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Management of pregnancy-related emergencies: What do Polish anesthesiologists know?
Gestión de emergencias relacionadas con el embarazo: ¿qué saben los anestesiólogos polacos?
a Department of Teaching Anaesthesiology and Intensive Therapy, University of Medical Sciences in Poznan, Poznan, Poland
b Department of Anesthesiology, Texas Tech University, Health Sciences Center, El Paso, Texas, USA
c Department of Anesthesiology, Intensive Therapy and Pain Treatment, University of Medical Sciences in Poznan, Poznan, Poland
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"apellidos" => "Grzeskowiak" "email" => array:1 [ 0 => "mgrzesko@ump.edu.pl" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "K.M." "apellidos" => "Kuczkowski" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Drobnik" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Teaching Anaesthesiology and Intensive Therapy, University of Medical Sciences in Poznan, Poznan, Poland" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Anesthesiology, Texas Tech University, Health Sciences Center, El Paso, Texas, USA" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Anesthesiology, Intensive Therapy and Pain Treatment, University of Medical Sciences in Poznan, Poznan, Poland" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Gestión de emergencias relacionadas con el embarazo: ¿qué saben los anestesiólogos polacos?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Emergencies in pregnancy can occur at any time. The management of obstetric emergencies should be familiar to obstetricians and midwives, who are the first-line personnel for pregnant patients.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Several reports have assessed the knowledge and skills of maternity professionals, obstetricians, and midwives regarding obstetric emergencies.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Many groups have proposed simulations as an effective method of acquiring knowledge and skills in obstetric emergencies.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a> Some countries have created a special courses (e.g. Advanced Life Support in Obstetrics – ALSO in the USA, Maternity Emergency Care – MEC course in Australia) and training programs (e.g. Managing Obstetric Emergences and Trauma – MOET in the UK) to improve such knowledge.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6–10</span></a> A review of training programs in acute obstetric emergencies using databases from 2003 concluded that “few training programmes have been described and even fewer have been evaluated” and that “further … research for this important intervention is urgently required.”<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Anesthesiologists and intensive therapists should also be familiar with obstetric emergencies, but few articles have evaluated this knowledge in these specialists.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,13</span></a> The majority of studies evaluated knowledge and skills of maternity professionals, obstetricians, and midwives, and few of them assessed knowledge of family practice residents and health practitioners. We found only one article which presented assessment of knowledge regarding cardiopulmonary resuscitation of parturients among anesthesiologists.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> We did not find the studies which assessed knowledge regarding other emergencies in pregnancy among this group of physicians.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of the study was to examine the acquisition of basic and advanced knowledge regarding the management of emergencies in pregnancy among specialists and physicians who specialize in anesthesiology during residency training.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This study was performed in 2010, wherein 280 physicians were included in the survey after agreeing to participate. We prepared a questionnaire, the first section of which obtained the respondents’ demographics; a second section included a multiple choice question (MCQ) test that evaluated the participants’ knowledge. The questionnaire was distributed to specialists in anesthesiology (S group, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>122) who attended the national Polish meeting in Popowo, attended primarily by ward heads and their assistants (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>87), or an international conference on obstetric anesthesia and perinatal medicine in Poznan (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>35). The questionnaire was filled out anonymously. The response rate was 54% and 40%.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Physician-residents who were training for their specializations (DS group, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>28) were also tested at the beginning of the obligatory courses for specialization. The control group comprised postgraduate doctors who have not started the residence (PD group, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>130) that were tested at the beginning of AN emergency course during postgraduate education. The response rate in the DS and PD groups was 100%.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Demographics are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The MCQ test was constructed based on Bloom taxonomy, which was transformed by Niemierko into ABC taxonomy.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14,15</span></a> In increasing order of difficulty, the levels of knowledge that we assessed were: (1) retention of knowledge (i.e., remembering, which is a passive knowledge) and (2) use of the knowledge in difficult situations (e.g., if the algorithm is more complicated). Questions also evaluated both basic and advanced knowledge for the management of emergencies in pregnancy.</p><p id="par0045" class="elsevierStylePara elsevierViewall">To examine the acquisition of knowledge regarding the management of emergencies in pregnancy from a broader perspective, we also inquired about the management of foreign body airway obstructions and cardiac arrest in pregnancy.