Emergency Care Unit Research Articles

Comparison of the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses: A cross-sectional-correlation study

IntroductionNurses’ sensitivity to moral issues, especially in emergency and intensive care units is essential for providing complex nursing care. Therefore, the present study aimed to determine the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses. MethodsThe present multi-center cross-sectional correlational study was conducted in 2022 on 180 nurses in five emergency departments and four intensive care units of general hospitals affiliated to Semnan University of Medical sciences. The study tools include a demographic questionnaire, 25 item Lutzen Moral Sensitivity Questionnaire (MSQ), and a standardized Competency Inventory for Registered Nurses (CIRN). Data were analyzed by mean, standard deviation and MANOVA, Pearson’s correlation coefficient test. ResultsThe two groups did not have significant differences in demographic characteristics (p < 0.05). Majority of two emergency department nurses (83.9%) and Intensive care nurses (81.8%) had a moderate level of moral sensitivity. Also, clinical competence of majority of emergency department nurses (73.3%) and Intensive care nurses (75.8%) were in moderate level. There was significant positive relationship between moral sensitivity with Clinical competence in emergency department nurses (p ≤ 0.01, r = 0.61). No significant relationship was observed between moral sensitivity and the clinical competence of intensive care nurses (p > 0.05, r = 0.15). ConclusionsThere is need for improving the level of knowledge of nurses about moral principles and increasing moral sensitivity which can expand the components of clinical competence, especially in intensive care units.

Critical care specialists, the missing link in organ procurement for transplantation

The procurement process for organ donation begins with the identification of potential organ donors in emergency or critical care units (CCU), followed by their clinical evaluation, diagnostic procedures, and therapeutic interventions, mostly conducted in CCUs. It concludes with the request for organ donation and, if accepted, the retrieval of organs. Despite most interventions occurring in detection units, there has been a neglect of the strategic role played by critical care specialists (CCS) in managing and caring for brain-dead or near-brain-death patients. Questions arise: Are they willing to undertake this responsibility? Do they fully comprehend the nature of organ procurement? Are they aware of the specific interventions required to maintain possible organ donors in optimal physiological condition? Our objective is to examine the role of CCS in organ procurement and propose ways to enhance it, ultimately aiming to increase and enhance organ donation rates.

Early predictive value of lipocalin-type prostaglandin D synthase for 28-day mortality in cardiac arrest patients: study protocol for a prospective study

IntroductionPublic training in cardiopulmonary resuscitation and treatment in emergency and intensive care unit have made tremendous progress. However, cardiac arrest remains a major health burden worldwide, with brain damage being...

Spectrum of Magnetic Resonance Imaging Findings in Acute Pediatric Traumatic Brain Injury - A Pictorial Essay.

Head trauma (HT) in pediatric patients is the number one cause of mortality and morbidity in children. Although computer tomography (CT) imaging provides ample information in assessing acute traumatic brain injuries (TBIs), there are instances when magnetic resonance imaging (MRI) is needed. Due to its high sensitivity in diagnosing small bleeds, MRI offers a well-documented evaluation of primary acute TBIs. Our pictorial essay aims to present some of the latest imaging protocols employed in head trauma and review some practical considerations. Injury mechanisms in accidental HT, lesions' topography, and hematoma signal variability over time are also discussed. Acute primary intra- and extra-axial lesions and their MRI aspect are showcased using images from patients in our hospital. This pictorial essay has an educational purpose. It is intended to guide young emergency and intensive care unit doctors, neurologists, and neurosurgeons in diagnosing acute primary TBIs on MRI while waiting for the official radiologist's report. The presentation focuses on the most frequent traumatic lesions encountered in acute pediatric head trauma.

Protocol for the Development and Analysis of the Oxford and Reading Cognitive Comorbidity, Frailty and Ageing Research Database-Electronic Patient Records (ORCHARD-EPR)

BackgroundHospital electronic patient records (EPRs) offer the opportunity to exploit large-scale routinely acquired data at relatively low cost and without selection. EPRs provide considerably richer data, and in real-time, than...

