Evaluation of the relationship between testosterone levels and burnout levels and job satisfaction in emergency department female employees: A prospective study.

OBJECTIVE: To evaluate the effect of testosterone on the status of burnout and job satisfaction. METHODS: The prospective study was conducted at the Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey, from April 1 to May 1, 2019, and comprised all female employees working in the emergency department. Data was collected using the Maslach Burnout Inventory and Minnesota Job Satisfaction Scale. Blood samples 5 cc were taken to measure the testosterone hormone level. Data was analysed using SPSS 20. RESULTS: There were 95 females with a mean age of 33.6±7.1 years (range: 18-53 years). The level of exhaustion was high in 64(67.3%) subjects, intermediate in 20(21%) and low in 11(11.5%). the difference among the groups in relation to testosterone levels was significant (p<0.05). Though the difference in testosterone levels in the groups in terms of job satisfaction was also noted, it was not statistically significant (p>0.05). CONCLUSIONS: Hormone levels released from endocrine systems were found to be affected by psychosocial factors.

Critical pancreatitis management associated with hypertriglyceridemia in pregnancy in emergency service.

Because of the variable clinical features of acute pancreatitis, it is difficult to make a differential diagnosis in patients presenting with abdominal pain in emergency departments. Acute pancreatitis due to severe hypertriglyceridemia during pregnancy is rare but due to the increased risk of maternal and fetal mortality, diagnosis and treatment options should be known and should be performed in the emergency department, which is the first admission site. In this case report, we present a 20-year-old woman with 19 weeks pregnant who presented to the emergency department with abdominal pain and whose biochemistry parameters were high enough to give lipemic stimulation was hospitalized in the emergency intensive care unit (EICU) in the emergency department and lipid apheresis treatment was planned successfully. Lipid apheresis treatment in patients with resistant hypertriglyceridemia in the emergency department should become an easy, safe and effective option with the use of an emergency intensive care unit.

The role of soluble urokinase plasminogen activator receptor (SuPAR) as an indicator of the severity of acute pancreatitis

Background/aim: Soluble urokinase plasminogen activator receptor (suPAR) has been reported to have a positive correlation with the activation degree of the immune system. This study's aim is to investigate the efficiency of SuPAR serum levels in acute pancreatitis (AP) patients in determining the severity of disease. Materials and methods: This prospective research involves patients who arrived at the emergency service, were over 18 years old, had nontraumatic abdominal pain and diagnosis of AP, and agreed to join the study. Demographic characteristics, contact information, laboratory and imaging test parameters, Ranson's criteria, the Balthazar Severity Index, the Rapid Acute Physiologic Score (RAPS), and the modified Glasgow (Imrie) score of all patients were recorded. Two study groups were created as score of <3 (mild, Group I) and ≥3 (severe, Group II) for pancreatitis according to Ranson's criteria. Results: During the study period, 59 sequential patients with AP were included in the study. It was seen that 79.7% of the study group (n = 47) were in Group I. Etiologically 67.8% (n = 40) cases were biliary and 32.3% (n = 19) were nonbiliary diseases. According to the results, suPAR level was effective in distinguishing the severity of AP (AUC = 0.902, P < 0.001 (95% CI: 0.821­0.984)). With regard to determining severe disease, suPAR had an optimum cutoff value of 6.815 ng/mL, sensitivity of 91.66%, specificity of 82.97%, and negative predictive value of 97.5%. Conclusion: Our study was performed the determine the efficiency of suPAR level in predicting severe disease in AP patients. We found it significant in indicating the severity of disease according to the study results.

Comparative effectiveness of standard CPR vs active compression-decompression CPR with CardioPump for treatment of cardiac arrest.

