Dr Parag Padmakar Rishipathak
@siu.edu
Professor & Director, Symbiosis Centre for Health Skills ( SCHS), Symbiosis International (Deemed University)
Scopus Publications
Scholar Citations
Scholar h-index
Scopus Publications
Parag Rishipathak, Monesh Bhandari and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Introduction: Violence against children is widespread and affects millions of children globally. Violenceagainst children occurs in various forms including physical violence, maltreatment, bullying, emotional orpsychological violence, forced and bonded labour, and trafficking.To prevent child abuse, it is essential that a high degree of awareness is essential amongst all stakeholdersincluding parents, educators and medical professionals. The common thread among all studies conducted inmedical professionals is the lack of focused training and sensitisation that can enhance the ability to detectsuch cases and respond to them promptlyObjective: To Assess Awareness Regarding Child Abuse and Neglect among Emergency MedicalProfessionals in PuneMethodology: As part of an awareness initiative by the Institute, an online session was conducted for theEmergency Medical Professionals (EMP) in Pune city. 65 Emergency Medical Professionals working invarious hospitals located around all parts of Pune participated in the session. After the session was completed,informed consent was taken from the participants for answering a questionnaire based on the subject.The questionnaire chosen for the study was Child Abuse and Neglect Awareness Scale (CANA-S) a pretestedand validated tool. The CANA-S tool comprises 4 sections, each section comprising a subscale dedicatedto one of the major categories of child abuse and neglect i.e. physical abuse, sexual abuse, emotional abuse,and neglect.Conclusion: Though the overall awareness about Child Abuse and Neglect is satisfactory, further trainingprograms should be encouraged, to achieve near 100 % awareness amongst EMS professionals in order toprevent and report every single case of Child Abuse and Neglect.
Parag Rishipathak, Monesh Bhandari and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Introduction: Natural disasters cause an estimated 60,000 deaths every year. Although low-frequency, highimpact events like earthquakes and tsunamis are not preventable, albeit loss of human lives can be preventedby developing an efficient disaster management system. In the last few decades robust emergency responsesystems, emergency preparedness, resilient infrastructure and accurate forecasting have significantlyreduced the death rate caused due to such calamities. Similar to natural disasters, MCIs drastically impactthe healthcare system and society at large.Emergency medical services (EMS) professionals play a pivotal role during disasters, mass casualty incidentsetc. and are an integral part of disaster management apparatus. The level of awareness and preparednessamongst EMPs with regards to disaster management is primordial. The areas requiring improvement includeskillset training strategic and operational planning and familiarity with the emergency preparedness indisaster management. Designing an effective training program for Indian EMS professionals, would requirea thorough understanding of the baseline level of preparedness among them.Objective: To assess preparedness in disaster management among Emergency Medical Professionals.Methodology: The study was conducted among Emergency Medical Professionals (EMPs) employed invarious hospitals in the city of Pune, India. The questionnaire tool utilized for the study was EmergencyPreparedness Information Questionnaire (EPIQ) a pretested and validated tool. The revised EPIQ toolcomprises of 42 items and is divided into eight sections.All 42 items were required to be mandatorily filled. The tool was administered through online mode. 119respondents reverted with completely filled questionnaire.Conclusion: Disasters although infrequent, cause significant morbidity and mortality. A high degree ofpreparedness is expected amongst EMP’s which can only be achieved with regular training and feedback.