#924 Characteristics and outcomes of emergency department patients with acute kidney injury (AKI) stage 2 and 3 electronic alerts at a single UK centre

Abstract Background and Aims The epidemiology of Acute Kidney Injury (AKI) in hospitalized and critically ill populations has been well described but less is known about AKI in the emergency department (ED) patients. Community-acquired AKI represents about a quarter of AKI events observed in the hospital, and its incidence is increasing. Our aim was to look at the characteristics, early management, triage and outcomes of patients with AKI stage 2 and 3 alerts from busy emergency department. Method A retrospective review of patients with AKI 2 and 3 alerts from ED at Doncaster royal Infirmary (DRI) and Bassetlaw sister units in England over a 2 month period from August - September 2022 was conducted. All alerts from Ambulatory/SDEC (Same day emergency care) units have been excluded from this study. Data was gathered from trust electronic health system and patient discharge summaries. Results 158 AKI stage 2 and 3 alerts were received from ED at DRI and Bassetlaw of which 91 (57.5%) were AKI 2 alerts and 67 (42.4%) were AKI 3 alerts. Average age of patients was 73 yrs. Median length of stay in ED was 9hrs (Range 3 hrs–41 hrs). 44 (28%) patients died during this hospital episode of which 28 (64%) died in medical wards, 10 (23%) in critical care unit, 5 died in ED and 1 patient died in surgical ward. Average age of patients who died was 70 yrs and Median length of stay in ED was no different at 9hrs. 23 (52%) had sepsis as primary cause of death. 8 (18%) who died had active malignancy. 9 (20%) had either end stage heart failure/Liver failure or primary lung condition. 8 (18%) had either Frailty, Old age and/or Dementia listed as contributing to death. 8 (18%) patients were discharged home from ED. Discharge diagnosis was Dehydration and/or Falls. Only 4 of the 8 patients had AKI communicated to Primary care on ED discharge letter. 3 of the discharged patients had hospital readmission within 30 days. Looking at the initial intervention in ED, all patients had early warning score and initial resuscitation documented however none of the patients had Fluid balance charted. Bladder scan was performed on 15 (34%) patients where there was high suspicion of obstructive uropathy. Medication as a contributing factor to AKI was commented in 7 (4%) cases. Out of 106 patients who were discharged from hospital wards, sepsis, community acquired pneumonia, urinary tract infection and gastroenteritis were the commonest discharge diagnosis. Median length of Hospital stay was 11 days. Only 2 patients were admitted to specialist Renal ward directly from ED. AKI was communicated to primary care in 70 (62%) patients at discharge. 13 (12%) patients were readmitted to hospital within 30 days of discharge. Conclusion AKI is a marker of severity of illness and we note significant mortality in patients who present to ED with stage 2 and 3 AKI. Sepsis was commonest cause of death but we note a significant proportion of patients had either active malignancy or severe underlying chronic health condition. With increasing waiting times in ED, early recognition and AKI focused management is a priority. AKI education for nursing and medical staff in ED and Pharmacy input for patients who spend long hours in ED might help reduce length of overall hospital stay.

Stress level and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in Southern Ethiopia, 2023: explanatory sequential mixed-method study

BackgroundStress is a pervasive occurrence within certain professions, including nurses working in emergency and intensive care unit environments. Nurses in these settings often confront various stress-inducing factors, such as unsupportive management and distressing events like patient mortality, and experience notably higher levels of stress. Nevertheless, information is scarce regarding the precise level of stress in Ethiopia, particularly within southern hospitals.ObjectiveTo assess stress levels and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in southern Ethiopia, 2023.MethodsA facility-based cross-sectional explanatory sequential mixed-method study was undertaken, involving a total of 239 nurses. For the quantitative component, all nurses working in intensive care units and emergency rooms were included as participants, while a purposive sampling technique was employed to select participants for the qualitative aspect. Data for the quantitative study were gathered through the utilization of self-administered questionnaires, while interviews were conducted using a structured interview guide for the qualitative portion. Quantitative data entry and analysis were performed using EpiDataV4.6 and the Statistical Package for the Social Sciences software, respectively. Thematic analysis of the qualitative data was conducted using the OpenCode software.ResultsThe level of stress among nurses in the emergency and intensive care units was low (19.3%), moderate (55.9%), and high (24.8%). Workload (Adjusted odds ratio (AOR) = 3.51, 95% confidence interval (CI) (1.17–10.56) and time constraints (AOR = 2.5, 95% CI (1.03–6.07) were significantly associated with moderate stress level, while duty demands (AOR = 3.03, 95% CI (1.17–7.14), availability of medical equipment and supplies (AOR = 1.42, 95% CI (1.18–4.97), and witnessing death and dying (AOR = 2.34, 95% CI (1.13–5.88) were significantly associated with high-stress level. The qualitative data analysis revealed that the participants underscored the significant impact of organizational factors, individual factors, and profession-related factors on the stress levels experienced by nurses in emergency and critical care settings.Conclusion and recommendationBased on the findings, the participants in this study experienced some level of stress, to varying degrees. Therefore, it is crucial to implement effective strategies such as optimizing staffing and workflow, improving communication and collaboration, providing adequate support and resources, leveraging technology and innovation, emphasizing patient-centered care, and implementing data-driven quality improvement to alleviate the burden.