BACKGROUND: Despite all of the studies conducted on cardiopulmonary resuscitation (CPR), the mortality rate of cardiac arrest patients is still high. This has led to a search for alternative methods. One of these methods is active compression-decompression CPR (ACD-CPR) performed with the CardioPump. OBJECTIVE: The differences in the restoration of spontaneous circulation; the 1-, 7-, and 30-day survival rates; and hospital discharge rates between conventional CPR and ACD-CPR performed with CardioPump were investigated. In addition, the differences between the 2 methods with respect to complications were also investigated. METHODS: Our study was a prospective, randomized medical device study with a case-control group. Cardiac arrest cases brought to our emergency medicine clinic by the 112 emergency ambulances from out of hospital and patients who had developed cardiac arrest inhospital clinics between April 2015 and September 2015 were included in our study. For randomization, standard CPR was performed on odd days of each month, and CPR using CardioPump was performed on the even days of each month. RESULTS: A total of 181 patients were included in our study. The number of patients who received conventional CPR was determined as 86 (47.5%), and the number of patients who received CPR using the CardioPump was determined as 95 (52.5%). We did not identify any difference between conventional CPR and CardioPump ACD-CPR with respect to restoration of spontaneous circulation, discharge rates, and the 1-, 7-, and 30-day survival rates. (P=.384, P=.601, P=.997, P=.483, and P=.803, respectively) The complication rate was higher in the patient group that received conventional CPR (P<.001). CONCLUSION: As a result of our study, we did not obtain any evidence supporting the replacement of conventional CPR with ACD-CPR performed using CardioPump.

Prognostic importance of neutrophil-lymphocyte ratio in critically ill patients: short- and long-term outcomes.

STUDY OBJECTIVE: The number of critically ill patients admitted to the emergency department increases daily. To decrease mortality, interventions and treatments should be conducted in a timely manner. It has been found that the neutrophil-lymphocyte ratio (NLR) is related to mortality in some disease groups, such as acute coronary syndrome and pulmonary emboli. The effect of the NLR on mortality is unknown in critically ill patients who are admitted to the emergency department. Our aim in this study is to evaluate the effect of the NLR on mortality in critically ill patients. METHODS: This study was planned as a prospective, observational cohort study. Patients who were admitted to the emergency department because they were critically ill and required the intensive care unit were included in the study. Demographic characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sepsis-related Organ Failure Assessment, Glasgow Coma Score, and NLR values were recorded upon emergency department admission. The patients were followed up for sepsis, ventilator-associated pneumonia, multiorgan failure, in-hospital mortality, and 6-month mortality. RESULTS: The median (interquartile range) age of the 373 patients was 74 (190) years, and 54.4% were men. Neutrophil-lymphocyte ratio values were divided into quartiles, as follows: less than 3.48, 3.48 to 6.73, 6.74-13.6, and more than 13.6. There was no difference among these 4 groups regarding demographic characteristics, APACHE II score, Sepsis-related Organ Failure Assessment score, Glasgow Coma Score, and length of hospital stay (P>.05). In the multivariable Cox regression model, in-hospital mortality and 6-month mortality NLR were hazard ratio (HR), 1.63 (1.110-2.415; P=.01) and HR, 1.58 (1.136-2.213; P=.007), respectively, and APACHE II scores were detected as independent indicators. CONCLUSION: The NLR is a simple, cheap, rapidly available, and independent indicator of short- and long-term mortalities. We suggest that the NLR can provide direction to emergency department physicians for interventions, particularly within a few hours after admission, in the critically ill patient group.

Neutrophil-lymphocyte ratio in patients with pesticide poisoning.

