Use of a Cardiopulmonary Resuscitation Video to Assist Intensive Care Unit Resident Physicians during Code Status Discussions.

Background: Code status discussions (CSDs) in the intensive care unit (ICU) are frequently conducted by resident physicians. Cardiopulmonary resuscitation (CPR) videos when used to aid ICU patients and families in code status decision making have been shown to have a positive impact. The purpose of this study is to evaluate the impact of a CPR video, when made available to supplement trainee-patient CSDs, on ICU residents' comfort level when conducting these discussions. Objectives: To assess whether a CPR video as an intervention tool would increase residents' comfort level when conducting CSDs. Methods: This is a pre- and postintervention pilot study. A presurvey querying details about trainees' comfort level when conducting CSDs was administered to the residents at the beginning of the ICU rotation, and a CPR video was availed to them to supplement their trainee-patient CSDs. A postsurvey was administered to trainees at the end of their ICU rotation to evaluate and analyze the impact of the CPR video on residents' comfort level when conducting trainee-patient CSDs. Results: A total of 118 trainees rotated through the ICU with 43 (36%) answering the presurvey and 28 (24%) answering the postsurvey. Twenty-two (51%) presurvey respondents felt extremely comfortable and 18 (42%) felt somewhat comfortable conducting CSDs. Thirteen (46%) postsurvey respondents felt extremely comfortable and 12 (43%) felt somewhat comfortable conducting CSDs. Most postsurvey respondents (79%) almost never used the video and (67%) neither agree nor disagree that the video was useful. Conclusion: In our small cohort, CPR video when made available to supplement trainee-patient CSDs did not impact resident physicians' comfort level when conducting these discussions. The residents' low level of engagement with this video, among other factors, could explain our results.

Hyperemesis Gravidarum Complicated by Wernicke's Encephalopathy: A Case Report.

Wernicke's encephalopathy (WE) is a rare neurologic disease caused by a deficiency in thiamine (B1). It is characterized by features of altered mental status, cerebellar dysfunction, and ophthalmoplegia. Most often, cases are attributed to long-term alcohol use; however, rarer causes have been described in the literature. In this article, we describe a case of WE caused by hyperemesis gravidarum in a 19-year-old female with no known medical history.