Comparison of four D-dimer assays in the context of venous thromboembolism in the emergency department.

This observational study conducted across seven emergency care units compares the efficacy of four D-dimer detection methods, namely HemosIL D-dimer HS (HS), HemosIL D-dimer HS-500 (HS-500), VIDAS D-dimer (VIDAS), and HemosIL AcuStar D-dimer (ACUSTAR). The primary focus is on patients with a clinical suspicion of deep venous thrombosis (DVT) or pulmonary embolism (PE). A total of 149 samples were collected from patients with suspected DVT or PE. The confirmation of DVT/PE was based on calf ultrasound or computed tomography-Angiography. Direct comparisons were made between the different detection methods, considering both their analytical performance and clinical utility. Additionally, the impact of an age-adjusted cut-off on the diagnostic accuracy of each method was assessed. The results revealed comparable negative predictive value, sensitivity, and specificity across the methods, with a notable exception of increased specificity for HS compared with HS-500 (50.8% vs. 41.5%, p = 0.03). Further analysis incorporating an age-adjusted cut-off demonstrated a significant improvement in specificity for HS. When using the age-adjusted cut-off, HS exhibited a substantial increase in specificity compared with HS-500 (63.1% vs. 49.2%, p = 0.004) and demonstrated significantly higher specificity compared with VIDAS (63.1% vs. 53.8%, p = 0.04). The study emphasizes the nonuniversal effect of an age-adjusted cut-off and discusses the potential necessity for different cut-off values, particularly in the case of HS-500. These findings contribute to the understanding of D-dimer detection methods in the context of DVT and PE, providing insights into their relative performances and the potential optimization through age-adjusted cut-offs.

Knowledge of intensive care unit and emergency unit nurses about the chest pain protocol

Introduction: Acute myocardial infarction is caused by prolonged ischemia, as time passes by it leads to myocardial injury and necrosis, resulting in the loss of cardiac muscle function. Therefore, the management of myocardial infarction should be swift, involving an institutionalized protocol implemented by trained professionals in specific locations for the admission of patients with chest pain. Objective: To identify the level of knowledge among nurses regarding a chest pain protocol. Method: A descriptive cross-sectional study was conducted at a teaching hospital involving nurses from the Emergency and Intensive Care Units (certificado de apresentação de apreciação ética - CAAE: 70232723.9.0000.5342). Results: The study revealed that the knowledge of nurses in emergency and intensive care units was good, with an average of 7.7 correct answers. Questions related to the protocol's objectives (n=20; 87.0%) and the recommended time for performing coronary angiography (n=9; 36.0%) had the highest error rates. Conclusion: It was identified that nurses in emergency and intensive care units possess qualification and experience regarding the chest pain protocol.

Effect of a topical silicone gel and a polyurethane dressing on the evolution of scars

ObjectiveTo assess the effectiveness and safety of a topical silicone gel (BE + Gel reductor y reparador de cicatrices) and a polyurethane dressing (BE + Apósito reductor y reparador de cicatrices) on the evolution of scars of patients who were previously recruited in the emergency care unit while seeking wound care. MethodA single center, stratified observational, open label study was performed in the emergency care unit of Donostia Universitary Hospital (recruitment) and in the Biodonostia Health Research Institute (intervention). Scars located in unexposed body areas with the dressing, and scars located in exposed areas with either the gel or the dressing. Investigators assessed interventions at day 1 and on weeks 4, 8 and 12. Vancouver Scar Scale (VSS) and a photographical assessment were used to determine the scars evolution, and the subjective perception of the scar was evaluated by means of a questionnaire administered to the patients. ResultsPatients whose scars were treated with the silicone gel had an average initial VSS score of 5.4 ± 2.08. This value was reduced to 0.86 ± 1.17 after 90 days of treatment. Patients treated with the polyurethane dressing had an average initial VSS score of 5.8 ± 2.29. After 90 days of treatment, this average score was reduced to 0.33 ± 0.66. Positive evolution of scars was also supported by photographs and by a patient questionnaire. ConclusionsBoth treatments appear to be safe and effective, objectively, and subjectively, in the context of scar evolution.

