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aldar AA, Krishna B, Sampath S, Paramasivam SK. Simulation Training in Hemodynamic Monitoring and Mechanical Ventilation An Assessment of Physician's Performance. Indian J Crit Care Med 2020;24(6)423-428.

Multiple scoring systems are designed and prepared nowadays that can be used to determine and predict the severity, morbidity, and mortality rate of patients. Among them, the rapid emergency medicine score (REMS) system has been designed to predict the motility of nonsurgical patients admitted to the emergency department (ED). This study was performed with the aim of evaluating the predictive value of REMS in the mortality rate of nonsurgical patients.

This study was carried out in 2017 among 300 nonsurgical patients referred to the ED. Data were collected using a checklist containing two parts of demographic information and REMS scale.

Based on the results, we found a significant correlation between the duration of hospitalization and other parameters of the study. The results of this study indicated that the REMS of patients increased by 11%, 3%, and 5%, per each unit rise in patient's age, heart rate, and respiratory rate, respectively. On the contrary, 12% and 22% decrements for every unit increase in SPO

and GCS levels were observed, respectively. All the reported findings were statistically significant.

In sum, the outcomes of the present study corroborate the REMS system as a successful scale in predicting mortality and the duration of hospitalization in nonsurgical ED patients.

Ala A, Vahdati SS, Jalali M, Parsay S. Rapid Emergency Medicine Score as a Predictive Value for 30-day Outcome of Nonsurgical Patients Referred to the Emergency Department. Indian J Crit Care Med 2020;24(6)418-422.

Ala A, Vahdati SS, Jalali M, Parsay S. Rapid Emergency Medicine Score as a Predictive Value for 30-day Outcome of Nonsurgical Patients Referred to the Emergency Department. Indian J Crit Care Med 2020;24(6)418-422.

Patients in the neurointensive care unit have high utilization of devices, thereby increased chance of getting device-associated infection (DAI). Central line-associated bloodstream infection (CLABSI) remains one of the most important DAI. Education remains an important part of the hospital infection control and improves the infection-control practices.

To evaluate the effectiveness of a quality initiative in reducing incidence of CLABSI, a prospective study (January 2017-December 2018) was done estimating CLABSI incidence before and after the intervention. Continuous teaching and training for hand hygiene practice and central-line catheter hub care were used as the tool for this study.

The quality improvement (QI) initiative achieved a 48% reduction in the CLABSI rate from the baseline rate of 8.7 to 4.5 per 1000 catheter days. The overall mortality showed a reduction from 1.5 to 0.05% during the post-intervention period. There was a significant improvement in compliance with the hand hygiene practice Unit. Indian J Crit Care Med 2020;24(6)414-417.

Cardiopulmonary resuscitation (CPR) is a lifesaving skill performed during the cardiac arrest. learn more Various factors of rescuer affect CPR quality, and rescuers physical fitness is one among the important factors needs to be explored for improved CPR quality. This study aimed to assess the physical activity (PA) levels of the health care providers (HCPs) who were trained in basic life support (BLS) and its relationship on chest compression duration, hemodynamic parameters, and fatigue levels of the rescuers.

A single-center, cross-sectional study was conducted on 48 HCPs who were trained in BLS within one year. Eligible participants were contacted by email, and the responders' level of PA was determined using the global physical activity questionnaire (GPAQ). The participants were recruited for chest compression-only cardiac arrest scenarios. Each subject performed continuous chest compression on the manikin until they perceived maximum fatigue. Heart rate (HR), blood pressure (BP), oxygen saturation (SpO

), au AS, Krishna HM. Influence of Physical Activity of the Rescuer on Chest Compression Duration and its Effects on Hemodynamics and Fatigue Levels of the Rescuer a Simulation-based Study. Indian J Crit Care Med 2020;24(6)409-413.

Early initiation of end-of-life (EOL) care in terminally ill patients can reduce the administration of unnecessary medications, minimize laboratory and radiological investigations, and avoid procedures that can provoke untoward complications without substantial benefits. This retrospective observational study was performed to compare early vs late initiation of EOL care in terminally ill ICU patients after the recognition of treatment futility.

The medical records of all patients who were considered to be terminally ill any time after ICU admission between January 2014 and December 2018 were extracted from the ICU database. The patients who were recognized for treatment futility were eligible for inclusion. The patients who were already on EOL care prior to the ICU admission or whose diagnosis was unconfirmed were excluded from the study. The treatment futility was a subjective decision jointly undertaken by the primary physician and the intensivist based upon the disease stage and the available therapeutare Med 2020;24(6)404-408.

Obstetric early warning score (OEWS) has been used conventionally for early identification of deteriorating obstetric patients in the labor room and ward settings. This study was conducted to determine if this simple clinical score could be used for prognosticating a critically ill patient in the ICU setting instead of sequential organ failure assessment score (SOFA) and acute physiology and chronic health evaluation (APACHE II) score.

A cohort study was conducted at Obstetrics Critical Care Unit, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. A total of 250 obstetric patients were recruited after informed consent. The OEWS, SOFA, and APACHE II scores were calculated within 24 hours of admission. The patients were followed to study the maternal outcome.

The area under receiver operator characteristic (AUROC) curve of OEWS, SOFA, and APACHE II for prediction of maternal mortality was 0.894 (95% CI, 0.849-0.929), 0.924 (95% CI, 0.884-0.954), and 0.93 (95% CI, 0.891-0.958), respectively.