Video laryngoscopy versus direct laryngoscopy in achieving successful emergency endotracheal intubations: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Intubating a patient in an emergent setting presents significant challenges compared to planned intubation in an operating room. This study aims to compare video laryngoscopy versus direct laryngoscopy in achieving successful endotracheal intubation on the first attempt in emergency intubations, irrespective of the clinical setting. METHODS: We systematically searched PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials from inception until 27 February 2023. We included only randomized controlled trials that included patients who had undergone emergent endotracheal intubation for any indication, regardless of the clinical setting. We used the Cochrane risk-of-bias assessment tool 2 (ROB2) to assess the included studies. We used the mean difference (MD) and risk ratio (RR), with the corresponding 95% confidence interval (CI), to pool the continuous and dichotomous variables, respectively. RESULTS: Fourteen studies were included with a total of 2470 patients. The overall analysis favored video laryngoscopy over direct laryngoscopy in first-attempt success rate (RR = 1.09, 95% CI [1.02, 1.18], P = 0.02), first-attempt intubation time (MD = - 6.92, 95% CI [- 12.86, - 0.99], P = 0.02), intubation difficulty score (MD = - 0.62, 95% CI [- 0.86, - 0.37], P < 0.001), peri-intubation percentage of glottis opening (MD = 24.91, 95% CI [11.18, 38.64], P < 0.001), upper airway injuries (RR = 0.15, 95% CI [0.04, 0.56], P = 0.005), and esophageal intubation (RR = 0.37, 95% CI [0.15, 0.94], P = 0.04). However, no difference between the two groups was found regarding the overall intubation success rate (P > 0.05). CONCLUSION: In emergency intubations, video laryngoscopy is preferred to direct laryngoscopy in achieving successful intubation on the first attempt and was associated with a lower incidence of complications.

COVID-19 Vaccination Knowledge, Perception, and Reason for Adherence and nonadherence Among Nursing Students in Egypt.

Introduction: Vaccines are considered preventive measures to reduce coronavirus disease 2019 (COVID-19) spread around the world. There are many factors for adherence and acceptance of COVID-19 vaccination. Objectives: The study aimed to investigate nursing students' knowledge, perception, and factors that influence their adherence to COVID-19 vaccines. Methods: A descriptive cross-sectional study design was conducted among nursing students at the Faculty of Nursing, Mansoura University, Egypt, during the period between September 1 and November 30, 2021. Results: Of the total of 500 participants, 76% took a COVID-19 vaccination. About 89% of participants rated the correct answer related to COVID-19 vaccination. Obligatory to enter the faculty, protect family and friends, and protect myself were the most reasons of adherence (80.3, 73.7, and 70.8%, respectively) while fear of adverse events and lack of information about vaccine were the most reasons of nonadherence (87.5 and 79.2%, respectively) to COVID-19 vaccination. The majority of participants (62%) had expressed positive perception toward COVID-19 vaccination. Education level, training program about COVID-19, previous infection with COVID-19, perception toward COVID-19 vaccination, and knowledge toward COVID-19 vaccination were significantly (p = .035, p = .027, p = .009, p = .008 and p = .033, respectively) associated with students' adherence to take COVID-19 vaccines. Conclusion: Accurate knowledge and perception about COVID-19 vaccines are the stronger predictors of vaccine hesitance or acceptance among nursing students in Egypt. Campaigns to increase knowledge and perception of COVID-19 and its vaccines among nursing students are needed to improve vaccine acceptance and reduce vaccine hesitance.

Asthma Outcome Measures Before and After the COVID-19 Outbreak Among the Pediatric Population in a Community Hospital.

