Articles: pandemics.
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Pediatric emergency care · Oct 2022
Diagnostic Yield of Cardiac Biomarker Testing in Predicting Cardiac Disease and Multisystem Inflammatory Syndrome in Children in the Pandemic Era.
This study aimed to assess whether elevations in cardiac biomarkers are associated with pediatric cardiac diagnoses in the era of COVID-19 and multisystem inflammatory syndrome in children (MIS-C). ⋯ Children with elevated cardiac biomarkers have increased odds of a cardiac diagnosis or MIS-C and warrant workup regardless of indication for testing. Although a negative hsTropT may reassure providers, further investigation is critical in developing algorithms to reliably exclude cardiac disease.
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One in 4 deaths from COVID-19 has been attributed to hospital crowding. We simulated how many ambulances would be required to rebalance hospital load through systematic interhospital transfers. We assessed the potential feasibility of such a strategy and explored whether transfer requirement was a helpful measure and visualization of regional hospital crowding during COVID-19 surges. ⋯ This simulation demonstrated that for most weeks during the pandemic, ambulance availability and bed capacity were unlikely to have been the main impediments to rebalancing hospital loads. Our metric provided an immediately available and much more complete measure of hospital system strain than counts of hospital admissions alone.
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To test the prognostic performance of different scores, both specifically designed for patients with COVID-19 and generic, in predicting in-hospital mortality and the need for mechanical ventilation (MV). We retrospectively collected clinical data of patients admitted to the Emergency Department of the University Hospital AOU Careggi, Florence, Italy, between February 2020 and January 2021, with a confirmed infection by SARS-CoV2. We calculated the following scores: Sequential Organ Failure Assessment (SOFA) score, CALL score, 4C Mortality score, QUICK score, CURB-65 and MuLBSTA score. ⋯ Compared to survivors, non-survivors showed significantly higher values of all the prognostic scores (4C: 13 [10-15] vs 8 [4-10]; CALL: 11 [10-12] vs 9 [7-11]; QUICK: 4 [1-6] vs 0 [0-3]; SOFA: 5 [4-6] vs 4 [4-5]; CURB: 2 [1-3] vs 1 [0-1]; MuLBSTA: 11 [9-13] vs 9 [7-11], all p < 0.001). Discriminative ability evaluated by the Receiver Operating Curve analysis showed the following values of the Area under the Curve: 0.83 for 4C, 0.74 for CALL, 0.70 for QUICK, 0.68 for SOFA, 0.76 for CURB and 0.64 for MuLBSTA. The mortality rate significantly increased in increasing quartiles of 4C and CALL score (respectively, 2, 8, 24 and 54% for the 4C score and 1, 17, 33 and 68% for the CALL score, both p < 0.001). 4C and CALL score allowed an early and good prognostic stratification of patients admitted for pneumonia induced by SARS-CoV2.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2022
[Hospital Crisis Management in the Pandemic].
Pandemics pose different challenges for hospitals than classic damage events. Crises require a specific management structure on the operational and the strategic level. Hospitals therefore need crisis management structures and processes. ⋯ They should also be established in hospitals on the operational and the strategic level. Since crisis teams in hospitals are not part of everyday work, regular training and exercises are indispensable. Furthermore, financing including training and staffing must be provided.
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Background and Objectives: Midwifery students were not able to participate in internship programs and related practices during the COVID-19 pandemic. This kept them from meeting graduation requirements because they could not do the one-on-one observations for clinical case management. In this study, we aim to determine the effects of Individualized Information and Emotional Support Education (IESE) on the midwifery students' anxiety levels during the COVID-19 pandemic. ⋯ Conclusions: The IESE positively affected the students' anxiety levels. Even just showing interest can make people feel cared for and valued, and people are sensitive to their needs. After this study, 30 students with high anxiety levels were sent for consultation with an expert and have been followed up by researchers.