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  1. An evaluation of knowledge and skill on cricoid pressure among emergency personnel
    Hanizah N, Affirul CA, Fadzlon MY
    Clin Ter, 2014;165(5):e336-41.
    PMID: 25366949 DOI: 10.7417/CT.2014.1759
    BACKGROUND: Cricoid pressure (CP) is a step during rapid sequence induction. Previous studies showed a poor clinical application of CP despite a reasonable theoretical knowledge of CP. This study aims to evaluate the proficiency and knowledge retention on CP among the emergency staff in the Emergency Department, Universiti Kebangsaan Malaysia Medical Centre.

    MATERIALS AND METHODS: This is questionnaire-based observational comparative study. Once the questionnaire is filled, the application of CP is tested on an airway model and competency level is documented. An education hand out is passed to all participants after the procedure. The improvement and knowledge retention were assess after 2 month.

    RESULTS: A total of 81 completed surveys were returned comprises of of 34 medical officers, 23 staff nurses and 24 assistant medical officers. 75.3% subjects have work experience more than a year but only 59.3% of them were trained in CP application. A total of 69.1% participants passed the pre educational handout test and 100% passed the post educational handout test. However, for pre educational handout phase, 81.5% participants passed the theory part while only 42% passed the practical component. In post educational handout phase, the number of respondents who passed both components was 97.5% and 63% respectively. There are positive correlation between designation and working experience with overall passes in this study.

    CONCLUSIONS: The theoretical knowledge of CP is satisfactory but clinical application is poor especially in the pre educational handout phase. The educational handout is proved to improve the knowledge transfer and retention with regards to CP.

  2. Training exposure and confidence level among medical officers: Does an Emergency Physician make a difference?
    Zakiah MJ, Nidzwani M, Hanizah N, Affirul CA
    Clin Ter, 2016;167(1):e1-5.
    PMID: 26980635 DOI: 10.7417/T.2016.1911
    The training of emergency medical officers has always been informal. Only recently, the presence of emergency physician may have a positive influence in their training and development. This study aims to determine the effect of Emergency Physician (EP) presence on the training exposure and confidence level of medical officers in their practice.
  3. Novel usage of fresh frozen plasma in hereditary angioedema
    Hanizah N, Affirul CA, Farah NA, Shamila MA, Ridzuan MI
    Clin Ter, 2016 Nov-Dec;167(6):182-184.
    PMID: 28051822 DOI: 10.7417/CT.2016.1969
    Hereditary angioedema (HAE) is a rare and potentially life threatening autosomal dominant disease characterized by recurrent episodes of cutaneous and mucosal oedema. It results from reduced expression or loss of function of CI-esterase inhibitors (C1-INH). As opposed to the more common histamine-mediated angioedema, HAE does not respond well to conventional treatments with anti-histamines, steroids and adrenaline. Early recognition and timely intervention with the correct treatment are crucial particularly preventing airway obstruction. New disease specific treatment including plasma derived or recombinant C1-INH, ecallantide and icatibant have recently emerged and its appropriate use can reduce HAE-associated mortality and morbidity. However due to its costs, these disease specific treatments have yet to reach Malaysia. Despite that no randomized clinical trial on FFP has been performed, its efficacy in treating acute attacks of HAE is only demonstrated in case studies. This case report illustrates the successful treatment of acute HAE episode with FFP in a Malaysian government hospital setting.
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