A National Survey Assessing the Variability in the Management of Traumatic Cardiac Arrest.

BACKGROUND: Resuscitation of traumatic cardiac arrest (TCA) is variable, with approaches that overlap Advanced Trauma Life Support (ATLS) and Advanced Cardiac Life Support (ACLS) algorithms. There is no standard algorithm for TCA, with some withholding ACLS protocols given abysmal outcomes. This study aims to assess surgeon practices and attitudes toward resuscitation practices in TCA. MATERIALS AND METHODS: A 16-question web-based survey was distributed to the membership of a national trauma association. Respondent demographics and management of TCA were analyzed. Chi-squared tests determined statistical significance. Open-ended responses were coded and analyzed inductively. RESULTS: Two hundred and three surveys were completed. 73.4% of respondents reported utilizing ACLS, while 26.6% reported they never utilized ACLS. A statistically significant difference in the performance of ACLS was found based on number of years in practice (P = .025) and the state of practice (P = .006). There was no significant difference in self-reported survival rates or legal, ethical, or interpersonal conflicts. Qualitative data highlighted themes of interpersonal conflict and futility. DISCUSSION: This study shows that one-quarter of respondents never utilize ACLS in TCA. Of those that utilize ACLS, there was variability in the technique, indication, and duration of resuscitation. Despite significant variability in technique, there appears to be similar survival rates and incidence of conflict. The association between years in practice and ACLS use suggests this may represent an emerging change in practice. The low response rate limits generalizability; however, there is significant variability in practice, highlighting a need for evidence-based guidelines.

The information trail of the 'Freshman 15'--a systematic review of a health myth within the research and popular literature.

QUESTION: How does health misinformation become part of the American and Canadian vernacular? DATA SOURCES AND SELECTION: Twenty-three databases were searched for articles discussing university freshmen weight gain. Research articles were examined for methodology, number and gender of the participants and weight gain. Popular press articles were reviewed for the types of information published: expert/anecdotal, weight gain, nutrition, exercise, health and alcohol. A timeline of article publication dates was generated. RESULTS: Twenty peer-reviewed, 19 magazine, 146 newspaper, and 141 university newspaper articles were discovered. Appearance of media articles about the 'Freshman 15' mirrored the peer-reviewed articles, yet the information did not reliably depict the research. Research indicated a weight gain of less than five pounds (2.268 kg), while half of the popular press publications claimed a 15-pound (6.804 kg) weight gain. The misinformation was frequently accompanied by information about achieving weight control through diet, exercise, stress reduction and alcohol avoidance. CONCLUSION: Understanding of how the concept of the 'Freshman 15' developed indicates that remediation efforts are needed. Collaborative efforts between health science and academic librarians, faculty and journalists to construct new paradigms for the translation of scientific evidence into information that individuals can use for decisions about health and well-being is suggested.