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a global health threat that has affected patient care enormously. Moderate to severe asthma was listed as a risk factor for severe SARS-CoV-2 disease by the Centers for Disease Control. Little is known about the impact of the pandemic on asthma control in children, particularly African American children. Objective The present study sought to determine how changes during the coronavirus disease 2019 (COVID-19) pandemic affected asthma metrics in a majority African American pediatric population at a pediatric pulmonology clinic in a community hospital in New York. Methods This is a retrospective, pre-post, comparative cross-sectional study that included children three to 18 years of age with a known diagnosis of asthma followed in a pulmonary clinic. Data were gathered from electronic medical records. Subjects were selected if they presented to a pulmonology clinic within a certain time window both before and after the outbreak of the COVID-19 pandemic. Outcome variables included asthma medication statistics and healthcare utilization statistics. Results Inclusion criteria were met by 104 pediatric patients. The majority were African American. Emergency department visits, primary physician visits, and hospitalizations significantly decreased in the post-COVID study group compared to the pre-COVID control group. Conclusion Among a majority African American pediatric population, there were significant improvements in asthma outcomes after COVID-19 societal changes when compared to before COVID-19 based on outcome variables.

Basic life support knowledge in a war-torn country: a survey of nurses in Yemen.

BACKGROUND: Successful implementation of Basic life support (BLS) is critical to improving survival rates and outcomes, especially among healthcare workers. To our knowledge, there is no available literature pertaining to the level of BLS knowledge of health care professionals in Yemen. METHODS: Data was collected for this cross-sectional descriptive study from June to August 2020, using a 10-item questionnaire related to cardiopulmonary resuscitation (CPR) and BLS, along with questions on socio-demographic characteristics. Participants were nurses in public and private hospitals located in Al-Rahida and Al-dimna cities, Taiz governance and Hodeidah city, Hodeidah governance in Yemen. RESULTS: Out of 220 distributed questionnaires, 200 were returned with a response rate of 90.9%. More than a half (53.65%) of answer choices for BLS knowledge were correct. There was a significant difference in knowledge score based on level of education where those who had Bachelor degree had more knowledge (P = 0.000). Those who said they had received training in CPR or received information about CPR had significantly higher scores than those who did not receive (P = 0.000). CONCLUSIONS: BLS knowledge among nurses in Yemen is below an acceptable level to ensure maximum survival in the event of cardiac arrest. Disseminating BLS information and training in a cost effective and efficient manner will provide a large benefit in terms of lives saved with minimal costs.

A peer-driven mentoring case management community reentry model: an application for jails and prisons.

Welcome Home Ministries (WHM) is a peer-driven reentry program for women reentering the community from jail and prison. One of the major contributing factors to a high recidivism rate is the presenting issue of co-occurring disorders stemming from early childhood abuse and trauma found in 85% of the women seeking the assistance of WHM. The peers within WHM, having experienced mental health issues, substance abuse, and incarceration themselves, identified and developed a specific reentry program for this population. This article presents the results of a yearlong study that addresses the following: (1) the issue of co-occurring disorders; (2) the impact of early childhood trauma and abuse on the rate of incarceration; (3) the outcomes for restoration and recovery; and (4) the desire of the women to give back to the community.

An analysis of effects of San Diego wildfire on ambient air quality.

The impact of major gaseous and particulate pollutants emitted by the wildfire of October 2003 on ambient air quality and health of San Diego residents before, during, and after the fire are analyzed using data available from the San Diego County Air Pollution Control District and California Air Resources Board. It was found that fine particulate matter (PM) levels exceeded the federal daily 24-hr average standard during the fire. There was a slight increase in some of the gaseous pollutants, such as carbon monoxide, which exceeded federal standards. Ozone (O3) precursors, such as total hydrocarbons and methane gases, experienced elevated concentration during the fire. Fortunately, the absence of sunlight because of the cloud of thick smoke that covered most of the county during the fire appears to have prevented the photochemical conversion of the precursor gases to harmful concentrations of O3. Statistical analysis of the compiled medical surveillance data has been used to establish correlations between pollutant levels in the region and the resultant health problems experienced by the county citizens. The study shows that the increased PM concentration above the federal standard resulted in a significant increase in hospital emergency room visits for asthma, respiratory problems, eye irritation, and smoke inhalation. On the basis of the findings, it is recommended that hospitals and emergency medical facilities engage in pre-event planning that would ensure a rapid response to an impact on the healthcare system as a result of a large wildfire and appropriate agencies engage in the use of all available meteorological forecasting resources, including real-time satellite imaging assets, to accurately forecast air quality and assist firefighting efforts.