Wireless handheld focused ultrasound in student teaching during the COVID-19 pandemic: Initial results of a pilot study1.

OBJECTIVE: The study aim was to investigate the use of a novel device, the Vscan Air™, for rapidly and effectively performing ultrasound in student teaching during the COVID-19 pandemic. MATERIAL AND METHODS: As part of the ultrasound practical course with integrated hands-on activity required by the regular medical curriculum, 100 medical students were instructed in the use of the Vscan Air™, including duplex mode. They then evaluated the quality of the ultrasound images obtained by the Vscan Air™ from previously selected organs. RESULTS: 100 students were interviewed (female n = 68, male n = 32; age >18 years n = 100). The rated image quality never fell below a mean of 3 for the examined organs and portal vein flow (liver 4,58; spleen 3,99; kidneys 4,29; aorta 4,16; Douglas/rectovesical space 4,14; portal vein 4,43; pancreas 3,53; Focused Assessment with Sonography for Trauma 4,38). Scores below 3 were found sporadically in ultrasounds of the spleen (n = 4), kidneys (n = 3), Douglas/rectovesical space (n = 2), and pancreas (n = 15). The liver was rated the lowest for 59 ratings. The portal vein was evaluated in 68 cases. The hepatic artery and hepatic veins could be also visualized in all 68 examinations. The aorta was evaluated in 62 cases. CONCLUSION: The Vscan Air™ technology offered adequate image quality and provided a new, fast and patient-oriented technique to support continuous ultrasound examinations and education of students, especially during a pandemic. Particularly noteworthy is the uncomplicated compliance with the required high level of hygiene.

Consequences of the Corona crisis on outpatient oncological care - a qualitative study among nurses and medical assistants.

INTRODUCTION: The Covid-19 pandemic has caused great personal stress for medical staff. To ensure adequate outpatient care for cancer patients, extensive safety and hygiene measures must be taken. This interview-based study examines the effects-both personal and professional-of the pandemic on the work routine of outpatient hematology/oncology nurses and medical assistants. PATIENTS, MATERIALS AND METHODS: Half a year after the outbreak of Covid-19 and the introduction of infection control regulations in three outpatient hematological/oncological centers, the affected medical staff (n = 15) were surveyed about the consequences for patient care and clinical work using audio-recorded telephone interviews. The interviews were transcribed and analyzed using a qualitative content analysis. RESULTS: The Covid-19 pandemic has complicated the medical care of cancer patients, but only a slight deterioration of medical and psycho-oncological care was observed. The level of stress experienced by medical staff is moderate, with hygiene and safety measures at the workplace helping to reduce stress. CONCLUSION: From the point of view of medical staff, the Covid-19 pandemic has had a moderate impact on the outpatient care of cancer patients. Safety measures against Covid-19 are decisive for ensuring the continuation of therapy and for motivating employees.

SAPV-Patienten in der COVID-19-Krise : Eine interviewbasierte Studie über Erfahrungen von Palliativpatienten SAPV patients in the COVID-19 crisisAn interview-based study of palliative care patients’ experiences