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Questions that assessed the retention of knowledge asked respondents to choose the recommended maneuvers for pregnant women who are choking ineffectively, give the proper number of cycles of cardiopulmonary resuscitation (CPR) in pregnancy, and estimate the time to cesarean section during CPR and the risk of anesthesia in pregnancy (physiological changes that render intubation difficult). Questions that examined the use of knowledge in difficult situations were about case reports and the management of pulseless electrical activity (PEA) in a hypovolemic pregnant victim, the recognition of amniotic embolism and its treatment, and the recognition of eclampsia and its treatment.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The questions were developed based on the current literature and the 2005 European Resuscitation Council (ERC) Guidelines.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16,17</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">We compared the number of correct answers between the groups (S, DS, PD). Additionally we divided the group of specialists in anesthesiology and residents during specialization into age ranges to find any correlation between them. Statistical analysis was performed using Fisher–Freeman–Halton and Fisher's Exact tests with StatSoft Statistica 9.0. Fisher–Freeman–Halton test was used because there were three groups and low expected frequencies. In few cases, we had to use Fisher's Exact test for the tables 2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2 and low expected frequencies. <span class="elsevierStyleItalic">p</span> values<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 were considered statistically significant.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The number of correct answers on the test and the statistical analysis are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Because the groups differed in age, we divided the specialists in anesthesiology and doctors during specialization into 5 age brackets and compared them according to age (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Between all groups, the results did not differ by gender (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0080" class="elsevierStylePara elsevierViewall">When comparing all the tested groups together according to their position at work, a statistical significance was found for two questions (maneuvers for a pregnant woman who is choking with ineffective cough and cycles of CPR in pregnancy).</p><p id="par0085" class="elsevierStylePara elsevierViewall">The presence of an intensive therapy unit at the hospital at which the test group worked was associated with the question on cycles of CPR in pregnancy.</p><p id="par0090" class="elsevierStylePara elsevierViewall">The participant's opinion on having the knowledge on the management of emergencies in pregnancy was linked to two questions – the maneuvers for a pregnant woman who is choking with an ineffective cough; but unfortunately, despite the tested group not answering that question properly, they did in contrast give a correct answer to the question about cycles of CPR in pregnancy.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">The questionnaire was based on the recommendations from recent experiences and reports regarding the instruction of critical obstetric problems. There is a need to understand physiological changes in pregnancy, availability of management in eclampsia, amniotic fluid embolism, blood loss, and awareness of cesarean section.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Eclampsia occurs in 1 in 2000 maternities and is associated with high rates of mortality.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Embolism, the most common of which being thrombi and amniotic fluid embolisms, cause approximately 20% of deaths in pregnancy.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> We cannot avoid trauma, which are also a leading cause of death.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Obstetric hemorrhage leads to roughly 25% of maternal deaths.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Cardiac arrest in pregnancy is rare but occurs once in approximately 30,000 pregnancies.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">We wanted to assess the acquisition of knowledge regarding the management of emergencies in pregnancy by anesthesiologists (specialists and doctors during specialization). Based on the low response rate (54% in Popowo and 40% in Poznan) of the questionnaires, one explanation is that anesthesiologists in Poland do not want their knowledge to be verified.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Our survey asked basic questions according to taxonomy about the maneuvers for a pregnant woman who is choking, cycles of CPR in pregnancy, time to cesarean section during CPR, and the risk of anesthesia in pregnancy and assess the retention of such knowledge. Basic knowledge was poorer compared with advanced knowledge. The DS group had better basic management skills than specialists in anesthesiology and the PD group, because they are completing the specialization, and their knowledge is current. Unfortunately, specialists have poor basic knowledge – poorer than postgraduate doctors. It appears as though they do not review basic knowledge, consistent with another report.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Worse results were achieved on the questions about maneuvers for a pregnant woman who is choking and time to cesarean section during CPR. Cohen et al. also reported inadequate awareness of essential basic knowledge regarding CPR in pregnancy.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> They noted that 88% of anesthesiologists answered the question on physiological changes in pregnancy correctly, similar to our question on the risk of anesthesia in pregnancy; in our study, however, we observed a higher percentage (91.9–100%). Fifty-nine percent answered correctly on the question about time to cesarean section during CPR in Cohen et al., vs. 29.8% to 50% in our survey.