RESUMEN
INTRODUCTION: One of the leading causes of morbidity and mortality worldwide is out-of-hospital cardiac arrest. Early defibrillation and high-quality cardiopulmonary resuscitation (CPR) have improved survival. The main goal of CPR is to achieve return of spontaneous circulation (ROSC), which is assessed by looking for a pulse, analyzing the heart rhythm, and assessing carbon dioxide levels. The use of cartography during CPR to confirm the correct position of the endotracheal tube during intubation or to assess the effectiveness of chest compressions has increased significantly in the last years. The aim of this review was to identify correlations between end-tidal carbon dioxide levels and the likelihood of ROSC in patients with out-of-hospital cardiac arrest. METHODS: A literature search was performed in MEDLINE (via Pubmed), Scopus, Web of Science, and Google Scholar databases from September to November 2022. Keywords combined with the Boolean operators (AND/OR) were used in both free text and Medical Subject Headings. Studies on adult patients published between 01/01/2016 and 28/09/2022 were searched, with no geographical restrictions. RESULTS: At the end of the selection process, 14 studies were included that investigated capnography in out-of-hospital CPR and reported at least 1 outcome between end-tidal carbon dioxide and ROSC or survival. DISCUSSION: Capnography is an advantageous tool due to its noninvasive characteristics, ease of use, and immediacy of data. In out-of-hospital cardiac arrest, the use of the end-tidal carbon dioxide appears to be an appropriate complementary tool to support clinical decisions, such as correct positioning of the endotracheal tube, optimizing ventilation in CPR, and as a predictor of ROSC.
Asunto(s)
Capnografía , Dióxido de Carbono , Reanimación Cardiopulmonar , Paro Cardíaco Extrahospitalario , Retorno de la Circulación Espontánea , Paro Cardíaco Extrahospitalario/terapia , Humanos , Dióxido de Carbono/análisisRESUMEN
INTRODUCTION: Relatively few studies focused on the coping strategies adopted by the healthcare workers during the second phase of the pandemic. The present study compared the coping strategies between Italian nurses working in Covid-19 and in other units and it explored whether socio-demographic and work-related variables moderate the relation between the type of unit and coping strategies. METHODS: A web-based questionnaire that included sociodemographic and work-related questions and the Coping Orientation to Problem Experienced-New Italian Version-25 item was administered. Moderation effects between variables and coping strategies were analyzed using generalized linear models. RESULTS: 253 nurses participated. Nurses who worked in a Covid-19 unit had significantly lower scores on Avoidance Strategies subscale and higher scores on Positive Attitude and Social Support subscales than nurses working in other units. DISCUSSION: Gender differences emerged only on the social support coping dimension, with women being more likely to adopt social support than men. No association between the type of unit and the other coping strategies was found. CONCLUSION: Nurses working in Covid-19 units showed better coping strategies than their colleagues: this suggests that support interventions aimed to promote coping strategies should be offered also to Covid-19-free units' nurses.
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COVID-19 , Adaptación Psicológica , Modificador del Efecto Epidemiológico , Femenino , Humanos , Masculino , Pandemias , Apoyo SocialRESUMEN
. The complications of enteral nutrition in medical wards. INTRODUCTION: The effects of Enteral Nutrition (EN) in patients unable to feed themselves have been widely explored although studies in low-/mean- intensity words are lacking. AIM: To measure the prevalence of EN side effects in medical wards and to explore their risk factors. Metodi. Observational, retrospective study on matched patients. All patients in the medical departments of the Azienda Ospedaliero-Universitaria Senese were enrolled (81 cases and 162 controls) from 1 August 2018 to 1 September 2019, aged over 50 years and hospitalized for longer than 4 days. The NE side effects such as diarrhea, vomiting, gastric stagnation and abdominal pain were collected from clinical records The presence of EN, age of patients, mobilization and use of antibiotics during hospitalization were considered risk factors. RESULTS: The prevalence of diarrhea, vomiting, gastric and abdominal pain ranged from 4.9% to 11.1%. The EN was not a significant risk factor for the onset of gastrointestinal disorders, and these complications were always lower than in the controls. Vomiting, diarrhea and abdominal pain were more frequently, though not significantly, associated to antibiotic treatments; the age of subjects significantly predicted the diarrhea, showing a protective effect with the age increase. CONCLUSIONS: The study shows a low prevalence of diarrhoea, vomiting and abdominal pain compared to the literature. These symptoms were not significantly associated to the EN, that cannot be considered a risk factor.
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Nutrición Enteral , Enfermedades Gastrointestinales , Anciano , Diarrea/epidemiología , Nutrición Enteral/efectos adversos , Humanos , Estudios Retrospectivos , Vómitos/epidemiologíaRESUMEN
BACKGROUND: Caring for patients with COVID-19 requires wearing a full set of personal protective equipment (PPE) to avoid contamination. Personal discomfort has been associated with use of PPE, and anecdotal reports describe pressure injuries related to wearing PPE. OBJECTIVES: To investigate the occurrence of device-related pressure injuries due to wearing PPE among Italian nurses caring for patients with COVID-19 in critical care settings. METHODS: This descriptive study used an online survey investigating both the demographic characteristics of respondents and complications related to wearing PPE, including the development of pressure injuries. RESULTS: A total of 266 nurses throughout Italy completed the survey; 32% of respondents were men. Nurses' median age was 36 years (range 22-59 years), and the median time spent working in their current clinical setting (an intensive care or high-dependency unit) was 3 years (range 0-32 years). Personal protective equipment was worn for a median duration of 5 hours (range 2-12 hours). While wearing PPE, 92.8% of nurses experienced pain and 77.1% developed device-related pressure injuries, mainly on the nose, ears, and forehead. Pain was more frequent among nurses with such injuries. Transparent dressings, emollient cream, and no dressing were associated with development of device-related pressure injury. CONCLUSIONS: Pressure injuries related to PPE represent an important adverse effect for nurses caring for patients with COVID-19. This topic deserves study to determine adequate solutions for preventing and treating such injuries and their potential influence on nurses' work tolerance.