Evaluation of a peer‐led self‐management education programme PEP Talk: Diabetes,Healthy Feet and You

PEP (Peer Education Programme) Talk: Diabetes, Healthy Feet and You is a peer‐led self‐management programme developed to address the problems of growing prevalence of diabetes and its complications, and limited health care dollars. An evaluation of the programme, how it might be situated within a public health perspective and potential bridges for its implementation in communities throughout Canada and worldwide, are presented. The programme consisted of workshops that were conducted by volunteer peer leaders and health care professionals in 12 communities in 10 Canadian provinces; the volunteers were supported through monthly mentoring teleconferences, on‐line tips and discussion board conversations. A web portal was developed to be used by the team, volunteers and community participants. Workshop curriculum was developed based on diabetes footcare and self‐management best practise guidelines. Community participants answered pre‐and post‐workshop statements that indicated that learning occurred, as indicated by an increase in the number of statements answered correctly. Participants' feedback about the workshops was positive. In telephone follow‐up interviews, 97% of respondents reported having changed their foot self‐management behaviours. The portal was commonly used according to website visits, but not as much as expected for registration of community participants. It is recommended that this programme be made widely available and tailored to the specific needs of the communities and that further evaluation be conducted.     

P ARAMEDIC U SE OF E NDOTRACHEAL T UBE I NTRODUCERS FOR THE D IFFICULT A IRWAY

Objective. To evaluate the ability of paramedics to learn and apply the skill of introducer-aided oral intubation in the setting of the simulated “difficult airway.” The authors hypothesized that, following a brief introduction to the device, intubation success rates would not differ for traditional and introducer-aided intubations of an immobilized airway mannequin. Methods. During a paramedic recertification class, experienced paramedics were given a brief didactic introduction to the “bougie-like” Flex Guide endotracheal tube introducer (ETTI). The participants were then asked to intubate adult mannequins immobilized in the head-neutral position, with and without the ETTI. “Successful placement” was defined as completion of the procedure within 30 seconds and endotracheal tube position confirmed by the investigator with direct visualization. Results. For both traditional and ETTI intubations, 34 (97%) of the 35 paramedics successfully intubated within 30 seconds. The two unsuccessful intubation attempts were recognized by the paramedic as esophageal intubations, and correct tube placement was obtained within an additional 30 seconds. Conclusion. In this study, use of the ETTI was mastered by the participants after only a brief didactic introduction to the device, with their ability to intubate an immobilized mannequin using the ETTI being equal to their ability to perform traditional intubation. These results suggest that use of the ETTI is easily learned, and may support the device's role in the prehospital management of the difficult airway.