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">On advanced level questions (assessing the use of knowledge in difficult situations by taxonomy), the specialists (S) and residents in anesthesiology (DS) group achieved very good, comparable results, outperforming the PD group, indicating that specialists and DS doctors know how to manage emergencies in pregnancy. Specialists have much experience, which likely helped them answer the questions correctly. They recognized PEA in hypovolemia and treated it properly. This skill is critical, because hemorrhage and hypovolemia often lead to maternal death. So the recognition of this emergency situation at early stage gives a chance to save the pregnant patient.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Based on the case in the test, all tested participants recognized eclampsia and amniotic embolism and treat these conditions properly: by oxygenation and magnesium sulfate administration in eclampsia, and oxygenation and fluid administration in embolism. Our results appear to be better than those of Ellis et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">We did not observe any statistical significance between any groups concerning gender. Significance differences were noted on two questions at the basic level (maneuvers for a choking pregnant woman and cycles of CPR) with regard to the level of position at work. In Poland, it is common that the elder doctor assumes the highest position at work. Among specialists in anesthesiology and doctors during specialization, older doctors achieved significantly worse results – i.e., 41–60-year olds on the question about choking maneuvers and 61–70-year olds on the questions about cycles of CPR and the management in PEA. We conclude that older specialists are unfamiliar with current ERC guidelines. Einav et al. generated similar findings.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Significant differences were observed on two advanced questions with regard to participant age. Worse results were achieved by the 24–40-year old group on the question about recognition of amniotic embolism (64.5%) and by the 61–70-year old group on the question about the risk of anesthesia in pregnancy (50%). These doctors do not work in the obstetrics ward; thus, they are unfamiliar with this knowledge.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Although 161 doctors answered that they were familiar with the management of emergencies in pregnancy, we did not observe this correlation with regard to basic knowledge, as evidenced by the statistical significance on two questions (maneuvers for a choking pregnant woman and cycles of CPR). Such illusions are dangerous when doctors mistakenly believe that they know how to manage emergencies in pregnancy. Basic management should not be assumed to be simple, because problems arise as the emergencies progress, as shown in our survey.</p><p id="par0140" class="elsevierStylePara elsevierViewall">A limitation of our study was that only physician knowledge was assessed, failing to translate our findings into clinical practice. However, the acquisition of advanced knowledge appears to benefit one's practice. The other limitation is a small number of residents participating in this study.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Older specialists in anesthesiology do not know how to manage basic emergencies in pregnancy – particularly choking women and time to cesarean section during CPR. Anesthesiologists were familiar with the management of advanced problems, such as eclampsia and amniotic embolism. Thus, no relationship between remembering (passive knowledge) and using the knowledge in difficult situations was observed, suggesting that the fundamental elements of the teaching process from a didactic perspective deteriorated. The teaching process of acute obstetric emergencies is inadequate and requires improvement through the implementation of national obligatory courses and verification of knowledge every few years.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres114883" "titulo" => array:5 [ 0 => "Abstract" 1 => "Background" 2 => "Methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec102186" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres114882" "titulo" => array:5 [ 0 => "Resumen" 1 => "Antecedentes" 2 => "Métodos" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec102185" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-07-09" "fechaAceptado" => "2012-09-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec102186" "palabras" => array:7 [ 0 => "Anesthesiologists" 1 => "Pregnancy" 2 => "Emergencies in pregnancy" 3 => "Obstetric emergencies" 4 => "Amniotic fluid embolism" 5 => "Eclampsia" 6 => "Cardiopulmonary resuscitation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec102185" "palabras" => array:7 [ 0 => "Anestesiólogos" 1 => "Embarazo" 2 => "Emergencias durante el embarazo" 3 => "Emergencias obstétricas" 4 => "Embolia amniótica" 5 => "Eclampsia" 6 => "Reanimación cardiopulmonar" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Emergencies can occur at any time during pregnancy. In addition to obstetricians and midwives, anesthesiologists should also be familiar with pregnancy-related emergencies. The aim of this study was to assess the basic and advanced knowledge regarding the management of pregnancy-related emergencies of anesthesiologists.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An anonymous questionnaire was distributed to anesthesiologists at two conferences (S1, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>87; S2, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>35), and to other groups comprising doctors during specialization (DS, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>28) and postgraduate doctors (PD, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>130). Ultimately, 280 doctors were included in the survey. The first part of the questionnaire collected demographics, and a second one evaluated both their basic and advanced knowledge by taxonomy.