BACKGROUND: Pesticides are highly toxic to human beings, and pesticide poisoning is associated with high morbidity and mortality. The identification of powerful prognostic markers is important for the management of patients with pesticide poisoning in emergency settings. OBJECTIVE: To investigate the prognostic value of the neutrophil-lymphocyte ratio and hematological parameters measured in patients with pesticide poisoning within the first 24 h after admission to the emergency department (ED). METHODS: All patients (≥15 years old) admitted to the ED from July 2008 through February 2013 due to pesticide poisoning were enrolled in the study. The written and electronic medical charts of patients were reviewed. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were calculated for each patient using absolute neutrophil, lymphocyte, and platelet counts. Mechanical ventilation requirement and mortality were used as the primary endpoints. RESULTS: A total of 189 patients were included in the study. The mechanically ventilated patients had significantly higher leukocyte and neutrophil counts, and neutrophil-lymphocyte and platelet-lymphocyte ratios (p < 0.001, p < 0.001, p < 0.001, p = 0.003, respectively), whereas they had significantly lower lymphocyte counts compared to nonventilated patients (p = 0.011). Survivors had significantly higher leukocyte and neutrophil counts, and neutrophil-lymphocyte ratios (p < 0.001, p < 0.001, p = 0.002, respectively), whereas there was no significant difference between groups in terms of lymphocyte counts (p = 0.463), compared to nonsurvivors. CONCLUSION: Leukocyte counts, neutrophil counts, and neutrophil-lymphocyte ratios measured within the first 24 h after admission to the ED are useful and easy-to-use parameters for estimating prognosis in the follow-up of patients with pesticide poisoning.

A new marker for myocardial injury in carbon monoxide poisoning: T peak-T end.

OBJECTIVES: Carbon monoxide (CO) poisoning frequently affects repolarization, resulting in abnormal electrocardiography findings. The goal of this study was to examine the effect of CO poisoning on the novel transmyocardial repolarization parameters T peak-T end (Tp-e), Tp-e dispersion, and Tp-e/QT and the relationship of these parameters to myocardial injury (MI). METHODS: This prospective study included 94 patients with CO poisoning and 40 healthy controls. Participants received an electrocardiography and had their blood drawn at admission and 6 and 24 hours after admission. The QT, Tp-e, Tp-e dispersion, and the Tp-e/QT ratio were calculated. Myocardial injury was determined based on an elevation in troponin any time during the first 24 hours. The patients were divided into 2 subgroups: those with and without MI. RESULTS: T peak-T end, Tp-e dispersion, and the Tp-e/QT ratio were higher at admission than after 6 and 24 hours of hospitalization and were higher than the control group (P < .001). There was a correlation between the carboxyhemoglobin level at admission and Tp-e and Tp-e dispersion (P < .001). The MI subgroup (n = 14) had a higher Tp-e at admission than did the non-MI subgroup (n = 80) (96 [11] milliseconds vs 87 [12] milliseconds, P = .03). There were no any significant differences in the Tp-e dispersion or the Tp-e/QT ratio between the 2 MI subgroups. Receiver operating characteristic analysis showed that a Tp-e cutoff value for MI of 91.5 milliseconds had a sensitivity of 72.7% and a specificity of 67.2%. CONCLUSION: Transmyocardial repolarization parameters indicative of arrhythmia were prolonged in patients with CO poisoning. T peak-T end was associated with MI.

Diamine oxidase in diagnosis of acute mesenteric ischemia.

OBJECTIVE: Acute mesenteric ischemia (AMI) is an important clinical condition with a high mortality rate in abdominal emergencies due to delay in diagnosis in spite of the new strategies in the management. We have studied the role of diamine oxidase (DAO) in the early diagnosis of AMI. METHODS: In the study, 21 New Zeland rabbits were used. Subjects were named as the groups of controls, sham, and ischemia. No intervention was performed in the subjects in the control group. In the subjects from sham and ischemia groups, laparotomy was performed with middle line incision. However, superior mesenteric artery was found and tied in those from ischemia group after the performance of laparotomy. From the animals in 3 groups, blood was drawn at the hours of 0, 1, 3, and 6, and DAO and amylase were studied in these samples. RESULTS: The increase in serum amylase levels was found to be statistically significant in the ischemia group compared with the control and the sham groups (P < .05). The decrease in serum DAO levels was found to be statistically significant in the ischemia group compared with the control and the sham groups (P < .05). Diamine oxidase levels were found to decrease, beginning from the 1 hour after ischemia had been developed, and this rise was found to continue for 6 hours (P < .05). CONCLUSION: Serum DAO levels were decreased in ischemia. Further clinical and experimental investigations would be valuable to confirm the probable role of DAO in AMI.

