No abstract

There is a need to develop safe and cost-effective ways to test healthcare workers for COVID19. Here we describe a rapid antigen testing strategy in a cohort of 497 Healthcare workers exposed to SARS-CoV-2 that can be applied by systems facing a surge of COVID19 cases, increased exposures in their workforce and limited RT-PCR availability. Our findings support an expanded use for antigen testing beyond its current indication and highlights the importance of further studying this modality for the diagnosis of COVID19 on asymptomatic individuals.

Refractory ventricular fibrillation is a rare condition seen in both in-hospital and out-of-hospital cardiac arrest. A 56-year-old male was identified to have refractory ventricular fibrillation after an in-hospital cardiac arrest with multiple unsuccessful standard defibrillation attempts that was converted with dual-sequential defibrillation (DSD) to normal sinus rhythm. Advanced cardiac life support (ACLS) is the most widely used algorithmic treatment approach for various cardiopulmonary emergencies but has yet to provide recommendations for the treatment of refractory ventricular fibrillation. DSD may be a viable treatment strategy for refractory ventricular fibrillation when ACLS recommendations are ineffective.

The emergency department is a challenging environment to practice medicine, primarily due to the pace and logistics of practicing emergency medicine. Cognitive errors and provider handoffs can lead to poor patient outcomes. By acknowledging and addressing cognitive errors, including premature closure, anchoring, and diagnosis momentum, we can potentially improve patient care. Additionally, by completing thorough, yet efficient sign-outs, as per The American College of Emergency Physicians' (ACEP) “Safer Sign Out Protocol,” the chances of a poor outcome are further reduced. Below, a case of “migraine headache” is presented, highlighting cognitive errors and the risks associated with provider hand-offs in the emergency department.