Humanized care for critically ill patients in Urgent and Emergency care units

To show the importance of the role of health professionals in providing care and humanized assistance in Urgent and Emergency Care Units. The chosen methodology was bibliographical research, of the integrative literature review type, and the search for manuscripts was carried out on the electronic pages: SCIELO, VHL, LILACS and MEDLINE, limiting those published between the years 2018 to 2022. Studies have shown that humanized assistance is of great relevance in urgent and emergency services and should have as its main objective the promotion of the patient's well-being, taking into account not only their clinical status, but also their emotional and mental health. their family members. These results are part of a search that found 142 articles, of which 29 were excluded for not meeting the research objective, 18 were excluded for being in English or Spanish, 34 were incomplete, 46 did not meet the time frame from 2018 to 2022 , with only 15 remaining included in the final sample of this review. Of these, 15 (100%) were in Portuguese, 06 (40%) are from 2018, 05 (33.33%) are from 2019, 01 (6.67%) are from 2020 and 03 (20%) are from 2021. Through the studies analyzed, it is concluded that even in the face of all the difficulties encountered, humanization and assistance in care, especially in the urgency and emergency sectors, are of great importance for all work performed to take place satisfactorily offering a quality service, trust, dignity and respect for human beings.

COVID-19 outbreaks surveillance through text mining applied to electronic health records

BackgroundThe COVID-19 pandemic has caused significant disruptions to everyday life and has had social, political, and financial consequences that will persist for years. Several initiatives with intensive use of technology were quickly developed in this scenario. However, technologies that enhance epidemiological surveillance in contexts with low testing capacity and healthcare resources are scarce. Therefore, this study aims to address this gap by developing a data science model that uses routinely generated healthcare encounter records to detect possible new outbreaks early in real-time.MethodsWe defined an epidemiological indicator that is a proxy for suspected cases of COVID-19 using the health records of Emergency Care Unit (ECU) patients and text mining techniques. The open-field dataset comprises 2,760,862 medical records from nine ECUs, where each record has information about the patient’s age, reported symptoms, and the time and date of admission. We also used a dataset where 1,026,804 cases of COVID-19 were officially confirmed. The records range from January 2020 to May 2022. Sample cross-correlation between two finite stochastic time series was used to evaluate the models.ResultsFor patients with age ≥18 years, we find time-lag (τc\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\ au_c$$\\end{document}) = 72 days and cross-correlation (p^ij\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\widehat p}_{ij}$$\\end{document}) ~0.82, τc\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\ au_c$$\\end{document} = 25 days and p^ij\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\widehat p}_{ij}$$\\end{document} ~0.93, and τc\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\ au_c$$\\end{document} = 17 days and p^ij\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\widehat p}_{ij}$$\\end{document} ~0.88 for the first, second, and third waves, respectively.ConclusionsIn conclusion, the developed model can aid in the early detection of signs of possible new COVID-19 outbreaks, weeks before traditional surveillance systems, thereby anticipating in initiating preventive and control actions in public health with a higher likelihood of success.

Factors affecting physicians' decision to start prehospital blood product transfusion in blunt trauma patients: A cohort study of Helsinki Trauma Registry.

Prehospital blood transfusions are increasing as a treatment for bleeding trauma patients at risk for exsanguination. Triggers for starting transfusion in the field are less studied. We analyzed the factors affecting the decision of physicians to start prehospital blood product transfusion (PHBT) in blunt adult trauma patients. Data of all adult blunt trauma patients from the Helsinki Trauma Registry between March 2016 and July 2021 were retrospectively analyzed. Univariate analysis for the identification of predictive factors and multivariate regression analysis for their importance as predictive factors for the initiation of PHBT were applied. There were 1652 patients registered in the database. A total of 556 of them were treated by a physician-level prehospital emergency care unit, of which by transfusion-capable unit in 394 patients. PHBT (red blood cells and/or plasma) was started in 19.8% of the patients. We identified three statistically highly important clinical triggers for starting PHBT: high crystalloid volume need, shock index ≥0.9, and need for prehospital pleural decompression. PHBT in blunt adult trauma patients is initiated in ~20% of the patients in Southern Finland. High crystalloid volume need, shock index ≥0.9 and prehospital pleural decompression are associated with the initiation of PHBT, probably reflecting patients at high risk for bleeding.