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Basic knowledge regarding the management of pregnancy-related emergencies of the tested group was poorer compared with advanced knowledge. The DS group had better basic management skills than anesthesiology specialists and the PD group. Significantly worse results of the tested group were obtained on the questions about maneuvers for choking pregnant women and time to cesarean section during cardiopulmonary resuscitation. The specialists and the DS group had results on advanced level questions better than the PD group.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Older specialists in anesthesiology did not know how to properly manage pregnancy-related emergencies at the basic level; however, anesthesiologists were familiar with advanced management. No relationship between recalling and using such knowledge in difficult situations was observed. The teaching process of acute obstetric emergencies must be improved through implementation of compulsory nationwide courses and verification of knowledge every few years.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las emergencias pueden ocurrir en cualquier momento del embarazo. Además de obstetras y matronas, los anestesiólogos también deberían familiarizarse con las emergencias relacionadas con el embarazo. El objetivo del presente estudio es valorar los conocimientos básicos y avanzados de los anestesistas en lo que a la gestión de las emergencias relacionadas con el embarazo se refiere.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Durante dos congresos se distribuyó un cuestionario a anestesiólogos (S1, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>87, S2, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>35) y a otros grupos entre los que se encontraban médicos residentes en proceso de especialización (DS, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>28) y médicos que no habían comenzado la residencia (PD, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>130). En la encuesta participaron un total de 280 doctores. En la primera parte del cuestionario se recopilaban datos demográficos y en la segunda se evaluaban sus conocimientos básicos y avanzados conforme a la clasificación de los grupos.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los conocimientos básicos acerca de la gestión de emergencias relacionadas con el embarazo del grupo analizado fueron más pobres en comparación con los conocimientos avanzados. El grupo DS presentó mejores habilidades de gestión que los anestesiólogos y que el grupo PD. Se consiguieron unos resultados considerablemente peores en las preguntas sobre maniobras contra la asfixia en embarazadas y sobre el tiempo para la cesárea durante la reanimación cardiopulmonar. Los resultados de los especialistas y el grupo DS en las preguntas de nivel avanzado fueron mejores que los del grupo PD.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los anestesiólogos más mayores no sabían cómo gestionar correctamente las emergencias relacionadas con el embarazo de tipo básico; no obstante, sí estaban familiarizados con la gestión de nivel avanzado. No se encontró relación entre el conocimiento y la aplicación de dichos conocimientos en situaciones complicadas. Se debe mejorar el proceso de aprendizaje de las emergencias obstétricas agudas realizando cursos nacionales obligatorios y comprobando los conocimientos cada pocos años.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0155" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">1.</span></span><p id="par0160" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">30 years old pregnant woman (30 week) was admitted to a hospital. In the hospital when eating lunch suddenly she was choking. She was conscious but could not cough and speak. The emergency treatment is:</span><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">A.</span><p id="par0165" class="elsevierStylePara elsevierViewall">Back blows between scapula 5× and abdominal thrusts 5×</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">B.</span><p id="par0170" class="elsevierStylePara elsevierViewall">Back blows between scapula 5× and chest compressions 5×</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">C.</span><p id="par0175" class="elsevierStylePara elsevierViewall">Only back blows between scapula</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">D.</span><p id="par0180" class="elsevierStylePara elsevierViewall">Only chest compressions</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">2.</span></span><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A pregnant woman (25 week) who was admitted to the Emergency Department 15<span class="elsevierStyleHsp" style=""></span>min ago because of abdominal pain demonstrated a massive hemorrhage from genital tract. After 2<span class="elsevierStyleHsp" style=""></span>min she was in cardiac arrest. The recommended number of resuscitating cycles is:</span><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">A.</span><p id="par0190" class="elsevierStylePara elsevierViewall">30 chest compressions: 2 breaths</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">B.</span><p id="par0195" class="elsevierStylePara elsevierViewall">15 chest compressions: 2 breaths</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">C.</span><p id="par0200" class="elsevierStylePara elsevierViewall">30 chest compressions: 1 breath</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">D.</span><p id="par0205" class="elsevierStylePara elsevierViewall">15 chest compressions: 1 breath</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">3.</span></span><p id="par0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A defibrillator was attached to a patient described above and QRS complexes with a rate of 30/min were observed on a monitor. A pulse was undetectable. The next step of treatment is:</span><ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">A.</span><p id="par0215" class="elsevierStylePara elsevierViewall">Continuing resuscitation and administering 1<span class="elsevierStyleHsp" style=""></span>mg of Adrenaline iv</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">B.