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Cardiopulmonary Resuscitation III: AED Use01:23

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Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
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Developing a pediatric emergency medicine simulation-based learning curriculum in Nepal.

Morgan Bowling1,2,3, Samantha Langer4, Christine Saracino1,2

  • 1Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.

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|July 2, 2025
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Summary

Low-fidelity simulation effectively improves pediatric emergency care skills for providers in Nepal. This training enhances comfort with critical procedures, leading to better patient outcomes in resource-limited settings.

Keywords:
Global healthNepalPALSPediatric emergency medicineSimulation-based learning

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Area of Science:

  • Medical Education
  • Pediatric Emergency Medicine
  • Simulation-Based Learning

Background:

  • Pediatric Emergency Medicine (PEM) is underdeveloped in low- and middle-income countries like Nepal.
  • There's a lack of PALS certification and pediatric-specific curricula for local providers.
  • Low-fidelity simulation offers an effective educational approach to enhance skills for critically ill children.

Purpose of the Study:

  • To certify providers in Pediatric Advanced Life Support (PALS).
  • To design, implement, and evaluate a localized, simulation-based curriculum for pediatric emergencies at Dhulikhel Hospital, Nepal.
  • To improve provider confidence and competence in managing pediatric emergencies.

Main Methods:

  • Included medical professionals caring for pediatric patients at Dhulikhel Hospital.
  • Developed simulation cases based on local needs (respiratory distress, status epilepticus, preterm delivery, organophosphate poisoning).
  • Utilized pre- and post-simulation surveys, debriefing, hands-on skills stations, and a 3-month follow-up survey.

Main Results:

  • 37 providers participated; 54% were new to simulation.
  • Statistically significant increases in provider comfort across all assessed areas.
  • Greatest comfort improvements were observed in skills practiced at stations, not routine tasks.
  • 3-month follow-up confirmed sustained comfort levels.

Conclusions:

  • Low-fidelity simulation is effective for improving pediatric emergency care skills in low- and middle-income countries.
  • Recommended for high-acuity, low-occurrence skills (e.g., intraosseous/umbilical line placement).
  • Simulation-based learning enhances provider comfort and can improve pediatric patient outcomes.