Factors Associated With Distress Related to Perceived Dignity in Patients With Rheumatic Diseases.

The loss of perceived dignity is an existential source of human suffering, described in patients with cancer and chronic diseases and hospitalized patients but rarely explored among patients with rheumatic diseases (RMDs). We recently observed that distress related to perceived dignity (DPD) was present in 26.9% of Mexican patients with different RMDs. The study aimed to investigate the factors associated with DPD. This cross-sectional study was performed between February and September 2022. Consecutive patients with RMDs completed patient-reported outcomes (to assess mental health, disease activity/severity, disability, fatigue, quality of life [QoL], satisfaction with medical care, and family function) and had a rheumatic evaluation to assess disease activity status and comorbidity. Sociodemographic variables and disease-related and treatment-related variables were retrieved with standardized formats. DPD was defined based on the Patient Dignity Inventory score. Multivariate regression analysis was used. Four hundred patients were included and were representative of outpatients with RMDs, while 7.5% each were inpatients and patients from the emergency care unit. There were 107 patients (26.8%) with DPD. Past mental health-related comorbidity (Odds Ratio [OR]: 4.680 [95% Confidence Interval [CI]: 1.906-11.491]), the number of immunosuppressive drugs/patient (OR: 1.683 [95% CI: 1.015-2.791]), the physical health dimension score of the World Health Organization Quality of Life-Brief questionnaire (WHOQOL-BREF) (OR: 0.937 [95% CI: 0.907-0.967]), and the emotional health dimension score of the WHOQOL-BREF (OR: 0.895 [95% CI: 0.863-0.928]) were associated with DPD. DPD was present in a substantial proportion of patients with RMDs and was associated with mental health-related comorbidity, disease activity/severity-related variables, and the patient QoL.

Adaptation of a specialized cardiac centre to patient management and health care services in the midst of the COVID-19 crisis: The Bahrain experience

BackgroundHospitals worldwide had to implement several measures to control SARS-CoV-2 pandemic, particularly in cardiac center. However, the extent to which these adapted measures have been perceived by the nurse care provider as effective needs to be explored in order to identify the most successful measures that can be considered in future health care crises. AimTo explore the adaptation of patient management and cardiac health care services at a specialized cardiac center in the Kingdom of Bahrain during the COVID-19 pandemic. MethodsA cross-sectional study was employed among nurses working at the main cardiac in Bahrain centre using a convenience sampling method along with the Patient Management and Cardiac Health Care Services questionnaire. ResultsA total of 214 nurses were enrolled in the study. Most participants were females (89.3 %) with a mean age of 34.6 ± 7.9 years. The majority of participants have experienced a reduction in the number of hospitalized patients (87.4 %) during the Coronavirus-19 pandemic. According to the participants, smartphone applications were used to overcome face-to-face consultations (52.8–65 %) and the appointments were changed to phone consultations (60.7 %). Outpatient and diagnostic services were the most affected services (95.8 % and 94.4 %, respectively). In contrast, the emergency and critical care units were the least affected services (56.6 % and 30.8 %, respectively), (p ˂ 0.001). ConclusionEssential cardiac services continued to function during the COVID-19 pandemic. However, several diagnostic and outpatient services were disrupted. Thus, there is an urgent need for developing a protocol for care of patients admitted in cardiac center during health crisis times.

HFMEA-fuzzy model: an evaluation of the main risk factors occurring in 47 emergency care units (ECU)

Este estudo propõe um modelo para avaliar os fatores de risco em 47 Unidades de Pronto Atendimento (UPA) utilizando o método para gestão de risco HFMEA (Healthcare Failure Mode and Effect Analysis) com apoio da lógica Fuzzy. O HFMEA oferece uma abordagem sistemática para identificar falhas nos processos de saúde, enquanto a lógica Fuzzy lida com incerteza dos dados. O modelo revelou que duas unidades estão sujeitas a causas raiz não resolvidas, como insatisfação da gestão e deficiências na estrutura física. A pesquisa também mapeou características de cada tipo de desperdício, fornecendo observações importantes para futuras investigações.