Hintergrund COVID-19 betrifft im ambulanten Bereich vor allem auch Palliativpatienten, die im Rahmen der spezialisierten ambulanten Palliativversorgung (SAPV) versorgt werden. Zur Vermeidung von Infektionen wurde die Implementierung von neuen Sicherheitsvorkehrungen und telemedizinischen Kommunikationsmöglichkeiten in die an der Studie beteiligten SAPV erforderlich. Ziel der Arbeit Die Studie untersucht die Auswirkungen der COVID-19-Pandemie auf die persönlichen und sozialen Probleme von Palliativpatienten und ihre Erfahrungen mit der betreuenden SAPV. Material und Methoden 20 SAPV-Patienten wurden in halbstrukturierten Telefoninterviews zu ihren Problemen im Zusammenhang mit der Pandemie und Erfahrungen mit der SAPV-Betreuung befragt. Ergebnisse Angst vor Einsamkeit und Infektion belasten Palliativpatienten sehr. Die meisten Patienten wollten Krankenhausaufenthalte wegen erhöhter Infektionsgefahr vermeiden. Schutzmaßnahmen der SAPV gaben ihnen ein Gefühl der Sicherheit und wurden trotz Einschränkung des persönlichen Kontakts akzeptiert. Moderne Kommunikationsformen waren nützlich, konnten aber den persönlichen Kontakt nicht ersetzen. Diskussion Die Pandemie führte zu Veränderungen in der SAPV und hatte Auswirkungen auf das soziale Umfeld von Palliativpatienten. Schutzmaßnahmen sind für das Sicherheitsgefühl der betreuten Palliativpatienten wichtig. Die Versorgungsqualität der an COVID-19 angepassten SAPV-Struktur wird von den Patienten meist nicht als verschlechtert wahrgenommen. Ängste vor sozialer Isolation nehmen bei den Palliativpatienten einen hohen Stellenwert ein und können durch die SAPV abgebaut werden. Der persönliche Kontakt zur SAPV kann durch moderne Kommunikationsmöglichkeiten nicht ersetzt werden, wobei die Patienten Telemedizin im Sinne einer „Notlösung“ durchaus akzeptieren.

The tumor patient in the COVID-19 pandemic-an interview-based study of 30 patients undergoing systemic antiproliferative therapy.

INTRODUCTION: Five months after COVID-19 first occurred and protective regulations were introduced, patients at three outpatient hematological/oncological centers in Bavaria who had received antiproliferative tumor therapy (n = 30) were questioned about the pandemic's impact. PATIENTS, MATERIALS AND METHODS: In recorded semi-structured telephone interviews, the patients answered questions about their quality of life, treatment procedures, their relationship with medical care staff and modern communication technologies. Each interview consisted of 28 questions. The average length of an interview was 30 minutes. The interviews were transcribed and analyzed by means of a qualitative content analysis according to Mayring. RESULTS: The COVID-19 pandemic adds to the burden of patients by decreasing their social contacts. They perceived the new isolation and protective measures in outpatient clinics as mostly positive and said its impact had been only slightly adverse. With the implemented safety measures, they feel adequately protected and looked after and want their antiproliferative therapy to be performed as scheduled. Talking to medical staff provides additional reassurance. CONCLUSION: Although the COVID-19 pandemic has exacerbated the social isolation of tumor patients, it has had only a minor effect on tumor therapy in the surveyed patient population. The benefits of modern communication options to tumor patients remains uncertain and should be investigated further in future studies.

Preinfection laboratory parameters may predict COVID-19 severity in tumor patients.

BACKGROUND: Infection with SARS-CoV-2 leads to COVID-19, the course of which is highly variable and depends on numerous patient-specific risk factors. Patients with tumor diseases are considered to be more susceptible to severe COVID-19; however, they also represent a heterogeneous group of individuals with variable risk. Identifying specific risk factors for a severe course of COVID-19 in patients with cancer is of great importance. METHODS: Patients diagnosed with solid tumors or hematological malignancies and PCR-confirmed SARS-CoV-2 infection were included into the multicentric ADHOK (Arbeitsgemeinschaft der Hämatologen und Onkologen im Krankenhaus e.V.) coronavirus tumor registry. Detailed information about the patients' cancer disease, treatment, and laboratory parameters prior to infection, was collected retrospectively. The outcome of the SARS-CoV-2 infection was graded according to the WHO. RESULTS: A total of 195 patients (68% with solid neoplasms and 32% with hematological malignancies) were included in the registry. Overall, the course of the SARS-CoV-2 infection varied greatly, as 69% of all patients were either asymptomatic or encountered a mild to moderate course, while 23% of the cohort died from COVID-19. In multivariable analysis, preinfection laboratory parameters (determined at least 10 days and a median of 21 days before the first documentation of SARS-CoV-2 infection) significantly correlated with severe course of the disease. Out of these, the absolute neutrophil count prior to infection showed the strongest association with COVID-19-related death. CONCLUSION: The course of COVID-19 in patients with tumor diseases is highly variable. Preinfection laboratory parameters may aid to identify patients at risk for severe COVID-19 at an early stage prior to infection with the virus. German Clinical Trials Register identification: DRKS00023012.