Canadian journal of anaesthesia = Journal canadien d'anesthésie
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In response to the rapid spread of SARS-CoV-2, hospitals in Canada enacted temporary visitor restrictions to limit the spread of COVID-19 and preserve personal protective equipment supplies. This study describes the extent, variation, and fluctuation of Canadian adult intensive care unit (ICU) visitation policies before and during the first wave of the COVID-19 pandemic. ⋯ During the first wave of the COVID-19 pandemic, most Canadian hospitals had public-facing visitor restriction policies with specific exception categories, most commonly for patients at end-of-life, patients requiring assistance, or COVID-19 positive patients (varying from not allowed to case-by-case). Further studies are needed to understand the consistency with which visitation policies were operationalized and how they may have impacted patient- and family-centred care.
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Review Case Reports
The role of echocardiography in amniotic fluid embolism: a case series and review of the literature.
Amniotic fluid embolism (AFE) is a rare, but often fatal condition characterized by sudden hemodynamic instability and coagulopathy occurring during labour or in the early postpartum period. As the mechanisms leading to shock and the cardiovascular effects of AFE are incompletely understood, the purpose of this case series is to describe how AFE presents on echocardiography and review limited reports in the literature. ⋯ This case series and literature review of AFE emphasizes the importance of echocardiography in elucidating the etiology of maternal shock. The presence of right ventricular failure may be considered an important criterion to diagnose AFE.
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Randomized Controlled Trial
The impact of a perceptual learning module on novices' ability to visually estimate left ventricular ejection fraction by transesophageal echocardiography: a randomized controlled study.
Echocardiography is a difficult tool to master. Competency requires the supervised interpretation of hundreds of exams. Perceptual learning modules (PLMs) are novel learning tools that aim to speed up this learning process by enabling learners to go online and interpret numerous clinical images, followed systematically by expert feedback. We developed and tested a PLM aimed at improving novices' ability to quickly visually estimate left ventricular ejection fraction (LVEF) on transesophageal echocardiography images, a critical skill in acute care. We hypothesized that using the PLM would improve the accuracy and the speed of learners' estimations. ⋯ Participation in a short online PLM significantly improved novices' short-term ability to accurately estimate LVEF visually, compared with controls. The effect was not sustained at six months.