Efficacy of aprotinin treatment on bilateral blunt chest trauma created in rabbits.

OBJECTIVES: To investigate the effects of aprotinin, on blood gasses, oxidant-antioxidant status, and lung histopathology in an experimental bilateral blunt chest trauma model. METHODS: Conducted at the Experimental Animal Laboratory of Meram Medical School at Selcuk University, Konya, Turkey, the study comprised 21 New Zealand female albino rabbits who were divided into three groups.Trauma was applied on the sham and aprotinin groups, which was administered intravenous Aprotinin 20.000 U/kg. Arterial blood samples were obtained from all rabbits at hours 0, 3, 24, and 96. At hour 96 after trauma, all rabbits were sacrificed using the decapitation method, and then blood and lung tissue samples were obtained. Blood nitric oxide, malondialdehyde and blood gas measurements were made. Histopathological changes in the lung were examined with a light microscope. RESULTS: While no positive effect of aprotinin was observed on nitric oxide malondialdehyde and partial pressure of carbon dioxide values, it was seen to have an increasing effect on partial oxygen pressure level. Aprotinin had a partial effect on lung histopathology. CONCLUSION: Aprotinin was determined to have a positive effect on PO2 levels. We could not find any positive effects especially on alveolar haemorrhage.

Diagnostic value of ischemia-modified albumin in acute coronary syndrome and acute ischemic stroke.

OBJECTIVE: To investigate diagnostic value of ischemia-modified albumin (IMA) levels in patients applying to emergency with symptoms of acute coronary syndrome (ACS) and acute ischemic stroke (AIS). METHODS: Two patient groups (ACS and AIS) and a control group were constituted. The study was discontinued upon reaching 30 patients in each group. Following patient approval at the initial visit, a total of 10 ml venous blood sample was obtained from all patients with a high clinical suspicion of ACS and AIS. The Troponin I and the IMA levels were determined in the blood samples. RESULTS: Statistically significant higher IMA values were determined in the patient groups compared to the control group (p<0.001 for both groups). No statistically significant correlation was found between the IMA and the Troponin I values in the ACS and the AIS groups (p>0.05 for both groups). The sensitivity of IMA was 83% and 87% for ACS and AIS, respectively. The specificity of IMA was 90% and 87% for ACS and AIS, respectively. CONCLUSION: The sensitivity and specificity values, determined according to the optimal cut-off values in the groups demonstrated that IMA could be a useful diagnostic marker in ACS and AIS patients.

Investigation of the effectiveness of the Quick Sequential Organ Failure Assessment-Troponin scores in non- ST-elevation myocardial infarction.

OBJECTIVE: A reliable predictor is needed for non-ST-elevation myocardial infarction patients with high mortality risk. The aim of this study was to assess the effectiveness of the Global Registry of Acute Coronary Events and Quick Sequential Organ Failure Assessment-Troponin (qSOFA-T) scores on in-hospital mortality rate in non-ST-elevation myocardial infarction patients. METHODS: This is an observational and retrospective study. Patients admitted to the emergency department with acute coronary syndrome were evaluated consecutively. A total of 914 patients with non-ST-elevation myocardial infarction who met inclusion criteria were included in the study. The Global Registry of Acute Coronary Events and qSOFA scores were calculated and investigated its contribution to prognostic accuracy by adding cardiac troponin I (cTnI) concentration to the qSOFA score. The threshold value of the investigated prognostic markers was calculated by receiver operating characteristic curve analysis. RESULTS: We found the in-hospital mortality rate to be 3.4%. The area under the receiver operating characteristic curve for Global Registry of Acute Coronary Events and qSOFA-T is 0.840 and 0.826, respectively. CONCLUSION: The qSOFA-T score, which can be calculated easily, quickly, and inexpensively and obtained by adding the cTnI level, had excellent discriminatory power for predicting in-hospital mortality. Difficulty in calculating the Global Registry of Acute Coronary Events score, which requires a computer, can be considered a limitation of this method. Thus, patients with a high qSOFA-T score are at an increased risk of short-term mortality.