Parag Rishipathak, Shrimathy Vijayaraghavan and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Introduction:‘Breaking Bad News’ (BBN) in the scenario of poor prognosis or death is considered to beone of the most stressful aspects of the duties of a Healthcare professional. In the recent years, the subject ofBBN has gained traction among healthcare professionals and psychologist leading to the creation of somecomprehensive models to train professionals. Emergency Medical Professionals are among the likeliest toencounter BBN situations. Hence it is imperative that they be formally trained to deal with patients and theirfamilies effectivelyObjective: To assess the training needs regarding ‘Breaking Bad News’ (BBN); amongst EmergencyMedical Services (EMS) Professionals.Methodology: The study was conducted amongst 150 Emergency Medical Professionals in Pune, India. Apreviously tested and validated questionnaire developed by Rasmus etal in June 2020 was utilized for thestudy. Questionnaire was administered to the respondents through online mode after obtaining informedconsent. Responding to all questions was mandatory. The respondents were given one day to fill thequestionnaire. Any queries pertaining to questionnaire were clarified during data collection.Discussion: The present study was done to assess the baseline awareness of EMS professionals about BBNand to devise a customized training program for them. Unfortunately, majority of the respondents werenot even aware that BBN is a separate subject having specific procedures and protocols followed globally.The lack of training instils fear of facing such situations and adversely affects the mental health of EMSprofessionals. This can be corrected by utilizing tools like simulation and role play to provide adequateexposure to EMS professionals in a safe environment.Conclusion: The findings of the study point towards an emergent need of formal practical training on thiscrucial yet ignored aspect of the health care professionals’ duties. Comparative Studies can be conducted inthe future to assess the effectiveness of this training program.
Parag Rishipathak, N. Sengupta and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Background: In trauma cases acute major hemorrhage in the first few hours of injury is the leading cause ofdeath in as many as 30% – 40% cases. Major hemorrhage can result in the collapse of the circulatory systemand the patient can present to the emergency room in a state of shock. EMS professionals are expected tohave high degree of awareness as well as should possess the requisite skills and preparedness in the varioustechniques utilized to control life threatening hemorrhage.Aim: To assess the Awareness and Preparedness regarding management of major traumatic hemorrhage inprehospital settings among EMS students.Methodology: The study was conducted amongst 141 Emergency Medical Service professionals. Theoriginal questionnaire consisted of 2 parts, first containing two clinical scenarios testing the awareness leveland the second one containing twenty four items pertaining to the preparedness of EMS professionals inmajor traumatic hemorrhagic situations.Result: The mean score obtained for the parameter awareness was 18.32 out of maximum score of28.Respondents scored well on the parameter pertaining to the management of venous bleeding and amputatedlimb while scored relatively lower on the items pertaining to the management of capillary bleeding.Conclusion: The present study provides encouraging results with regards on the awareness and preparednesslevels of EMS professionals. It also provides insight into future training needs to enhance preparedness incases of infrequent hemorrhagic emergencies.
Parag Rishipathak, Shrimathy Vijayaraghavan and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Introduction: An Out of Hospital Cardiac Arrest (OHCA) is defined as the loss of cardiac mechanical function that occurs outside of the hospital setting and confirmed by the absence of signs of systemic circulation. OHCA has a very low survival rate. Timely provision CPR and Rapid Defibrillation during Cardiac Arrest requires adequately trained and qualified personnel. It is therefore important to understand the current level of Knowledge, Attitude and Practice (KAP) with regards to AED amongst EMS responders. Objective: To assess Knowledge, Attitude and Practice on the Use of Automated External Defibrillation (AED) by Emergency Medical Services (EMS) Providers. Methodology: The Knowledge, Attitude and Practice (KAP) study was conducted amongst 120 Emergency Medical Services Providers at SCHS, Pune, India. A previously tested and validated KAP questionnaire by Marcus EH Ong et.al 9 was utilized for the study. The final questionnaire consisted of 15 items spanning 3 parameters -5 items testing Knowledge, 8 items measuring Attitude and 2 items measuring Practice related to use of AED. Discussion: The study was aimed at assessing the current knowledge, attitude and practices with regards to AED amongst EMS respondents. Most respondents reflected positive attitude towards utilizing AED in out of Hospital Cardiac Arrest patients. Conclusion: The study reemphasizes the need for formal training on AED usage. Although the study is limited by its sample size, it provides broad perspective on the subject.
