Clinical questionIs a vasopressin, steroid, and epinephrine (VSE) protocol for in-hospital cardiac arrest resuscitation associated with better survival to hospital discharge with favourable neurologic outcome compared to epinephrine alone?Article chosenMentzelopoulos S, Malachias S, Konstantopoulos D, et al. Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest: a randomized clinical trial. JAMA 2013;310:270-9.ObjectiveTo determine if a VSE protocol during cardiopulmonary resuscitation with hydrocortisone administration in patients with postresuscitative shock at 4 hours after return of spontaneous circulation would improve survival to hospital discharge with favourable neurologic outcome.

Oral HTS is effective in reversing symptoms of mild-to-moderate hyponatremia in EAH.

To explore physicians' and nurses' perceptions and attitudes toward sickle cell patients in Jazan, Kingdom of Saudi Arabia (KSA). Methods: A cross-sectional study conducted in Jazan, KSA from November 2018 to March 2019. A convenience sample of nurses and physicians (N=244) from 12 hospitals in Jazan region completed the general perceptions about sickle cell disease patients scale questionnaire. Inferential statistics were conducted as appropriate to compare attitudes among groups within all variables. A p<0.05 was considered significant. Original Article Results: The response rate was 81%. The mean age was 33.73±7.89 years. Approximately, half of the participants were nurses (54.9%) and 40.8% were males. In comparison with physicians (39.6%), approximately two-thirds (65.7%) of nurses have more negative attitudes (p=0.000). Emergency healthcare providers have more negative attitudes than providers in the pediatric department (p=0.043). Those treating primarily children had higher positive attitude than those treating adults (p=0.013) or treating both, (p=0.017). Emergency providers (p=0.000), and internal medicine providers (p=0.001), had higher concern-raising behaviors' scale scores than pediatric providers. Conclusion: Findings highlight a significant proportion of providers in Jazan region, KSA, to have negative attitudes toward and high concerns about drug-seeking behaviors among sickle cell patients. These attitudes can contribute to lower quality of care for people with sickle cell disease. Further studies are recommended to find out the factors behind these attitudes as well as the adherence to guidelines in the management of sickle cell disease.

Clinical QuestionCan an accelerated 2-hour diagnostic protocol using the cardiac troponin I (cTnI) measurement as the only biomarker be implemented to allow an earlier and safe discharge of low-risk chest pain patients?Article ChosenThan M, Cullen L, Aldous S, et al. 2-Hour accelerated diagnostic protocol to assess patients with chest pain symptoms using contemporary troponins as the only biomarker: the ADAPT trial. J Am Coll Cardiol 2012;59(23):2091-8.ObjectiveTo determine whether an accelerated diagnostic protocol (ADP) for possible cardiac chest pain could identify low-risk patients suitable for early discharge using cTnI as the sole biomarker.