Maximizing Mobilization of Resources for Unplanned Certified Registered Nurse Anesthetist Staffing Deficiencies in a Large Midwest Multi-Hospital Trauma Center.

Acute staffing deficiencies pose a challenge for hospitals because shortages can negatively impact patient safety. The purpose of this study was to examine the most effective staff recall system (SRS) for Certified Registered Nurse Anesthetists (CRNAs) during times of acute staffing deficiencies, whether from unforeseen emergencies or mass call outs. A preposttest design was used to explore the efficacy of the hospital's current CRNA SRS compared to a newly developed short message system (SMS) Acute Staffing Deficiency Recall Plan. Two 60-minute simulation drills were conducted to test the two systems with a convenience sample of 317 CRNAs. Data were gathered related to CRNAs: contacted, availability, and length of time to contact. Surveys were utilized pre/ post to evaluate knowledge, confidence, and selfefficacy regarding the recall systems. During the first simulation drill, 26% of CRNAs were contacted and 19% confirmed availability within 60 minutes using the standard CRNA SRS. During the second simulation, 86% of the CRNAs were contacted and 38% confirmed availability using the SMS messaging system within 60 minutes (P < .00001 and P < .0001 respectively). The SMS messaging improved CRNA contact by 60% and availability improved by 19% over the standard SRS.

Precooling's Effect on American Football Skills.

Bradley, LJ, Miller, KC, Wiese, BW, and Novak, JR. Precooling's effect on American football skills. J Strength Cond Res 33(10): 2616-2621, 2019-Precooling (i.e., cooling before exercise) may reduce the risk of exertional heatstroke (EHS) in American football athletes. However, implementation of precooling by coaches or medical staff would likely be poor if it impaired performance. We investigated whether precooling impacted American football skill performance in this randomized, crossover, counterbalanced study. Twelve men (24 ± 2 years, mass = 85.5 ± 6.3 kg, height = 181.8 ± 8.1 cm) completed a familiarization day to practice each skill and then 2 testing days. On testing days (wet-bulb globe temperature = 19.3 ± 4.1° C), subjects were either precooled for 15 minutes using cold-water immersion (10.1 ± 0.3° C) or not (control). Then, they donned an American football uniform and completed several bouts of 8 different football skills. Rectal temperature (Trec) was measured before, during, and after skill testing. Precooling did not affect vertical jump, broad jump, agility, dynamic or stationary catching, or maximum throwing distance (p ≥ 0.13). Precooling impaired 40-yard dash time (precooling = 5.72 ± 0.53 seconds, control = 5.31 ± 0.34 seconds; p = 0.03, effect size = 1.2) and throwing accuracy (precooling = 4 ± 1 points, control = 7 ± 2 points; p = 0.001, effect size = 1.4). On average, Trec was 0.58 ± 0.35° C lower during skills testing after precooling and statistically differed from control from minute 10 to the end of testing (∼35 minutes; p < 0.05, effect size ≥ 1.2). Precooling may be a useful EHS prevention strategy in American football players because it lowered Trec without impacting most skills. By lowering Trec, precooling would prolong the time it would take for an athlete's Trec to become dangerous (i.e., >40.5° C). If precooling is implemented, coaches should alter practice so that throwing accuracy and speed drills occur after an athlete's Trec returns to normal (i.e., >35 minutes).