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The use of video laryngoscopes by novice physicians may improve first-pass success rates compared with direct laryngoscopy.The aim of the present study was to assess whether time to intubation, number of laryngoscopy attempts, and first-pass success rate during laryngoscopy with the video laryngoscope or conventional Macintosh laryngoscope are affected by personal protective equipment (PPE) donning.Seventy inexperienced physicians were randomly assigned to video laryngoscope or Macintosh groups and were instructed to perform intubation with both devices on a manikin, using PPE or a standard uniform. The primary outcomes were insertion time, number of laryngoscopy attempts, and first-pass success rates for each device with or without donning PPE.In the Macintosh group, significantly less time was needed for the first successful intubation without PPE vs. with PPE (12.17 ± 3.69 s vs. 24.07 ± 5.09 s, respectively; p 0.0001). On the other hand, such difference was not observed in the video laryngoscope group (14.99 ± 3.01 s vs. 14.01 ± 3.35 s, respectively; p = 0.07). With PPE, the first-pass success rate was significantly higher in the video laryngoscope group [41 (58.6%) vs. 66 (94.3%), p 0.001]. The use of the video laryngoscope resulted in a significant decrease in insertion time compared with the Macintosh blade (14.01 ± 3.35 s vs. 24.07 ± 5.09 s, respectively; p 0.0001).First-pass success and insertion time with the video laryngoscope were not affected by PPE donning. However, both were negatively affected with the Macintosh laryngoscope.

Background It is unclear whether Peripherally Inserted Central Catheter (PICC) lines are associated with lower complication rates as compared to conventional Central Venous Catheters (CVCs), especially in high risk patients. Objective To compare Central Line Associated Bloodstream Infection (CLABSI) and catheter-related thrombosis rates in Intensive Care Unit (ICU) and onco-hematologic patients with PICC lines and CVCs. Methods We systematically reviewed the PubMed, Cochrane and Google Scholar databases to identify relevant studies. Study quality was evaluated using appropriate assessment tools and the pooled odds ratio (OR) and confidence interval (CI) were calculated. Sensitivity analyses were performed based on meta-analysis method, type of study and prophylaxis implementation. Results Thirteen studies were included in our meta-analysis. PICC lines were associated with a significantly higher rate of thrombosis in ICU [OR (95%CI): 2.58(1.80,3.70); Pz Conclusions PICC lines are associated with higher rates of thrombotic events. However, they might be suitable for onco-hematologic patients due to lower CLABSI rates.

Background Out-of-hospital cardiac arrest (OHCA) is an important cause of mortality and disability worldwide. The health care community hoped that, with the development of the automated external defibrillator (AED), the mortality and functional outcomes of patients with OHCAs would improve. Despite their effectiveness, their use in OHCA has not yet become common practice. Unfortunately, in 18–59% of cases, public access AEDs were deemed to be in poorly accessible areas or not available all of the time. Objective We present the existing literature on the implementation of drone delivery of AEDs to improve the response time of the emergency medical services. Discussion Test flights and mathematical/geographic models have been used to assess the effectiveness of drones in delivering AEDs to patients with OHCA. The results of those studies showed promising outcomes given that drone usage led to improved delivery times of AEDs compared with emergency medical services delivery. Conclusions While drones have the potential to dramatically improve cardiac arrest patient care, further studies are needed to evaluate their effectiveness in real-life clinical scenarios.