Anand Hinduja, Parag Rishipathak and Shrimathy Vijayaraghavan
Institute of Medico-legal Publications Private Limited
Introduction: The provision of high quality cardio pulmonary resuscitation (CPR) is a key modifiable factor associated with survival in cardiac arrest. Management of a patient with cardiac arrest is a dynamic and high-pressure challenge requiring critical decision making in a short period of time. Numerous studies emphasize that quality of chest compressions directly influences survival rate from cardiac arrest. Hence, improving CPR quality is of paramount importance. This can be achieved by accurate measurement of various CPR metrics and provision of real time feedback to the rescuer. Objective: The study aims to assess impact of high fidelity simulation training on quality of CPR performance of EMS Professionals. Methods: A high fidelity manikin was utilized to create four unique healthcare simulation scenarios based on cardiac arrest. The manikin software was capable of capturing real-time CPR data and measured parameters like chest compression depth (CCD), chest compression rate (CCR), chest recoil (CR) and chest compression fraction (CCF). The participants were initially taught the assessment and management of cardiac arrest. The participants underwent a pre-intervention test conducted on high fidelity manikin. The CPR metrics were recorded during the session. The participants were then imparted training with real time CPR feedback for a period of two months. This was followed by a post-intervention test and the CPR metrics of both tests were compared. Discussion: The participants showed improvement in chest compression depth and chest compression rate but the chest recoil frequency and chest compression fraction decreased after the two-month intervention period. The overemphasis on achieving target depth and rate led to ignorance of the other two parameters affecting overall quality of CPR. Conclusion: Maintaining adequate attention on all aspects of CPR metrics is a complex challenge even for trained professionals. Utilizing technology for real-time feedback is a reliable method to gauge improvement in quality of CPR during training sessions of EMS professionals.
Parag Rishipathak, N. Sengupta and Anand Hinduja
Institute of Medico-legal Publications Private Limited
-Background: Respiratory emergencies is one of the life threatening conditions that quickly develop into respiratory failure landing into cardiac arrest hence EMS professional should posses updated knowledge regarding oxygen therapy and same should reflect in their beliefs and practice patterns. Aim: To assess the Awareness, Beliefs and Practice patterns regarding Oxygen therapy in prehospital management of respiratory emergencies amongst EMS professionals in Pune, India Methodology: The study was conducted among 100 EMS professionals at Symbiosis Center for health Skills, Pune, India. A pretested and validated questionnaire developed by Aloushan et al 3 was circulated among EMS professionals. The original 25 items questionnaire was utilized for the study, 9 items pertaining to awareness, 7 items pertaining to belief and 9 items pertaining to practice patterns. EMS professionals were given 1 day time limit to submit the completed questionnaire. The data collected was tabulated and statistically analyzed using SPSS version 23.0. Result: The mean awareness score of the participants in the study was found to be 4.67 and S.D is 1.63 whereas the mean Practice pattern score of the participants in the study was found to be 3.44 and S.D is 1.44. Majority of respondents agreed that oxygen should be given under medical supervision and that humidified oxygen prevented dryness of upper respiratory tract. Greater emphasis needs to be laid on practical sessions demonstrating oxygen therapy in the EMS programs. Conclusion: It is essential that EMS professionals undergo regular skill upgradation courses and are evaluated at the end of each course. This shall ensure appropriate utilization of the oxygen therapy and minimization of medical errors thereby saving more lives.
Parag Rishipathak, Monesh Bhandari and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Introduction: With rapid evolution of information and research in Healthcare, students find it very challenging to keep pace with the latest knowledge To overcome this challenge, Healthcare Information Technology should be implemented at multiple levels i e during their Under Graduate and Post-Graduate training which shall make them well versed with online learning During the COVID-19 pandemic many healthcare institutions have adapted to online teaching methodology, to continue with the academic year but it is necessary to assess the effectiveness and impact on students In developing countries, where efficient educators in Healthcare are less in number, adapting to online based curriculum shall increase the reach of Healthcare Education to maximum learners Objective: To assess the effectiveness of online teaching methodology among Emergency Medical Professionals Methodology: The study was conducted amongst 100 Emergency Medical Professionals in Pune, India An online session on Basic Life Support and Emergency Medical Services protocols was conducted via Zoom application Participants were asked to respond to a pretested and validated tool, the Student Evaluation of Online Teaching Effectiveness (SEOTE) Result and Discussion: Online teaching was introduced in most of the universities as an alternative to classroom training due to the COVID 19 pandemic The study is an unique attempt to assess the participant feedback on the effectiveness of a single online session The results clearly demonstrate that majority of the participants provided a very positive feedback of the online teaching session Conclusion: The participants’ feedback with regard to online teaching was found to be highly encouraging Further longitudinal studies are essential to gauge the impactfulness of online teaching as an alternative modality to classroom instruction © 2020, Institute of Medico-Legal Publications All rights reserved