The Vitamin D Serum Levels in Pregnant Women Affected by COVID-19: A Systematic Review and Meta-Analysis.

Vitamin D can modulate immune responses, and its deficiency is linked to increased autoimmunity and susceptibility to infection. In the general population, it has been observed that serum vitamin D levels are connected with the risk of COVID-19 and its severity. Our study aims to examine reported findings on the effect of vitamin D serum levels on infection of COVID-19 during pregnancy. PubMed, Web of Science, Embase, and Cochrane Library were searched for relevant studies. Serum vitamin D serum levels in COVID-19-positive and COVID-19-negative pregnant women were 24.61 ± 20.86 ng/mL and 24.12 ± 17.33 ng/mL, respectively. In mild vs. moderate to critical COVID-19 pregnant women, vitamin D serum levels were 16.71 ± 9.04 ng/mL vs. 10.7 ± 9.37 ng/mL and severe vs. non-severe were 13.21 ± 11.47 ng/mL vs. 15.76 ± 10.0 ng/mL. Only one study reported vitamin D serum levels in the placenta of COVID-19-positive pregnant women compared with the control and results varied and amounted to 14.06 ± 0.51 ng/mL vs. 12.45 ± 0.58 ng/mL, respectively. Vitamin D deficiency tends to be common in pregnant women who have COVID-19, and the level of this vitamin has been demonstrated to have a strong correlation with the severity of the illness. As vitamin D serum levels correlate with COVID-19 symptoms and even with its occurrence, appropriate vitamin D supplementation in the prenatal period is suggested.

Diagnostic and prognostic value of MR-pro ADM, procalcitonin, and copeptin in sepsis.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. There is a need for biomarkers that can be used for the diagnosis of sepsis and the early identification of patients at high risk of death. In this study, we aimed to investigate the relationship between Mid-regional pro-adrenomedullin (MR-proADM), procalcitonin (PCT), and copeptin in sepsis. A total of 28 sepsis, 32 septic shock, and 30 control patients were included in our prospective study. Patients' MR-proADM, PCT, and copeptin levels were recorded. Sequential organ failure assessment scores, length of hospital stay, and 30-day mortality were also recorded. These values were compared between the sepsis, septic shock, and control groups. The mean age of all participants was 64.04 ± 15.83 years. In the study, 37 (61.6%) patients were female and 23 (39.3%) were male. There was no statistically significant difference in gender/age between all patient groups and the control group (for all, p > 0.05). We found a significant difference between the survivors and nonsurvivors in terms of MR-proADM, PCT, and copeptin levels. There was a significant difference between the sepsis and septic shock groups in terms of MR-proADM and PCT. A significant correlation was found between the length of hospital stay and MR-proADM and copeptin. MR-proADM, PCT, and copeptin may be useful in the prognosis of sepsis and to predict the length of stay in hospital and mortality.

Fall-related injuries at home: Descriptive analysis from a Middle Eastern level 1 trauma center.

BACKGROUND: Injuries caused by falls from heights (FFH) and fall of heavy objects (FHO) in residential settings are underestimat-ed in the Middle East. We aimed to describe the fall-related injuries at home requiring admission at a level 1 trauma center. METHODS: We conducted a retrospective analysis of patients who were admitted following fall-related injuries at home between 2010 and 2018. Comparative analyses were performed based on age groups (<18, 19-54, 55-64, and ≥65 years), gender, severity of injuries, and height of fall. Time series analysis of fall-related injuries was performed. RESULTS: A total of 1402 patients were hospitalized due to fall-related injuries occurred at home (11% of total trauma admissions). Three quarters of victims were male. The most injured subjects were young and middle-aged (41.6%), followed by pediatric (37.2%) and elderly subjects (13.6%). FFH was the most frequent mechanism of injury (94%) followed by FHO (6%). Head injury was most common (42%) followed by lower extremity injury (19%). Older adults (≥65 years) had more complications, longer hospital stay, and higher in-hospital mortality. Patients who fell from greater heights had more chest and spinal injuries with greater severity and longer stay in the hospital. Time-series analysis did not show a seasonal variation of fall-related hospitalization. CONCLUSION: This study showed that 11% of trauma hospitalizations were related to fall at home. FFH was common in all age groups; however, FHO was more evident in the pediatric group. Preventive efforts should address the circumstances of trauma in the residential settings to better inform evidence-based prevention strategies.