Investigating the Effectiveness of Continuous Quality Improvement Methods in Preventing the Phenomenon of Pseudo-Poor Electrocardiogram Procedure by Nurses in an Emergency Care Unit

Objective: To investigate the effect of applying continuous quality improvement methods on preventing the phenomenon of pseudo-poor electrocardiogram (ECG) procedures by nurses in the emergency care unit. Methods: The study was conducted in Shangluo Central Hospital Shaanxi from August 2020 to August 2021, and 200 emergency patients who received ECG during this period were selected for the comparative study, and grouped into two groups: the control group was given routine management, while the experimental group was managed by continuous quality improvement. The two groups were compared in terms of pseudo-differences in ECG procedures. Results: The patients in the experimental group had a higher rate of qualified ECG readings and procedures, and a lower rate of pseudo-errors and nursing disputes, all of which were significantly different from the control group (P &lt; 0.05), which is significant, and the experimental group had a better effect. Conclusion: When ECG examination is carried out in the emergency care unit, the application of continuous quality improvement management methods is conducive to improving the quality of ECG examination, reducing the incidence of pseudo-discrepancy, and providing a reliable reference for clinical diagnosis and treatment.

Point-of-Care Ultrasound (POCUS) in Adult Cardiac Arrest: Clinical Review.

Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool available in emergency and intensive care units. In the context of cardiac arrest, POCUS application can help assess cardiac activity, identify causes of arrest that could be reversible (such as pericardial effusion or pneumothorax), guide interventions like central line placement or pericardiocentesis, and provide real-time feedback on the effectiveness of resuscitation efforts, among other critical applications. Its use, in addition to cardiovascular life support maneuvers, is advocated by all resuscitation guidelines. The purpose of this narrative review is to summarize the key applications of POCUS in cardiac arrest, highlighting, among others, its prognostic, diagnostic, and forensic potential. We conducted an extensive literature review utilizing PubMed by employing key search terms regarding ultrasound and its use in cardiac arrest. Apart from its numerous advantages, its limitations and challenges such as the potential for interruption of chest compressions during image acquisition and operator proficiency should be considered as well and are discussed herein.

Explaining decisions of a light-weight deep neural network for real-time coronary artery disease classification in magnetic resonance imaging

In certain healthcare settings, such as emergency or critical care units, where quick and accurate real-time analysis and decision-making are required, the healthcare system can leverage the power of artificial intelligence (AI) models to support decision-making and prevent complications. This paper investigates the optimization of healthcare AI models based on time complexity, hyper-parameter tuning, and XAI for a classification task. The paper highlights the significance of a lightweight convolutional neural network (CNN) for analysing and classifying Magnetic Resonance Imaging (MRI) in real-time and is compared with CNN-RandomForest (CNN-RF). The role of hyper-parameter is also examined in finding optimal configurations that enhance the model’s performance while efficiently utilizing the limited computational resources. Finally, the benefits of incorporating the XAI technique (e.g. GradCAM and Layer-wise Relevance Propagation) in providing transparency and interpretable explanations of AI model predictions, fostering trust, and error/bias detection are explored. Our inference time on a MacBook laptop for 323 test images of size 100x100 is only 2.6 sec, which is merely 8 milliseconds per image while providing comparable classification accuracy with the ensemble model of CNN-RF classifiers. Using the proposed model, clinicians/cardiologists can achieve accurate and reliable results while ensuring patients’ safety and answering questions imposed by the General Data Protection Regulation (GDPR). The proposed investigative study will advance the understanding and acceptance of AI systems in connected healthcare settings.

Impact of COVID-19 on inputs used in assistance in emergency care unit

Objective: To identify the impact of the pandemic on the consumption and costs of materials and medicines in an emergency care unit in a municipality located in the interior of the State of São Paulo. Method: This is a cross-sectional, retrospective study, with quantitative analysis of data from a health unit in the public pre-hospital network. Data were collected through management reports, generated by hospital management software, referring to the 12-month pre-pandemic period (January to December/2019), pandemic (July/2020 to June/2021) and the post-pandemic period (January to April/2023), being compared using the non-parametric Mann-Whitney test. Results: Most of the hospital supplies and medicines used to combat COVID-19 showed an increase in consumption and values above the parameters observed in the previous period and remained with values close to those practiced in the post-pandemic period. Conclusion: the increase in demand associated with the scarcity of products led to a sharp increase in the prices of inputs and medicines used to combat COVID-19, later reflecting on the costs of the institution in the studied unit.