Cross sectional observational study to assess the knowledge of drugs utilized in emergency medical conditions amongst medical interns and residents in tertiary care teaching hospital
Keywords:Emergency, Interns, Knowledge, Pharmacotherapeutics, Residents
Background: Medical interns and residents are future medical professionals and as first-line responders, they may confront any type of emergency. Knowledge of pharmacotherapeutics (PTs) is the backbone of emergency care. Therefore, this study is designed to assess PTs’ knowledge and identify the lacunae in handling various medical emergencies among medical interns and residents.
Methods: This was a cross-sectional, observational, questionnaire-based study. A self-structured questionnaire containing 30 close-ended questions, assessing the knowledge of drugs utilized in various medical emergency conditions was prepared and circulated in the form of a Google form. A credit score of “1” was given for each correct response. Grading of knowledge was done as “poor” (≤50%), “average” (>50-70%), and “adequate” (>70%-100%) The student’s unpaired t-test was used to analyse the data.
Results: A total of 282 candidates responded, with 148 (52.48 %) interns and 134 (47.52%) residents. Participants had the least knowledge of PTs for anaphylactic shock. Participants’ knowledge of PTs was found to be adequate regarding the central nervous system and electrolyte disorders while average regarding toxicology, immunization, and endocrine system. Results suggested that residents (mean score: 21.42±5.06) were significantly (p=0.0165) more knowledgeable than interns (mean score: 19.96±5.08). Among respondents, 17.6% of interns and 13.4% of residents had poor performance while 45.9% of interns and 53.7% of residents had adequate performance.
Conclusions: The current study provides valuable information regarding the state of PTs’ knowledge in medical emergencies among interns and residents, which can be used to improve undergraduate as well as postgraduate training.
Razzak J, Usmani MF, Bhutta ZA. Global, regional and national burden of emergency medical diseases using specific emergency disease indicators: analysis of the 2015 Global burden of disease study. BMJ Glob Health. 2019;4(2):e000733.
Chang CY, Abujaber S, Reynolds TA, Jr CAC, Obermeyer Z. Burden of emergency conditions and emergency care usage: new estimates from 40 countries. BMJ Glob Health. 2016;2(1):794-800.
Arora P, Bhavnani A, Kole T, Curry C. Academic emergency medicine in India and international collaboration. BMJ. 2013;3:294-6.
Dandona L, Dandona R, Kumar GA, Shukla DK, Paul VK, Balakrishnan K, et al. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet. 2017;390(10111): 2437-60.
Arnold JL, Corte DF. International emergency medicine: recent trends and future challenges. Eur J Emerg Med. 2003;10(3):180-8.
Ramanayake RPJC, Ranasingha S, Lakmini S. Management of emergencies in general practice: Role of general practitioners. J Fam Med Prim Care. 2014; 3(4):305.
Cheekavolu C, Pathapati RM, Laxmansingh KB, Saginela SK, Makineedi VP, Kumar A. Evaluation of drug utilization patterns during initial treatment in the emergency room : a retroprospective pharmaco-epidemiological study. Eur J Emerg Med. 2011; 2011:10-2.
Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison’s principles of internal medicine. 20th ed. Columbus: McGraw-Hill Education; 2018.
Brunton L, Knollman B, Hilal-Dandan R. Goodman and gilman’s the pharmacological basis of therapeutics. 13th ed. Columbus: McGraw-Hill Education/Medical; 2017.
Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG, et al. Adult basic and advanced life support: 2020 american heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142:366-468.
Vineeth Chandran K, Abraham S V. Basic life support: Need of the hour a study on the knowledge of basic life support among young doctors in india. Indian J Crit Care Med. 2020;24(5):332-5.
Jose R, Clesham GJ. Survey of the use of epinephrine (adrenaline) for anaphylaxis by junior hospital doctors. Postgrad Med J. 2007;83(983):610-1.
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: A report of the american college of cardiology foundation/american heart association task force on practice guidelines. Circulation. 2013;128(16).