Parag Rishipathak, Anand Hinduja and N. Sengupta
Institute of Medico-legal Publications Private Limited
Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the common, slow progressive disorder the respiratory system, considered an important cause of morbidity and mortality across the globe. Although being a chronic disability, COPD presents with acute exacerbations in the form of breathlessness and cough. Knowledge regarding about diagnosis of COPD, appropriate titration of Oxygen and effective management are essential to prevent mortality and morbidity due to COPD. Objective: To assess the Knowledge, Attitude and Practice level about management of Acute Exacerbation of COPD among EMS Professionals. Methodology: The study was conducted amongst 100 Emergency Medical Professionals in Pune, India. A previously tested and validated KAP questionnaire prepared by Sylvia Saade et al2 was utilized for the study. The questionnaire was administered through online mode after obtaining informed consent from the respondents. Discussion: The analysis of data shows EMS professionals are aware of the aetiology, pathophysiology and clinical features but require more training in management aspects of COPD. In terms of attitude towards COPD, broad agreement was found amongst respondents that COPD patients must quit smoking and passive smoking contributed to COPD. However, opinion amongst respondents with respect to recommendations regarding exercise was divided. In terms of Practices in COPD, broad consensus was found amongst the respondents on the usage and precautions regarding metered dose inhalers (MDI). Conclusion: The study finding point towards a healthy degree of knowledge, attitude, and practice with regards to COPD amongst EMS professionals. Although the finding do red flag areas of improvement which can be focused upon in future training session. The study is limited by number of respondents yet attempts to provide a broad view on Knowledge, attitude and Practices in COPD.
Parag Rishipathak, Monesh Bhandari and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Introduction: This paper summarizes a structured expert panel session on the subject of barriers in initiatingSimulation based andragogy in Healthcare Education in India. The expert panel consisted of members ofacademia in Medicine, Nursing, paramedical and representatives from the healthcare simulation technologyindustry.The global burden of unsafe medical care is significant and remains a cause of concern. Studies have shownthat majority of medical errors do not result from individual negligence. Majority of the medical errors havebeen found to be preventable. Simulation Based Medical Education is the way forward in achieving greaterpatient safety and improving patient outcomes.Hence there is an urgent need to incorporate Simulation into the healthcare education system in our country.Objective: To discuss the current scenario of healthcare education, the role of Simulation and experiencesharing on the barriers in its large scale initiation.Result: The key barriers that emerged during the discussion in utilization of Simulation based medicaleducation were capital investment, psychological resistance, difficulty in integrating curriculum and lack oftrained man power.Conclusion: This paper attempts to offer pragmatic solutions to the existing barriers and help mitigatemedical errors and improve patient safety.
N. Ahire and Parag Rishipathak
Institute of Medico-legal Publications Private Limited
Introduction: Customer satisfaction is an important determinant of health insurance penetration. It is not only indicative of customer loyalty but is also helpful in identifying the needs of the customer and further necessity of product innovation. As compared to other verticals of insurance, health insurance is more complex as for the administration and implementation of the policy various stakeholders are involved. Theses take holders are namely hospitals, Third Party Administrators and health insurance agents and advisors. Equally important is the satisfaction with the claim settlement process, which significantly impact overall satisfaction with health insurance policies. Aim and Objectives: To assess of customer satisfaction levels with the claim settlement process amongst health insurance policyholders in Pune, Maharashtra. Further, the study is aimed to identify the potential areas of dissatisfaction and weaknesses in the claim management system. Materials and Method: The study design is and exploratory and descriptive. Sequential random sampling used to select participants from the data of health insurance policyholders who have availed the benefit of health insurance through hospitalisation. 5-point Likert scale was used to assess the responses on claim settlement process. Results: Health insurance claims administration involves coordinated efforts of stakeholders viz insurance companies, TPA services, Hospitals and agents and advisors. The study shows scope of improvement in the claims settlement process. The policyholders experience depends on the coordination, timeliness and transparency in the process.
