Characteristics and outcomes of pediatric and adult non-traumatic out-of-hospital cardiac arrest during the COVID-19 pandemic: Descriptive study

Background@#Due to the COVID-19 pandemic, health care for patients who experienced out-of-hospital cardiac arrest (OHCA) has been suboptimal.@*Objective@#To describe the demographic, clinical, and logistical characteristics of patients who experienced OHCA during the peak of the COVID-19 pandemic. @*Design@#Descriptive study. @*Participants@#136 males and 58 females, aged 8 days to 89 years old, who experienced OHCA and were subsequently sent to the emergency department of Southern Philippines Medical Center (SPMC). @*Setting@#Southern Philippines Medical Center, Davao City, March 15 to December 31, 2020. @*Main outcome measures@#Demographic, clinical, and logistical characteristics of patients. @*Main results@#Of the 194 patients, 149 (76.80%) experienced OHCA at home. Among them, 42 (21.65%) received initial CPR at the scene, with 36 (85.71%) of these procedures performed by ambulance crews. Only one (0.52%) patient received automated extracorporeal defibrillation performed by a bystander. There were 147 (75.77%) patients who were transported by private vehicles. The average times for dispatch, response and turnaround of the emergency medical services (EMS) were 8 minutes, 19 minutes, and 56 minutes, respectively. Of the 194 patients, 176 (90.72%) were transported without ongoing resuscitation. Upon arrival at the emergency department, 184 (94.84%) patients had unknown arrest rhythm. Only one (0.52%) patient had a return of spontaneous circulation and was admitted to the ICU. All the other patients expired within 10 to 15 minutes upon arriving at the emergency department.@*Conclusion@#In this study, most OHCAs happened at home, with few receiving CPR at the scene, primarily from ambulance crews. The average EMS response time was 19 minutes. Most patients were transported from the scene without ongoing resuscitation, and had an unknown arrest rhythm upon arrival at the emergency department. All patients expired shortly after arriving at the emergency department.

Attitude and perception among emergency department healthcare workers on organ donation: A multicenter before and after study

@#In the Philippines, organ donation is regulated under the Organ Donation Act (RA7170) and promoted by the Department of Health through the Philippine Network for Organ Sharing (PHILNOS). The number of organ donors to meet the increasing demand in the country continues to lag. The emergency department (ED) was identified in several foreign studies to be a significant source of successful organ donation. This action research project investigated the attitude and perception of 125 ED healthcare workers (HCWs) from three hospitals in Metro Manila before and after an awareness event. The study reveals that ED nurses and doctors are generally supportive and hold positive perceptions and attitudes toward organ donation. Despite the positive attitude, HCWs seem to be uncomfortable or unwilling to perform tasks important to organ donation such as approaching relatives and management of the deceased organ donor. Future training on organ donation will increase the positive attitude, confidence and likelihood to participate in organ donation and transplant activities.

Southern Philippines Medical Center - One Hospital Command Center

@#The Department of Health (DOH), through Department Order (DO) 2020-0653, established a One Hospital Command System (OHCS) to facilitate coordination among health care facilities and enhance the referral system for patients with COVID-19.1 2 On August 6, 2020, the DOH and the Inter-agency Task Force on Emerging Infectious Diseases (IATF-EID) launched the One Hospital Command Center (OHCC) at the Metro Manila Development Authority Arena, Makati City.

Rizal D. Aportadera formula versus Parkland formula in the fluid resuscitation of patients with burn injuries: Cohort study

Background@#Fluid management is crucial during the first 24 hours after a burn injury due to different systemic responses of the body@*Objective@#To compare the outcomes of patients with partial- or full-thickness burns initially managed using the Parkland (PRK) formula with those initially managed using the Rizal D. Aportadera (RDA) formula, a fluid resuscitation formula with added sodium bicarbonate. @*Design@#Cohort study. @*Participants@#181 male and female patients, aged 7 months to 78 years, with partial- or full-thickness burns. @*Setting@#RDA Burn Unit of Southern Philippines Medical Center, Davao City, from January 2008 to December 2018. @*Main outcome measures@#Proportions of patients with prolonged hospital stay, sepsis, and death; odds ratio of having the outcomes for selected factors. @*Main results@#Of the 126 males and 55 females, with overall mean age 25.70 ± 20.92 years, included in this study, 175 (96.69%) had partial-thickness burns and 6 (3.31%) had full-thickness burns. Among the patients, 108/181; 59.67% were managed with the PRK formula, while 73/181 (40.33%) were managed with the RDA formula during fluid resuscitation. Compared to the PRK group, the RDA group had significantly lower mean length of hospital stay (11.67 ± 9.69 days vs 17.22 ± 20.45 days; p=0.0317) and lower proportion of patients with prolonged hospital stay (2/73, 2.74% vs 13/108, 12.04%; p=0.0287). Full-thickness burns had independent association with prolonged hospital stay, while major burns had independent association with death. @*Conclusion@#Compared to patients in the PRK group, those in the RDA group had significantly shorter hospital stay. Full-thickness burns and major burns were independently associated with prolonged hospital stay and death, respectively.