Each screen is divided in three parts. The first part comprises of the Basic Life Support protocols for the most common incidents, as a list, from which the user can choose the desired one. The second part encompasses Advanced Life Support protocols, to be employed for the advanced life support of a patient. The last part of each screen includes instructions about specific emergency operations such as endotracheal intubation, AED etc. Some of these operations are also demonstrated through videos.
The next seven screens support the following important issues:
Primary survey of an adult patient through a table that displays the ABCDE assessment (Airway, Breathing, Circulation, Disability, Exposure) and the proper management of the patient.
Evaluation of the patient status based upon the medical signs and indications and their classification into four categories, that is CPR, unstable patient, potentially unstable patient and stable patient. The classification is accordingly color encoded (red, orange, yellow and green).
Secondary survey of an adult patient (Head, Neck, Chest, Abdomen, Pelvis, Assessment of the level of consciousness, Extremities, Back).
Automatic External Defibrillation (AED). The basic screen displays the AED guidelines and gives to the user the possibility to be informed through a pop-up window with pictures and notes about the proper placement of the paddles of the defibrillator and to watch through another pop-up window the video of an on scene defibrillation.
A S.T.A.R.T. (Simple Treatment And Rapid Transport) flow diagram, which is used in the event of a Multiple Casualty Incident (MCI). This plan allows for the triage of patients, according to respiration, circulation, and mental status observations. The patients can be are marked with colored tags (Black, Red, Yellow, Green) depending on the severity of their condition.
An interactive drug management screen based on MS Access 2000 allowing for drug administration.
The last screen constitutes a typical powerful patient-record data-entry menu.
CONCLUDING REMARKS
The developed on-line CME tools offer a simple and helpful method to support the training of emergency personnel, allows for the retrieving of necessary information during the patient treatment, and finally, provides means for the recording of the incidences.