Film production during the Covid-19 pandemic.

BACKGROUND: The COVID-19 pandemic created unprecedented challenges for the film industry. Following a shutdown of productions, The Safe Way Forward document was developed to outline disease mitigation protocols. Despite this framework, many unanticipated scenarios arose during reopening of film production with the ongoing pandemic. AIMS: To identify and document promising practices for mitigating COVID-19 transmission in the film industry that can inform future pandemics and other industries. METHODS: We conducted a literature search to review research regarding COVID-19 disease mitigation efforts in the film industry. Through client-facing consultancy and consultant group meetings, we identified those factors most important for disease mitigation in the film industry and applicable to future pandemics and other industries. The Delphi Method enabled experts to review lessons learned as studio consultants during the COVID-19 pandemic; learnings were coded and analyzed for recurring themes. RESULTS: We identified anxiety, mistrust, and poor communication as key contributors to decreased compliance with COVID-19 protocols. In response, our team demonstrated multi-specialty expertise, provided scientific explanations, and developed trust by listening empathetically and responding with clear, consistent messaging. These measures served to alleviate anxiety, improve compliance, and provide a safe return to production. CONCLUSIONS: This study demonstrates the ability and agility of multi-disciplinary experts acting in the absence of clear guidance to support a safe return to film production. Workplace anxiety and non-compliance can be alleviated through effective communication by trusted experts. Lessons learned by our consultancy group can help protect workers across diverse industries in future pandemics.

Severe Systemic Envenomation Following Vipera berus Bite Managed with ViperaTAb Antivenom.

Bites by the European adder (Vipera berus) are a rare medical emergency in the UK with 20 to 50% of an estimated 50 to 200 cases per year necessitating treatment with antivenom. We present a case demonstrating both severe systemic and local effects necessitating out of hospital resuscitation, vasopressor support, and prolonged rehabilitation. Hemodynamic stability was restored promptly after administration of ViperaTAb antivenom, the first published case of its use in the UK.

A simple intervention to improve patient safety, save time and improve staff experience in the AMU procedure room.

Over the last decade, operating theatres and Intensive Care Units (ICUs) have established systematic methods for performing procedures on patients that have been shown to reduce complications and improve patient safety. Whilst the use of procedure rooms on Acute Medicine Units (AMUs) is highly recommended by patient safety groups and Royal College publications, they are not universally available or appropriately utilised. In this article we discuss a quality improvement project that was undertaken on an AMU at a large university teaching hospital in the United Kingdom, highlighting its successes and challenges.

Thromboprophylaxis awareness among hospital staff.

AIM: Following the introduction of thromboprophylaxis risk assessment tools at Southampton University Hospitals Trust in April 2008, this audit aimed to assess the level of understanding for correct thromboprophylaxis use for patients among hospital staff within the trust. METHODOLOGY: 50 members of staff, including doctors, nurses and pharmacists, chosen at random, were surveyed using a questionnaire. They were asked whether they thought venous thromboembolism was a problem among hospital patients; their awareness of the current prevention tools in the trust; whether they complete the assessment labels in patients' admission notes; and whether they have seen incorrect use of thromboprophylaxis and had they taken appropriate action to correct the errors. OUTCOMES/RESULTS: The authors found that while the general level of awareness for thromboprophylaxis is good within the organization, compliance with the Trust guidelines was inadequate at 32%, resulting in high levels of inappropriate thromboprophylaxis use which is poorly recognized by staff. In particular, there is a lack of participation from nursing staff owing to a lack of motivation and confidence. Only half of the doctors surveyed completed thromboprophylaxis assessment labels on patients' admission notes; all were junior doctors. Pharmacists were generally better at recognizing and correcting errors in thromboprophylaxis prescription compared with doctors. CONCLUSIONS: It is clear from this audit that staff knowledge and attitudes to thromboprophylaxis must be improved further by reinforcing educational programmes for both medical and non-medical health professionals. A thromboprophylaxis lead should be appointed for each professional group to ensure efficient monitoring. Teaching should be extended to patients to ensure individualized care for all.

A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom--the ACADEMIA study.

Many patients have physiological deterioration prior to cardiac arrest, death and intensive care unit (ICU) admission, that are detected and documented by medical and nursing staff. Appropriate early response to detected deterioration is likely to benefit patients. In a multi-centre, prospective, observational study over three consecutive days, we studied the incidence of antecedents (serious physiological abnormalities) preceding primary events (defined as in-hospital deaths, cardiac arrests, and unanticipated ICU admissions) in 90 hospitals (69 United Kingdom [UK]; 19 Australia and 2 New Zealand [ANZ]). 68 hospitals reported primary events during the three-day study period (50 United Kingdom, 16 Australia and 2 New Zealand). Data on the availability of ICU/HDU beds and cardiac arrest teams and Medical Emergency Teams were also collected. Of 638 primary events, there were 308 (48.3%) deaths, 141 (22.1%) cardiac arrests, and 189 (29.6%) unplanned ICU admissions. There were differences in the pattern of primary events between the UK and ANZ (P < 0.001). There were proportionally more deaths in the UK (52.3% versus 35.3%) and a higher number of unplanned ICU admissions in ANZ (47.3% versus 24.2%). Sixty percent (383) of primary events had a total of 1032 documented antecedents. The most common antecedents were hypotension and a fall in Glasgow Coma Scale. The proportion of ICU/HDU to general hospital beds was greater in ANZ (0.034 versus 0.016, P < 0.001) and medical emergency teams were more common in ANZ (70.0% versus 27.5%, P = 0.001). The data confirm antecedents are common before death, cardiac arrest, and unanticipated ICU admission. The study also shows differences in patterns of primary events, the provision of ICU/HDU beds and resuscitation teams, between the UK and ANZ. Future research, focusing upon the relationship between service provision and the pattern of primary events, is suggested.