Parag Rishipathak, Shrimathy Vijayaraghavan and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Introduction: Poison is any substance, which causes ill effects, or death when inhaled, ingested or injectedin living cells. Emergency Medical Professionals working in Ambulances play a very important role ininitial management of poisoning. Hence, it is imperative that the EMS professionals should have requisiteknowledge and possess the right attitude to be effective caregivers in cases of poisoning.Objective: To evaluate the Knowledge and attitude regarding management of Acute Poisoning amongst theEmergency Medical Professional in Pune, India.Methodology:The study was conducted amongst 170 Emergency Medical Professionals in Pune, India. The eighteen-itemquestionnaire comprised of two key parameters – eight items testing Knowledge and ten items measuringAttitude. Each item on the questionnaire required a binary response. All items were required to be mandatorilyfilled.Discussion: The study evaluated the knowledge and attitude of the EMS professionals in initial managementof cases of acute poisoning. Majority of the respondents possessed the right general knowledge aboutpoisoning except that most felt that it was more important to treat the poison rather than patient but couldnot correctly differentiate between the early stage and late stage symptom of poisoning.Conclusion: The study attempts to evaluate the knowledge and attitude of the EMS responders in acutepoisoning and provides with significant areas with scope of improvement that can guide educators toaccordingly tailor the teaching curriculum of the subject of poisoning
Shrimathy, Parag Rishipathak and Anand Hinduja
Institute of Medico-legal Publications Private Limited
Background: The word Triage means to sort or sieve and has originated from the French word “trier”. The concept of triage was first applied in the military to evaluate and categorize wounded soldiers quickly during the battle probably around 1792. Emergency medical services (EMS) professionals are the first responders during mass casualty incidents. Successful application of triage requires continued education and practice in real clinical situations. Hence, it is essential to assess the adequate preparedness with regards to triage among EMS Professionals on a regular basis. Objective: To assess the preparedness regarding triage skills amongst Emergency Medical Professionals in Pune, India. Methodology: The study was conducted amongst 120 Emergency Medical Professionals in Pune, India. A previously tested and validated Triage Skill questionnaire designed by Sitotaw Kerie etal and published in 2018 was utilized for the study. Participants were asked to respond to each item using 1-5 Likert scale. Questionnaire was administered to the participants through online mode after obtaining informed consent. Discussion: The results indicate that participants tended to over prioritize indicating lack of knowledge of degree of care required by different patients. Majority of the participants scored between 146 to 180 corresponding to high degree of confidence in their skills regarding triage and management of patient. The scores obtained in the scenarios do not correlate with the self-perceived confidence. Conclusion: The study throws light on the over prioritization bias amongst EMS professionals. Although the study has been conducted amongst 120 EMS Professionals and is limited, yet it provides insight on the various aspects of triage assessment. Regular hands on training is required to improve the knowledge and skill set of the EMS professionals with respect to triage that can be extremely useful in emergency situation.
Parag Rishipathak, N. Sengupta and Anand Hinduja
SynthesisHub Advance Scientific Research
Background- Traumatic Spinal Cord injuries (TSCI) are defined as the key factors of mortality and disability. If acute trauma of spinal cord is not recognized and intervened it may cause secondary injury to spinal column. It is therefore very important to create an awareness amongst Emergency medical Services personnel regarding the initial first aid management and transportation of the patients afflicted with spinal cord injuries.
Objective- To assess the Knowledge, Attitude and Practice about Prehospital care of Traumatic Spinal Cord Injury among Emergency Medical Service students
Methods-The KAP study was conducted among 150 Postgraduate students of Emergency Medical Services at SCHS, Pune, India. The questionnaire consisted of 13 items based on 3 parameters -5 testing Knowledge, 5 measuring Attitude and 5 measuring Practice related to out hospital care of Traumatic Spinal Cord Injuries.
Discussion- Majority of the students scored well in items testing the need to take care of maintaining the alignment of head, neck and spine. Majority students were aware of the importance of reassuring a responsive spinal injury patient and asking them not to move there head but a significant percentage of students answered incorrectly on when they should suspect a spinal injury.
Conclusion- EMS students showed encouraging level of KAP with regards to TSCI but there are areas of improvement. Improving KAP of EMS students can significantly impact the outcome in spinal injury patients.