The Prognostic Role of Platelet-to-Lymphocyte Ratio in Acute Coronary Syndromes: A Systematic Review and Meta-Analysis.

This study aimed to investigate the potential prognostic role of the platelet-to-lymphocyte (PLR) ratio in patients presenting with suspected acute coronary syndromes (ACS). A systematic search of PubMed Central, Scopus, EMBASE, and the Cochrane Library from conception through 20 August 2023 was conducted. We used odds ratios (OR) as the effect measure with 95% confidence intervals (CIs) for dichotomous data and mean differences (MD) with a 95% CI for continuous data. If I2 was less than 50% or the p value of the Q tests was less than 0.05, a random synthesis analysis was conducted. Otherwise, a fixed pooled meta-analysis was performed. Nineteen studies fulfilled the eligibility criteria and were included in the meta-analysis. PLR was higher in MACE-positive (164.0 ± 68.6) than MACE-negative patients (115.3 ± 36.9; MD = 40.14; 95% CI: 22.76 to 57.52; p < 0.001). Pooled analysis showed that PLR was higher in AMI patients who died (183.3 ± 30.3), compared to survivors (126.2 ± 16.8; MD = 39.07; 95% CI: 13.30 to 64.84; p = 0.003). It was also higher in the ACS vs. control group (168.2 ± 81.1 vs. 131.9 ± 37.7; MD = 39.01; 95% CI: 2.81 to 75.21; p = 0.03), STEMI vs. NSTEMI cohort (165.5 ± 92.7 vs. 159.5 ± 87.8; MD = 5.98; 95% CI: -15.09 to 27.04; p = 0.58), and MI vs. UAP populations (162.4 ± 90.0 vs. 128.2 ± 64.9; MD = 18.28; 95% CI: -8.16 to 44.71; p = 0.18). Overall, our findings confirmed the potential prognostic role of the plate-let-to-lymphocyte (PLR) ratio in patients presenting with suspected acute coronary syndromes (ACS). Its use as a risk stratification tool should be examined prospectively to define its capability for evaluation in cardiovascular patients.

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock.

Thyroid storm (TS) is a rare and fatal endocrine emergency that occurs due to undiagnosed and inadequately treated hyperthyroidism after stressful conditions in patients with thyroid disorders. The objective of this systematic scoping review was to better understand the pathophysiology of TS and its complications, in terms of myocardial affection, tachyarrhythmia, and cardiogenic shock. In addition, we explored the pharmacological, mechanical, and surgical treatments for TS. We also evaluated the outcomes of TS according to sex and cardiac involvement. Additionally, analytical analysis was performed on the selected data. A literature review of peer-reviewed journals was carried out thoroughly using medical terms, MeSH on PubMed, Google Scholar, and combinations such as thyrotoxicosis-induced cardiomyopathy, thyroid storm, cardiogenic shock, myocardial infarction, endocrine emergency, Burch-Wartofsky score, extracorporeal circulatory support, and thyroidectomy. A total of 231 papers were eligible (2 retrospective studies, 5 case series, and 224 case reports) with a total of 256 TS patients with cardiac involvement between April 2003 and August 2023. All age groups, sexes, patients with TS-induced cardiomyopathy, non-atherosclerotic myocardial infarction, tachyarrhythmia, heart failure, shock, and different forms of treatment were discussed. Non-English language articles, cases without cardiac involvement, and cases in which treatment modalities were not specified were excluded. Female sex was predominant, with 154 female and 102 male patients. Approximately 82% of patients received beta-blockers (BBs), 16.3% were placed on extracorporeal membrane oxygenation (ECMO) support, 16.3% received therapeutic plasma exchange (TPE), and 13.8% underwent continuous renal replacement therapy (CRRT), continuous venovenous hemofiltration (CVVHD), or dialysis. Overall, 18 females and 16 males died. BB-induced circulatory collapse, acute renal failure, CRRT, and ventricular fibrillation were significantly associated with mortality. Awareness of TS and not only thyrotoxicosis is vital for timely and appropriate treatment. The early diagnosis and management of TS in cardiac settings, including pharmacological, mechanical, and surgical modalities, can save high-risk patients. Sex matters in the presentation, treatment, and mortality of this population. However, further large-scale, and well-designed studies are required.