</span><p id="par0220" class="elsevierStylePara elsevierViewall">Continuing resuscitation, administering 1<span class="elsevierStyleHsp" style=""></span>mg of Adrenaline iv, administering fluids</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">C.</span><p id="par0225" class="elsevierStylePara elsevierViewall">Performing defibrillation, continuing resuscitation</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">D.</span><p id="par0230" class="elsevierStylePara elsevierViewall">Performing defibrillation, administering 1<span class="elsevierStyleHsp" style=""></span>mg of Adrenaline iv, continuing resuscitation</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">4.</span></span><p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">The resuscitation of a patient described above was not effective. A cesarean section should be done after … minutes from a moment of cardiac arrest</span><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">A.</span><p id="par0240" class="elsevierStylePara elsevierViewall">2<span class="elsevierStyleHsp" style=""></span>min</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">B.</span><p id="par0245" class="elsevierStylePara elsevierViewall">4<span class="elsevierStyleHsp" style=""></span>min</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">C.</span><p id="par0250" class="elsevierStylePara elsevierViewall">6<span class="elsevierStyleHsp" style=""></span>min</p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">D.</span><p id="par0255" class="elsevierStylePara elsevierViewall">8<span class="elsevierStyleHsp" style=""></span>min</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">5.</span></span><p id="par0260" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">30-years old woman gave birth on time through the natural passage. The delivery was without any complications. After about 30<span class="elsevierStyleHsp" style=""></span>min she felt unwell. She had dyspnea, peripheral cyanosis, and after a while became unconscious. Vital signs: pulse 100/min, blood pressure 60/20<span class="elsevierStyleHsp" style=""></span>mmHg. After next 15<span class="elsevierStyleHsp" style=""></span>min a hemorrhage from genital tract was observed. What should be diagnosed?</span><ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">A.</span><p id="par0265" class="elsevierStylePara elsevierViewall">Hypoxia due to massive hemorrhage</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">B.</span><p id="par0270" class="elsevierStylePara elsevierViewall">Eclampsia</p></li><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">C.</span><p id="par0275" class="elsevierStylePara elsevierViewall">Amniotic fluid embolism</p></li><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel">D.</span><p id="par0280" class="elsevierStylePara elsevierViewall">Stroke</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">6.</span></span><p id="par0285" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A treatment of a patient described above is:</span><ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">A.</span><p id="par0290" class="elsevierStylePara elsevierViewall">Giving oxygen, administering fluids</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">B.</span><p id="par0295" class="elsevierStylePara elsevierViewall">Giving oxygen only</p></li><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">C.</span><p id="par0300" class="elsevierStylePara elsevierViewall">Administering fluids only</p></li><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel">D.</span><p id="par0305" class="elsevierStylePara elsevierViewall">Administering 1<span class="elsevierStyleHsp" style=""></span>mg of Adrenaline iv</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0155"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">7.</span></span><p id="par0310" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">The risk of general anesthesia in pregnancy (later than 20 week) to cesarean section in emergency is high due to physiological changes. In this situation a personnel should take into consideration a risk of:</span><ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0160"><span class="elsevierStyleLabel">A.</span><p id="par0315" class="elsevierStylePara elsevierViewall">A full stomach</p></li><li class="elsevierStyleListItem" id="lsti0165"><span class="elsevierStyleLabel">B.</span><p id="par0320" class="elsevierStylePara elsevierViewall">A full stomach and difficult intubation</p></li><li class="elsevierStyleListItem" id="lsti0170"><span class="elsevierStyleLabel">C.</span><p id="par0325" class="elsevierStylePara elsevierViewall">There is no extra risk</p></li><li class="elsevierStyleListItem" id="lsti0175"><span class="elsevierStyleLabel">D.</span><p id="par0330" class="elsevierStylePara elsevierViewall">It can be difficult intubation</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0180"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">8.</span></span><p id="par0335" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">35-years old pregnant has got higher blood pressure 140/90<span class="elsevierStyleHsp" style=""></span>mmHg since 20 week of pregnancy. The edema was also observed. Yesterday she complained of headache, abdominal pain. Today morning she had seizure. What should be diagnosed?</span><ul class="elsevierStyleList" id="lis0045"><li class="elsevierStyleListItem" id="lsti0185"><span class="elsevierStyleLabel">A.</span><p id="par0340" class="elsevierStylePara elsevierViewall">Hypoxia due to massive hemorrhage</p></li><li class="elsevierStyleListItem" id="lsti0190"><span class="elsevierStyleLabel">B.</span><p id="par0345" class="elsevierStylePara elsevierViewall">Eclampsia</p></li><li class="elsevierStyleListItem" id="lsti0195"><span class="elsevierStyleLabel">C.</span><p id="par0350" class="elsevierStylePara elsevierViewall">Amniotic fluid embolism</p></li><li class="elsevierStyleListItem" id="lsti0200"><span class="elsevierStyleLabel">D.</span><p id="par0355" class="elsevierStylePara elsevierViewall">Stroke</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0205"><span class="elsevierStyleLabel"><span class="elsevierStyleBold">9.