Acute myocarditis after COVID-19 vaccination.

Heart muscle inflammations were reported following SARS-CoV-2 messenger ribonucleic acid (RNA) vaccination by the Disease Control Centers in America, and cases of these inflammations reported as adverse effects of this COVID-19 vaccine application increased 1000 times since April 2021. A male individual, 18-year-old received vaccination with mRNA-1273 vaccine, and after a while attended the Emergency Department at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Upon presentation, the patient complained of a history of chest pain, and he had a high troponin level along with new-onset electrocardiogram changes. During his stay in hospital the patient's blood circulation status remained stable, and no evidence of another infectious or immune cases was found. Although these vaccines are a must and very advantageous in fighting COVID-19 and their benefits are far beyond their risks, although it seems that there is a risk of myopericarditis cases. Under such conditions it is essential to rely on early diagnosis for control and deal with the possible cases of morbidity and mortality associated with these conditions.

Health care worker burnout during the COVID-19 pandemic: A cross-sectional survey study in Saudi Arabia.

OBJECTIVES: To estimate the prevalence of burnout among health care workers (HCWs) who are working in Saudi Arabia during the Coronavirus disease 2019 (COVID-19) pandemic, and explore individual and work-related factors associated with burnout in this population. METHODS: In this cross-sectional study conducted between June to August of 2020, we invited HCWs through social channels to complete a questionnaire. The questionnaire inquired about demographics, factors related to burnout, and used the Copenhagen Burnout Inventory scale to indicate burnout. A total of 646 HCWs participated. RESULTS: The mean (SD) age of participants was 34.1 (9.5) years. Sixty-one percent were female. The prevalence of burnout among HCWs was 75%. Significant factors associated with burnout were age, job title, years of experience, increased working hours during the pandemic, average hours of sleep per day, exposure to patients with COVID-19, number of times tested for COVID-19, and perception of being pushed to deal with COVID-19 patients. CONCLUSION: Health care workers as frontline workers, face great challenges during this pandemic, because of the nature of their work. Efforts should be made to promote psychological resilience for HCWs during pandemics. This study points out the factors that should be invested in and the factors that may not be influential.

The feasibility of simulation-based high-stakes assessment in emergency medicine settings: A scoping review.

Using simulation in high-stakes assessments has been evolving as a method to improve the assessment process. There is a concurrent need to address challenges and establish best practices to ensure the best quality when implementing high-stakes evaluations. The aim of this study is to provide an insight for stakeholders about using multiple modalities of simulation in high-stakes evaluations by presenting challenges, best practices, and future directions described in the relevant literature. A scoping review of original studies (from the year 1994-2021) including the use of common modalities (standardized patients, high-fidelity mannequins, part-task trainers, virtual simulation, and hybrid simulation) was conducted. The search covered the common databases: PubMed, Education Resource Information Center, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane library. Initial screening in the databases resulted in 111,253 articles. After the application of a refining search strategy, 47 articles were included for comprehensive evaluation. Most articles were about credentialing/licensure purposes of assessment. Many articles were specialty-specific, especially focusing on anesthesia. Most challenges described were related to the validity of the assessment that should be considered in the planning phase. Best practices were mostly related to planning for measures to assure the validity of the assessment tools and process. The use of multimodality simulation for high-stakes assessment is growing despite challenges; this growth is associated with the accumulation of experience shared in literature. This growth will help to improve planning, practices, and goals achievement from such an application.

Attitudes Towards Introduction of Multiple Modalities of Simulation in Objective Structured Clinical Examination (OSCE) of Emergency Medicine (EM) Final Board Examination: A Cross-Sectional Study.

PURPOSE: Objective Structured Clinical Examination (OSCE) is the current modality of choice for evaluating practical skills for graduating emergency medicine residents of final Saudi board examination. This study aims to evaluate the attitudes of both residents and faculty towards the idea of utilizing multiple modalities of simulation in a high-stakes emergency medicine (EM) examination. The goal is to propose a method to improve the process of this examination. PARTICIPANTS AND METHODS: The data were obtained using a cross-sectional survey questionnaire that was distributed to 141 participants, including both EM residents and instructors in the Saudi Board of Emergency Medicine. An online survey tool was used. The data were collected and subsequently analyzed to gauge the general and specific attitudes of both residents and instructors. RESULTS: Of the 141 participants, 136 provided complete responses; almost half were residents from all years, and the other half were primarily instructors (registrars, senior registrars, or consultants). Most of the participants from both groups (70% of the residents and 86% of the instructors) would like to see simulation incorporated into the final EM board OSCEs. Most of the participants (78%), however, had no experience with using multiple modalities of simulation in OSCEs. Overall, the majority (74.82%) expressed the belief that simulation-based OSCEs would improve the assessment of EM residents' competencies. The modalities that received the most support were part-task trainers and hybrid simulation (70.71% and 70%, respectively). CONCLUSION: From this study, we can conclude that both parties (residents and instructors) are largely willing to see multimodality simulation being incorporated into the final board examinations. Stakeholders should interpret this consensus as an impetus to proceed with such an implementation of multimodality simulation. Input from both groups should be considered when planning for such a change in this high-stakes exam.

