Plos One
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Multicenter Study Clinical Trial Observational Study
Ionized calcium level at emergency department arrival is associated with return of spontaneous circulation in out-of-hospital cardiac arrest.
Calcium level is associated with sudden cardiac death based on several cohort studies. However, there is limited evidence on the association between ionized calcium, active form of calcium, and resuscitation outcome. This study aimed to evaluate the potential role of ionized calcium in predicting resuscitation outcome in patients with out-of-hospital cardiac arrest. ⋯ A high ionized calcium level measured during cardiopulmonary resuscitation was associated with an increased likelihood of ROSC.
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Helicopter emergency medical services' (HEMS) effectiveness for pediatric trauma patients remains unclear. We aimed to examine the relation between HEMS and reduced mortality in pediatric trauma patients. ⋯ HEMS was not associated with reduced mortality among pediatric trauma patients compared with GEMS in this nationwide study. Further investigation is necessary to determine who clearly benefits from HEMS as compared to GEMS.
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Multicenter Study
A hybrid inductive-abductive analysis of health workers' experiences and wellbeing during the COVID-19 pandemic in the United States.
The COVID-19 pandemic puts health workers at increased risk of adverse mental health outcomes. However, no studies have assessed health workers' experiences using qualitative methods during the COVID-19 outbreak in the United States to identify novel factors that could relate to their mental health. In May 2020, we distributed an online survey to health workers across 25 medical centers throughout the United States. ⋯ Lastly, government and health system leadership and shelter-in-place policy were themes within the public policy level. Our findings provide insights into novel factors that have impacted health workers' wellbeing during the COVID-19 pandemic. These factors should be further explored to inform interventions and public policy that mitigate mental health morbidities among health workers during this and future outbreaks.
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Multicenter Study Observational Study
Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study.
Hydroxychloroquine has been touted as a potential COVID-19 treatment. Tocilizumab, an inhibitor of IL-6, has also been proposed as a treatment of critically ill patients. In this retrospective observational cohort study drawn from electronic health records we sought to describe the association between mortality and hydroxychloroquine or tocilizumab therapy among hospitalized COVID-19 patients. ⋯ Tocilizumab demonstrated a trend association towards reduced mortality among ICU patients. Our findings are limited to hospitalized patients and must be interpreted with caution while awaiting results of randomized trials. Trial Registration: Clinicaltrials.gov Identifier: NCT04347993.
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Multicenter Study Clinical Trial
A phenomenological study on the lived experiences of families of ICU patients, Addis Ababa, Ethiopia.
Family-centered care of ICU patients is increasingly recommended as it is believed to have effect on family members' psychosocial status and patient outcomes. Defining the nature and extent of families' involvement in a given health care environment for different stakeholders is a challenge. Understanding the lived experiences of families of ICU patients would help strategize on how to better engage family members for improved ICU care processes and outcomes. ⋯ The study gave an insight on the multiple and interrelated challenges faced by families of ICU patients admitted in the hospitals of Addis Ababa. Further contextualized interpretation of their experiences revealed that families were somehow in a state of despair and they implicitly need the ICU care for their family member be ended irrespective of the potential clinical consequences on the patient. The philosophy of family-centered care be advocated in hospitals. The study result affirms the need to include family members during nursing assessment of patients in ICUs and also offers the basis for guidelines development on informational support to the families of the patients hospitalized in ICUs.