A randomized crossover comparison of the bébé VieScope and direct laryngoscope for pediatric airway management by nurses in medical simulation settings.

BACKGROUND: Airway management in life-threatening emergencies is essential for children, and endotracheal intubation is the gold standard. It protects against regurgitation and enables mechanical ventilation. New types of airway management equipment are being developed and implemented to meet the needs of medical personnel. RESEARCH DESIGN AND METHODS: This prospective, randomized, cross-over simulation trial evaluated the success of endotracheal intubation in three scenarios: normal airway (scenario-A), tongue edema (scenario-B), and continuous chest compression (scenario-C), using the bébé Vie Scope™ laryngoscope (VieScope) and the Macintosh blade laryngoscope (MAC) as a comparative tool performed by nurses with limited tracheal intubation experience. RESULTS: The results of the study showed that in scenario-A, there were no significant differences in the first attempt success rate or endotracheal intubation time between VieScope and MAC. However, VieScope was associated with better visualization of the glottis. In scenarios B and C, VieScope was significantly more effective than MAC in terms of first-pass success rate, time to intubate, Cormack-Lehane grade, POGO score, and ease of endotracheal intubation. CONCLUSIONS: Bébé VieScope may be useful for endotracheal intubation in pediatric patients, particularly in cases of tongue edema and ongoing chest compression, providing a higher first-pass success rate than conventional laryngoscopes.

Effect of SARS-CoV-2 infection on out-of-hospital cardiac arrest outcomes - systematic review and meta-analysis.

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic caused by the SARS-CoV-2 virus has recently presented the world with an unprecedented challenge. The purpose of this systematic review and meta-analysis is to investigate the relationship between SARS-CoV-2 infection and out-of-hospital cardiac arrest (OHCA) by comparing data from infected and non-infected individuals. The study adds to our understanding of the broader effects of the pandemic on public health and emergency care by examining the influence of COVID-19 on OHCA. MATERIAL AND METHODS: A comprehensive systematic literature search was performed using PubMed, EMBASE, Scopus, Web of Science, the Cochrane Library and Google Scholar from 1 January 2020 - 24 May 2023. Incidence rates and odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) for risk factors were recorded from individual studies, and random-effects inverse variance modelling used to generate pooled estimates. RESULTS: Six studies, involving 5,523 patients, met the criteria for inclusion in the meta-analysis. Survival to hospital admission, defined as admission to the emergency department with sustained return of spontaneous circulation (ROSC), among patients with and without on-going infection was 12.2% and 20.1%, respectively (p=0.09). Survival to hospital discharge/30-day survival rate was 0.8% vs. 6.2% (p<0.001). Two studies reported survival to hospital discharge in good neurological condition; however, the difference was not statistically significant (2.1% vs. 1.8%; p=0.37). CONCLUSIONS: Compared to the non-infected patients, the ongoing SARS-CoV-2 infection was associated with worse OHCA outcomes.