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J Med Ethics 2022 Jul 1. Epub 2022 Jul 1.

Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.

Severe staffing shortages have emerged as a prominent threat to maintaining usual standards of care during the COVID-2019 pandemic. In dire settings of crisis capacity, healthcare systems assume the ethical duty to maximise aggregate population-level benefit of existing resources. To this end, existing plans for rationing mechanical ventilators and intensive care unit beds in crisis capacity focus on selecting individual patients who are most likely to survive and prioritising these patients to receive scarce resources. Read More

Allergy Asthma Proc 2022 Jul 1. Epub 2022 Jul 1.

Introduction: This study aimed to evaluate the preliminary diagnosis, demographic characteristics, and outcomes of patients whose serum total tryptase levels were measured while in a tertiary pediatric hospital and to ascertain the role of serum tryptase levels in the etiology, diagnosis, severity, and course of systemic anaphylaxis.

Methods: Patients ages between 1 month and 17 years who were followed up in the pediatric emergency department or as inpatients and with a diagnosis of immediate-type reactions between September 1, 2019, and August 31, 2021, were includedin the study. Patient data were obtained retrospectively by examination of medical records and patient observation forms. Read More

Home Healthc Now 2022 Jul-Aug 01;40(4):214-222

The early months of the COVID-19 pandemic caused suspension of physician home visits at our NYC home-based primary care practice as well as disruptions in community-based services homebound patients rely on. This produced gaps in care for a vulnerable patient population that is considered underserved and medically and socially complex. Telephone triage nurses at Mount Sinai Visiting Doctors Program responded to these gaps in care with targeted enhancements to telephonic patient assessment: creating an encrypted email address to receive photographs, the use of two Epic dot phrases to screen and educate regarding COVID-19, assessment of patients' ability to complete a video visit, the reassessment of goals of care, and the assessment of changes in home care services. Read More

Home Healthc Now 2022 Jul-Aug 01;40(4):209-213

Professional development is essential for the ongoing professional growth of nurses and ensures employers and patients that staff have current knowledge in the field. But what happens when there's no budget for professional development? This quality improvement project describes the use of a nurse champion intervention for a professional development program for perinatal home health nurses at a nonprofit health organization. A nurse champion mentors and advocates for nurse colleagues during a change project. Read More

Reg Anesth Pain Med 2022 Jul 1. Epub 2022 Jul 1.

University of Lausanne, Lausanne, Switzerland

Introduction: Hemidiaphragmatic paresis after ultrasound-guided supraclavicular brachial plexus block is reported to occur in up to 67% of patients. We tested the hypothesis that an injection outside the brachial plexus sheath reduces the incidence of hemidiaphragmatic paresis compared with an intrafascial injection while providing similar analgesia.

Methods: Fifty American Society of Anesthesiologists I-III patients scheduled for elective upper limb surgery received a supraclavicular brachial plexus block using 30 mL of 1:1 mixture of mepivacaine 1% and ropivacaine 0. Read More