Journal of the Royal Society of Medicine
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Multicenter Study
A multi-centre prospective cohort study of patients on the elective waiting list for cardiac surgery during the COVID-19 pandemic.
During the worldwide COVID-19 pandemic, elective cardiac surgery was suspended to provide ICU beds for COVID-19 patients and those requiring urgent cardiac surgery. The aim of this study is to assess the effect of the pandemic on outcomes of patients awaiting elective cardiac surgery. ⋯ This study has shown, for the first time, significant delays to treatment of patients awaiting elective cardiac surgery. Although there was a low risk of mortality or urgent intervention, important unmeasured adverse outcomes such as quality of life or increased perioperative risk may be associated with prolonged waiting times.
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The monkeypox virus outbreak continues to evolve worldwide. While most people recover without treatment, primary care clinicians may be the first point of contact for those affected. Prompt assessment, diagnosis, isolation, treatment and prophylaxis will reduce the risk of community transmission. ⋯ If individuals test positive for the monkeypox virus, self-isolation at home is recommended for most people with mild symptoms. If patients report severe symptoms, referral and admission to hospital will be needed, where further interventions such as antivirals may be administered. The infection can spread through close contact; therefore, healthcare professionals must take precautions, such as using appropriate personal protective equipment for possible or probable cases.
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The global demand for hospital treatment exceeds capacity. The COVID-19 pandemic has exacerbated this issue, leading to increased backlogs and longer wait times for patients. ⋯ Drawing on international examples, the authors explore the use of electronic PRO systems to triage clinical care. We summarise the key benefits of the approach and also highlight the challenges for implementation, which need to be addressed to promote equitable healthcare delivery.
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Delayed response to clinical deterioration as a result of intermittent vital sign monitoring is a cause of preventable morbidity and mortality. This review focuses on the clinical impact of multi-parameter continuous non-invasive monitoring of vital signs (CoNiM) in non-intensive care unit patients. ⋯ There is evidence of clinical benefit in implementing CoNiM in non-intensive care unit patients. This review supports the use of multi-parameter CoNiM outside of intensive care unit with further large-scale RCTs required to further affirm clinical impact.