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BackgroundCardiopulmonary Resuscitation (CPR) or Code status discussion usually happen late in the hospital admission. Lack of clear communication, various level of training of providers and discrepancy in health literacy among patient act as barrier in proper understanding of code status understanding. In this study we utilized brief video and validated survey to determine if viewing a short, educational video could improve patient understanding of CPR and code status at Robert Packer Hospital.MethodThis study was conducted as single center randomized study at Guthrie Robert Packer Hospital. Total number of participants was 150. Participants were randomly assigned (1:1) to Intervention group where they viewed brief educational video. The primary end point was the composite score ranging from 0 to 15 generated based on correct responses to the questionnaire (supplemental file). ResultThere was statistically significant high understanding of code status among intervention group with mean composite score of 8.6 with a significant difference between the video group (10.3) and control group (6.9) with a p-value < 0.001. The multivariate linear model had a significant F-statistic with a p-value of < 0.001. We found age and randomization group significantly changes the composite scores. On average, the composite score of the intervention group was 3.36 points higher than the control group with 95% confidence interval of 2.36 – 4.35, p<0.001, when adjusted for age and gender of the patient.ConclusionUnderstanding of cardiopulmonary resuscitation status holds important place in guiding management of a patient. Use of short video explaining CPR and code status was found to be effective in improving patient understanding of these issues. It has the potential to save time and improve patient’s understanding if incorporated into code status discussions with hospitalized patients.

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Anticoagulation for venous thromboembolism (VTE) in patients with recurrent subdural hematoma (SDH) is challenging. It becomes even more challenging when the patient develops phlegmasia cerulea dolens (PCD). We present a 66-year-old female with a recent history of recurrent SDH who received half-dose heparin therapy for VTE and PCD. The patient had improvement of dyspnea and resolution of PCD after two days of treatment. She was discharged with half-dose enoxaparin. At her one-month follow-up, there was no evidence of new SDH or progression of VTE. Half-dose anticoagulation therapy should be considered in patients with recurrent SDH when anticoagulation is inevitable.