</span></span><p id="par0360" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A treatment of a patient described above is:</span><ul class="elsevierStyleList" id="lis0050"><li class="elsevierStyleListItem" id="lsti0210"><span class="elsevierStyleLabel">A.</span><p id="par0365" class="elsevierStylePara elsevierViewall">Giving oxygen, administering fluids</p></li><li class="elsevierStyleListItem" id="lsti0215"><span class="elsevierStyleLabel">B.</span><p id="par0370" class="elsevierStylePara elsevierViewall">Giving oxygen only</p></li><li class="elsevierStyleListItem" id="lsti0220"><span class="elsevierStyleLabel">C.</span><p id="par0375" class="elsevierStylePara elsevierViewall">Administering fluids only</p></li><li class="elsevierStyleListItem" id="lsti0225"><span class="elsevierStyleLabel">D.</span><p id="par0380" class="elsevierStylePara elsevierViewall">Giving oxygen and magnesium sulfate iv</p></li></ul></p></li></ul></p>" "etiqueta" => "Appendix A" "titulo" => "MCQ test" "identificador" => "sec0030" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">M: male; F: female; NA: no answer.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Data as number (%).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Gender (M/F)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">113 (40)/165 (58.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age range</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>24–30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">156 (55.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>31–40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (11.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>41–50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (16.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>51–60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (14) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>61–70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Occupational level</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Chief or vice chief of the ward or operating theater \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (8.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Consultant, senior assistant or assistant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (19.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Resident \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (10.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Postgraduate doctor \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">130 (46.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (15.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">In-hospital intensive therapy unit</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Present \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">259 (92.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Absent \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (3.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">In-hospital obstetric ward</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Present \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">147 (52.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Absent \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">122 (43.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (3.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Participant's opinion about having knowledge on the management of emergencies in pregnancy</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">161 (57.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 (20.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not too much \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 (19.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab202800.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Demographics.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">S: specialists in anesthesiology; DS: doctors during specialization tested at the beginning of the obligatory courses for specialization; PD: postgraduate doctors tested at the beginning of the emergency course during postgraduate education.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Questions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">S<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>122 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">DS<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">PD<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>130 \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Questions assessing retention of knowledge</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Maneuvers for a pregnant woman who is choking<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (9.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (42.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cycles of CPR in pregnancy<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94 (77.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (96.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">124 (95.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Time to cesarean section during CPR<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">***</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 (33.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>The risk of anesthesia in pregnancy<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">#</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">115 (94.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (92.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">109 (83.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Questions assessing the use of knowledge in difficult situations</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Management in PEA – hypovolemic pregnant victim (case)<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">101 (82.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (71.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77 (59.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Recognition of amniotic fluid embolism (case)<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89 (73.