Carotid Blood Flow-Guided Fluid Therapy in Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy: A Case Report.

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is associated with significant volume shifts and requires meticulous hemodynamic management. The conventional and arbitrary "liberal" and "restrictive" fluid regimens are now being challenged. With increasing recognition of the need to individualize perioperative fluid therapy, dynamic assessment of fluid status and hemodynamic response to administration of fluids have become vital. Herein, we describe a case in which point of care ultrasound of the carotid artery and derived parameters were used to guide intraoperative fluid management. We discuss the reliability of this technique and the potential advantages it could offer.

Concerns of Health Care Professionals Managing non-COVID Patients during The COVID-19 Pandemic: A Descriptive Cross- Sectional Study.

CONTEXT: The coronavirus pandemic has put an unprecedented burden on the health-care workers who are the cornerstone of the work system, preparing to mitigate its effects. Due to the lack of protective equipments, guidelines for managing patients, or proper training and education regarding the same, health care professionals (HCPs) working in non-COVID areas may face even greater problems than those working in COVID areas of a hospital. Our aim was to find out the concerns of HCPs working in non-COVID areas. SUBJECTS AND METHODS: After obtaining institutional ethics approval, a descriptive cross-sectional study was planned. An online Google-based questionnaire was rolled out to all doctors through various social media platforms who were dealing with COVID-negative patients. RESULTS: We received a total of 110 responses. 84.5% of participants were concerned about the risk of infection to self and family, 67.3% were concerned by the disruption of their daily activities. 56.4% of HCPs were disturbed by the lack of any concrete protocol for patient management. Less staff availability, delay in discharging duties toward their patients, and increased workload were other concerns. More than half of the doctors received N-95 masks whenever required and were trained in donning and doffing of Personal protective equipment. Sixty-eight percemt of our respondents labeled their current quality of life as stressful. CONCLUSION: It is the need of the hour to develop a comprehensive strategy focussing on the above challenges that HCPs working in non-COVID areas are facing. This will go a long way in not only providing holistic care to the patients but also in controlling this pandemic.

Concerns of Health-care Professionals Managing COVID Patients under Institutional Isolation during COVID-19 Pandemic in India: A Descriptive Cross-sectional Study.

OBJECTIVE: Health-care professionals (HCPs) are the frontline warriors in the time of this uncertain and unpredictable crisis of COVID. They face many challenges while caring for these patients, yet they are expected to cope with it and deliver their duties for the betterment of humankind. Our primary aim was to identify and assess the concerns of HCPs working in COVID area in a tertiary institutional isolation center. METHODOLOGY: An online Google-based questionnaire survey was distributed through various social media platforms after approval of the institutional review board to a total of 100 HCPs who were treating and managing COVID-positive patients. RESULTS: Of 100 responses, 72% were concerned about the risk of infection to self and family, while 46% reported disruption of their daily activities at a personal level. At the institutional level, 17% were concerned about inadequate personal protective equipment-related challenges. 20% had inadequate knowledge and training about COVID. 16% of participants were anxious all the time, 11% feared all the time, and 12% had stress all the time while treating COVID patients. Connectedness and communication with family and friends, word of appreciation, music, and TV were few strategies to cope up with these challenges. CONCLUSION: There is a need to identify and address the concerns and challenges faced by HCPs and to develop a comprehensive strategy and guideline to provide a holistic care and to ensure their security in the workplace.