Parag Rishipathak, Monesh Bhandari, and Anand Hinduja
Diva Enterprises Private Limited
Introduction: Cardiopulmonary resuscitation (CPR) is emerging as a viable rescue strategy for refractory out-of-hospital cardiac arrest. Effective CPR implementation requires intensive and repetitive training foe Emergency Medical Service (EMS) providers. Adherence to ACLS protocols throughout an event is associated with increased revival rate of cardiac arrest patients. Using high fidelity simulation for BLS ACLS training improves the quality and confidence of EMS providers, students to abide by the AHA guidelines. Objective: To utilize high fidelity simulation training in improving adherence to critical actions during cardiopulmonary arrest. Methodology: A high fidelity manikin was utilized to create four unique clinical simulation scenarios based on cardiac arrest. 80 students of the Post Graduate Diploma in Emergency Medical Services (PGDEMS) program participated. Each simulation session lasted for approximately 10 minutes followed by structured debriefing lasting for 20 minutes. The video recorded sessions were analyzed by two independent facilitators to avoid bias. At the end of 8 week period, the students underwent post intervention simulation session structured in the same format as the pre-intervention session. Result: The study focused on critical performance steps to be followed as per AHA 2015 guidelines. Discussion: As per AHA 2015 guidelines, there are some critical performance steps to be followed while giving Basic Life Support (BLS) to a cardiac arrest patient. These steps if followed correctly, not only provide help to the patient immediately but also increase the chance of survival of the patient. The drastic increase in the total score obtained from pre-intervention to post-intervention underscores the importance of regular simulation sessions, to inculcate better assessment practices in a safe and non-threatening environment. Conclusion: Though participants performed the critical actions and managed the scenarios as per AHA 2015 guidelines, few actions, which superficially seemed to be insignificant were not performed.
Rohit Singh Tomar and Parag Rishipathak
Diva Enterprises Private Limited
Parag Rishipathak, Shrimathy Vijayraghavan, and Anand Hinduja
Diva Enterprises Private Limited
Shrimathy Vijayaraghavan, Parag Rishipathak, and Anand Hinduja
Medknow
Introduction: Bradyarrhythmias are a common clinical finding yet can be life-threatening in certain situations. Accordingly, diagnosis and prompt intervention remain the cornerstone of effective management of bradyarrhythmia. The study compares the two methods by assessing improvement in knowledge acquisition using pretest, posttest, and satisfaction survey with the teaching pedagogy. Materials and Methods: A randomized control trial of simulation-based teaching compared with case-based discussion was conducted among Postgraduate Diploma in Emergency Medical Services students. The students anonymously filled out pretest, posttest, and a satisfaction questionnaire composed of six statements in three domains (quality of instruction, debriefing, and overall satisfaction). The statements were rated using a 10-point scale. Test results were compared using t-test for equality of means of independent samples. Results and Discussion: All 40 students selected completed all the steps of the study. Knowledge improvement from pretest to posttest was observed in both teaching methods derived using paired sample t-test (P < 0.05). However, no significant difference was observed while comparing improvement scores of posttest versus pretest between both the groups. Mean satisfaction score of simulation group was significantly higher at 8.40 compared to case-based group which was at 7.87. Satisfaction survey showed marked significance (P = 0.03) for simulation-based teaching. Conclusion: As a single intervention, simulation-based teaching is superior to case-based discussion in terms of student satisfaction but remains similarly effective in terms of knowledge acquisition.
Parag Rishipathak, Monesh Bhandari, and Anand Hinduja
Diva Enterprises Private Limited
Parag Rishipathak, Shrimathy Vijayraghavan, and Anand Hinduja
Diva Enterprises Private Limited
Parag Rishipathak, Monesh Bhandari, and Anand Hinduja
Diva Enterprises Private Limited
Parag Rishipathak, Monesh Bhandari, and Anand Hinduja
Diva Enterprises Private Limited
Neha Ahire and Parag Rishipathak
Diva Enterprises Private Limited
Parag Rishipathak, Rajiv Yeravdekar, and Prasad Rajhans
Diva Enterprises Private Limited
Parag Rishipathak, Rajiv Yeravdekar, and Prasad Rajhans
Diva Enterprises Private Limited