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (60.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (43.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Treatment of amniotic fluid embolism<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">#</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">117 (95.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (96.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">116 (89.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Recognition of eclampsia (case) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">119 (97.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">124 (95.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Treatment of eclampsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">121 (99.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">123 (94.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab202798.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01 S vs. DS, and S vs. PD.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "**" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 S vs. DS, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01 S vs. PD.</p>" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "***" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01 S vs. PD.</p>" ] 3 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "#" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 S vs. PD.</p>" ] 4 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "&" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01 S vs. PD.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The number of correct answers on the test, expressed as the number of participants – <span class="elsevierStyleItalic">n</span> (%) and statistical analysis between groups.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Four participants did not give their age.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Questions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">24–30 years<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">31–40 years<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">41–50 years<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">51–60 years<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">61–70 years<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Maneuvers for a pregnant woman who is choking (ineffective cough)<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (34.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (25.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (4.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (25.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cycles of CPR in pregnancy<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (93.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (72.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (68.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time to cesarean section during CPR<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (55.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (16.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (43.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (31.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The risk of anesthesia in pregnancy<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (93.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43 (97.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (89.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Management in PEA – hypovolemic pregnant victim (case)<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (69.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (90.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (77.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (86.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recognition of amniotic embolism (case)<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (65.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (64.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (77.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (68.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Treatment of amniotic embolism \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (96.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (96.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (90.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recognition of eclampsia (case) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (95.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (97.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Treatment of eclampsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (100) 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 1 | 0 | 1 |
| 2020 April | 1 | 0 | 1 |
| 2018 December | 1 | 0 | 1 |
| 2017 July | 4 | 1 | 5 |
| 2017 June | 13 | 2 | 15 |
| 2017 May | 36 | 1 | 37 |
| 2017 April | 15 | 2 | 17 |
| 2017 March | 15 | 4 | 19 |
| 2017 February | 12 | 3 | 15 |
| 2017 January | 15 | 0 | 15 |
| 2016 December | 23 | 7 | 30 |
| 2016 November | 14 | 3 | 17 |
| 2016 October | 47 | 5 | 52 |
| 2016 September | 30 | 5 | 35 |
| 2016 August | 18 | 3 | 21 |
| 2016 July | 17 | 1 | 18 |
| 2016 June | 17 | 4 | 21 |
| 2016 May | 9 | 2 | 11 |
| 2016 April | 14 | 2 | 16 |
| 2016 March | 14 | 11 | 25 |
| 2016 February | 16 | 9 | 25 |
| 2016 January | 7 | 6 | 13 |
| 2015 December | 10 | 5 | 15 |
| 2015 November | 13 | 4 | 17 |
| 2015 October | 15 | 4 | 19 |
| 2015 September | 22 | 4 | 26 |
| 2015 August | 11 | 3 | 14 |
| 2015 July | 5 | 3 | 8 |
| 2015 June | 4 | 3 | 7 |
| 2015 May | 12 | 4 | 16 |
| 2015 April | 18 | 18 | 36 |
| 2015 March | 14 | 2 | 16 |
| 2015 February | 10 | 1 | 11 |
| 2015 January | 19 | 3 | 22 |
| 2014 December | 18 | 5 | 23 |
| 2014 November | 10 | 3 | 13 |
| 2014 October | 12 | 4 | 16 |
| 2014 September | 10 | 0 | 10 |
| 2014 August | 11 | 2 | 13 |
| 2014 July | 14 | 6 | 20 |
| 2014 June | 7 | 1 | 8 |
| 2014 May | 10 | 1 | 11 |
| 2014 April | 1 | 0 | 1 |
| 2014 March | 0 | 1 | 1 |
| 2013 November | 0 | 1 | 1 |
| 2013 July | 1 | 1 | 2 |
| 2013 February | 248 | 0 | 248 |
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