Knowledge of Nonmedical Individuals about Cardiopulmonary Resuscitation in Case of Cardiac Arrest: A Cross-Sectional Study in the Population of Jeddah, Saudi Arabia.

INTRODUCTION: In cardiac arrest victims, providing a high-quality cardiopulmonary resuscitation (CPR) is a fundamental component of initial care, especially in the out-of-hospital settings. In this study, we sought to assess the knowledge of nonmedical people regarding cardiopulmonary resuscitation in the case of out-of-hospital cardiac arrest. METHODS: A cross-sectional survey containing 22 questions was administered to individuals aged ≥ 18 years, who were not health care providers. Sample included residents of Jeddah, Saudi Arabia. The survey included knowledge about cardiac arrest findings, previous experience with CPR, knowledge of basic life support (BLS), and concerns related to CPR. RESULTS: The fully completed survey forms of 600 respondents were analysed. Out of these, 28.7% stated that they had previously received training in CPR. Regarding manifestations of cardiac arrest, 40.7% suggested loss of consciousness, 36.8% suggested cessation of breathing, and 24.7% suggested cessation of circulation. Only 11.7% among respondents were found to be able to perform chest compressions. Also, only 9.2% could perform mouth-to-mouth ventilation, and 29.5% were able to perform both. While 55.5% knew the location for performing chest compressions, 44.7% knew the correct depth, and only 18.5% knew the correct compression-ventilation rate. Bystander CPR had been performed by only 10.7%. CONCLUSION: In our sample, we found lack of knowledge regarding CPR. We advise for a coordinated national effort to improve the public awareness about CPR performance. This may include mass education, specialized training, and setting legislations.

Evaluation of Hospitals' Disaster Preparedness Plans in the Holy City of Makkah (Mecca): A Cross-Sectional Observation Study.

BACKGROUND: Makkah (Mecca) is a holy city located in the western region of the Kingdom of Saudi Arabia. Each year, millions of pilgrims visit Makkah. These numbers impact both routine health care delivery and disaster response. This study aimed to evaluate hospitals' disaster plans in the city of Makkah. METHODS: Study investigators administered a questionnaire survey to 17 hospitals in the city of Makkah. Data on hospital characteristics and three key domains of disaster plans (general evaluation of disaster planning, structural feasibility of the hospitals, and health care worker knowledge and training) were collated and analyzed. RESULTS: A response rate of 82% (n=14) was attained. Ten (71%) of the hospitals were government hospitals, whereas four were private hospitals. Eleven (79%) hospitals had a capacity of less than 300 beds. Only nine (64%) hospitals reviewed their disaster plan within the preceding two years. Nine (64%) respondents were drilling for disasters at least twice per year. The majority of hospitals did not rely on a hazard vulnerability analysis (HVA) to develop their Emergency Operations Plan. Eleven (79%) hospitals had the Hospital Incident Command Systems (HICS) present in their plans. All hospitals described availability of some supplies required for the first 24 hours of a disaster response, such as: N95 masks, antidotes for nerve agents, and antiviral medications. Only five (36%) hospitals had a designated decontamination area. Nine (64%) hospitals reported ability to re-designate inpatient wards into an intensive care unit (ICU) format. Only seven (50%) respondents had a protocol for increasing availability of isolation rooms to prevent the spread of airborne infection. Ten (71%) hospitals had a designated disaster-training program for health care workers. CONCLUSIONS: Makkah has experienced multiple disaster incidents over the last decade. The present research suggests that Makkah hospitals are insufficiently prepared for potential future disasters. This may represent a considerable threat to the health of both residents and visitors to Makkah. This study demonstrated that there is significant room for improvement in most aspects of hospital Emergency Operations Plans, in particular: reviewing the plan and increasing the frequency of multi-agency and multi-hospital drills. Preparedness for terrorism utilizing chemical, biologic, radiation, nuclear, explosion (CBRNE) and infectious diseases was found to be sub-optimal and should be assessed further. Al-Shareef AS , Alsulimani LK , Bojan HM , Masri TM , Grimes JO , Molloy MS , Ciottone GR . Evaluation of hospitals' disaster preparedness plans in the holy city of Makkah (Mecca): a cross-sectional observation study. Prehosp Disaster Med. 2017;32 (1):33-45.