Bontsevich RA, Mikhno A V., Dudchenko O V., Batisheva GA, Prozorova GG, Shagieva TM, et al. Assessment of physicians’ and medical majors’ knowledge of asthma basics: Current results of the ASSA-II study. Res Results Pharmacol. 2019;55(2): 79-88.
Palacherla S, Mattam BN, Burli KR, Moorthy S. Assessment of knowledge on pharmacotherapeutics among undergraduate medical students in a South Indian medical college. Int J Basic Clin Pharmacol. 2020;9(7):1119.
Leung AKC, Hon KL, Leung TNH. Febrile seizures: An overview. Drugs Context. 2018;7:1-12.
Betjemann JP, Josephson SA, Lowenstein DH, Burke JF. Trends in status epilepticus-related hospitalizations and mortality: Redefined in US practice over time. JAMA Neurol. 2015;72(6):650-5.
Khan SA, Siddiqui NI. Pharmacotherapeutics knowledge of some nonemergency and emergency conditions among medical undergraduates in an Indian medical college. Indian J Pharmacol. 2016; 48(3):252-7.
Bonvoisin T, Utyasheva L, Knipe D, Gunnell D, Eddleston M. Suicide by pesticide poisoning in India: A review of pesticide regulations and their impact on suicide trends. BMC Public Health. 2020; 20(1):1-16.
Subedi N, Paudel IS, Khadka A, Shrestha U, Mallik VB, Ankur KC. Knowledge of first aid methods and attitude about snake bite among medical students: A cross sectional observational study. J Occup Med Toxicol. 2018;13(1):1-7.
Parsons SM, Kuszajewski ML, Merritt DR, Muckler VC. High-fidelity simulation training for nurse anesthetists managing malignant hyperthermia: a quality improvement project. Clin Simul Nurs. 2019; 26:72-80.
Rosenberg H, Pollock N, Schiemann A, Bulger T, Stowell K. Malignant hyperthermia: a review. Orphanet J Rare Dis. 2015;10(1):1-19.
Lam NN, Huong HTX, Tuan CA. Preparation for major burns incidents: evaluation of continuing medical education training courses for professionals. Ann Burns Fire Disasters. 2018;31(4):322-8.
Madkhly TM, Mohammed FA, Majrashi HH, Kamili FH, Tawhari RAM, Hudisy AA, et al. Final-year medical students’ awareness and knowledge about DKA: A cross-sectional study from a Saudi University. J Family Med Prim Care. 2020;9(2): 1076-9.
Singh H, Thangaraju P, Kumar S, Aravindan U, Balasubramanian H, Selvan T. Knowledge and awareness of diabetes and diabetic ketoacidosis (DKA) among medical students in a tertiary teaching hospital: An observational study. J Clin Diagn Res. 2014;8(4):HC04-6.
Ono Y, Ono S, Yasunaga H, Matsui H, Fushimi K, Tanaka Y. Factors associated with mortality of thyroid storm analysis using a national inpatient database in Japan. Med. 2016;95(7):e2848.
Petersen KM. Douglas and Bennett’s principles and practice of infectious diseases. 7th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2009:4320.
Singh A, Ahluwalia S, Bhardwaj A, Mithra P, Siddiqui A. A cross-sectional study of the knowledge, attitude, and practice of general practitioners regarding dog bite management in nothern India. Med J Dr DY Patil Univ. 2013;6(2): 142.
Ferdous HS, Afsana F, Qureshi NK, Rouf RSB, Parvez AA, Mir AS. Recent advancement on current trend in the management of endocrine emergency in critically III patient. J Med. 2016;17(2):100-8.
Gunturi S, Sadiq Mantargi M, Vigneshwaran E, Farid Ahmed M, Dileep Krishna B, Ahmed T. Electrolytes imbalance and their clinical outcomes in the intensive care unit: A prospective, observational study. Int J Heal Allied Sci. 2021;10(1):17.
Afzalimoghaddam M, Hoseinidavarani H, Hossein-Nejad H. Evaluating the impact of emergency medicine education on medical interns’ knowledge scores. Eur J Emerg Med. 2011;18(5):257-60.