A simulation-enhanced, spaced learning, interprofessional "code blue" curriculum improves ACLS algorithm adherence and trainee resuscitation skill confidence.

In-hospital cardiac arrest resuscitation training often happens in silos, with minimal interprofessional training. The aim of this study was to implement and evaluate a simulation-enhanced, interprofessional cardiac arrest curriculum in a university hospital. The curriculum ran monthly for 12 months, training interprofessional teams of internal medicine residents, nurses, respiratory therapists, and pharmacy residents.

Ethical challenges with decisions to withhold or withdraw resuscitation in pediatric surgery.

Providers often dispute the ethical equivalence of withholding and withdrawing care, despite theoretical frameworks that support equivalency. We highlight two cases, one where providers express concern with initiation of aggressive resuscitation and another where providers experience emotional distress from the decision to cease resuscitation. Both cases illustrate how the ethical challenges encountered can result in high levels of provider distress.

Intravenous fluids for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography and cardiac catheterization.

: Contrast-induced nephropathy is a known complication that can occur after intravascular administration of iodinated contrast medium. Its consequences can range from a mild worsening of the renal function to renal failure requiring renal replacement therapy. There is no known effective treatment for contrast-induced nephropathy, and thus, efforts have focused on its prevention.

Rehabilitation in the Department of Veterans Affairs Polytrauma System of Care: Historical Perspectives.

The purpose of this article is to inform the reader of the historical aspects of the Polytrauma System of Care, understand the solutions that were implemented in addressing the continuum of care needs for service members and veterans, and provide an understanding of ongoing research efforts that will inform future solutions to strategically identified future care needs.

Current Practices of Intraventricular Antibiotic Therapy in the Treatment of Meningitis and Ventriculitis: Results from a Multicenter Retrospective Cohort Study.

Background: Central nervous system (CNS) infections are particularly prevalent in the adult neurocritical care patient population and are associated with significant morbidity and mortality. Factors relevant to the nature of CNS infections pose significant challenges to clinicians treating afflicted patients. Intraventricular (IVT) administration of antibiotics may offer several benefits over systemic therapy; however, the outcomes and current practices of such treatments are poorly described in the literature.

Hydroxocobalamin for the treatment of cardiac surgery-associated vasoplegia: a case series.

Purpose: Vasoplegia is a clinical syndrome marked by severe arteriolar vasodilatation, hypotension, and low systemic vascular resistance refractory to multiple vasopressor treatment. We report our experience with hydroxocobalamin (B) infusion as a potential rescue adjunct for refractory vasoplegia during cardiopulmonary bypass (CPB).

Methods: We performed a retrospective chart review of 33 patients undergoing cardiac surgery between 1 January 2013 and 31 December 2015, who were given intravenous B for refractory hypotension during, or immediately following, CPB.

2016 CAPS ethics session/Ein debate: 1. Regionalization of pediatric surgical care 2. Ethical introduction of surgical innovation 3. Addressing stress in a surgical practice: resiliency, well-being, and burnout.

The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2.

Is there a need for further trials for the treatment of prolonged seizures?

Prolonged seizures are associated with morbidity and mortality of varying degrees. It is important to recognize seizures early, and treat them appropriately. This leads to the best clinical outcome.

Antimicrobial use metrics and benchmarking to improve stewardship outcomes: methodology, opportunities, and challenges.

Measurement of antimicrobial use before and after an intervention and the associated outcomes are key activities of antimicrobial stewardship programs. In the United States, the recommended metric for aggregate antibiotic use is days of therapy/1000 patient-days. Clinical outcomes, including response to therapy and bacterial resistance, are critical measures but are more difficult to document than economic outcomes.

Patient-reported upper extremity outcome measures used in breast cancer survivors: a systematic review.

Objectives: (1) To identify English-language published patient-reported upper extremity outcome measures used in breast cancer research and (2) to examine construct validity and responsiveness in patient-reported upper extremity outcome measures used in breast cancer research.

Data Sources: PubMed, Cumulative Index to Nursing and Allied Health Literature, and ProQuest MEDLINE databases were searched up to February 5, 2013.

Study Selection: Studies were included if a patient-reported upper extremity outcome measure was administered, the participants were diagnosed with breast cancer, and the study was published in English.

Vitamin d deficiency in children with cancer.

A limited number of small studies have examined the vitamin D status of pediatric oncology patients, and the results indicate an increased prevalence of hypovitaminosis. We conducted a cross-sectional study with the primary aim of describing the vitamin D status of our pediatric cancer patients and any associations with demographic characteristics. Our secondary aim was to compare this prevalence to that of a healthy population.

Maternal and neonatal nurse perceived value of kangaroo mother care and maternal care partnership in the neonatal intensive care unit.

Background: Kangaroo Mother Care (KMC) enhances infant and maternal well-being and requires maternal-care partnerships (MCP) for implementation.

Objective: To examine maternal and neonatal nurse provider perspectives on the value of KMC and MCP.

Study Design: Prospective cohort design of neonatal nurses and mothers of preterm infants self-report anonymous questionnaire.

Hospital compliance with a state unfunded mandate: the case of California's Earthquake Safety Law.

Abstract In recent years, community hospitals have experienced heightened regulation with many unfunded mandates. The authors assessed the market, organizational, operational, and financial characteristics of general acute care hospitals in California that have a main acute care hospital building that is noncompliant with state requirements and at risk of major structural collapse from earthquakes. Using California hospital data from 2007 to 2009, and employing logistic regression analysis, the authors found that hospitals having buildings that are at the highest risk of collapse are located in larger population markets, possess smaller market share, have a higher percentage of Medicaid patients, and have less liquidity.

Spontaneous retroperitoneal hemorrhage in a dialysis patient.

Background: Patients with end-stage renal disease (ESRD) often present to the Emergency Department with a multitude of complaints. Abnormal vital signs and a chief complaint of pain can produce a diagnosis ranging from a cardiac etiology to an infectious source.

Objectives: Our goal is to discuss a case in which an ESRD dialysis patient presented with a rare, life-threatening emergency.

Etiology of chronic low back pain in patients having undergone lumbar fusion.

Objective: To estimate the prevalence of lumbar internal disc disruption, zygapohyseal joint pain, sacroiliac joint pain, and soft tissue irritation by fusion hardware in post-fusion low back pain patients compared with non-fused patients utilizing diagnostic spinal procedures.

Design: Retrospective chart review.

Setting: University spine center.

Effects of scapular dyskinesis and scapular assistance test on subacromial space during static arm elevation.

Background: Scapular dyskinesis is an abnormal scapular motion or position during active arm elevation. Dyskinesis is theorized to contribute to impingement syndrome by decreasing the subacromial space. A corrective maneuver of the scapular assistance test (SAT) proposes to increase scapular upward rotation and posterior tilt to increase the subacromial space.