Active learning improves self-reported engagement and satisfaction in medical education. Audience response systems are one mechanism of encouraging participation, especially in a setting in which learners in varying educational levels are present. Three fellowships participated in this educational quality improvement project where Poll Everywhere® was incorporated into didactics. Attendees were invited to complete a 4-question retrospective prepost satisfaction survey. Incorporation of the Poll Everywhere® audience response system resulted in a shift in more favorable satisfaction scores and self-perceived attentiveness compared to the pre-intervention responses.

Background As the healthcare system faced an acute shortage of personal protective equipment (PPE) during the COVID-19 pandemic, the use of 3D printing technologies became an innovative method of increasing production capacity to meet this acute need. Due to the emergence of a large number of 3D printed face shield designs and community-led PPE printing initiatives, this case study examines the methods and design best optimized for community printers who may not have the resources or experience to conduct such a thorough analysis. Case presentation We present the optimization of the production of 3D printed face shields by community 3D printers, as part of an initiative aimed at producing PPE for healthcare workers. The face shield frames were manufactured using the 3DVerkstan design and were coupled with an acetate sheet to assemble a complete face shield. Rigorous quality assurance and decontamination protocols ensured community-printed PPE was satisfactory for healthcare use. Conclusion Additive manufacturing is a promising method of producing adequate face shields for frontline health workers because of its versatility and quick up-start time. The optimization of stacking and sanitization protocols allowed 3D printing to feasibly supplement formal public health responses in the face of a global pandemic.

A 70-year-old man with known cold autoimmune haemolytic anaemia was referred to the emergency department with increased shortness of breath on exertion. He had been confirmed positive for non-variant COVID-19 infection 1 week earlier based on nasopharyngeal swab PCR assay. CT thorax demonstrated diffuse patchy bilateral ground glass opacities, consistent with COVID-19 pneumonia. Bloodwork demonstrated severe cold agglutinin mediated haemolytic anaemia. To help stabilise the patient, he was transferred to a tertiary care hospital for urgent therapeutic plasma exchange. Key supportive therapy included folic acid supplementation, ensuring the patient was kept warm and warmed infusions including transfusions via the apheresis machine. The patient made a good recovery following plasma exchange, and his haemoglobin levels remained stable by discharge.

Introduction: Sudden cardiac death (SCD) in the young is a rare but devastating event. Pre-participation evaluation is required prior to competitive sports. The Texas Adolescent Athlete Heart Screening Registry (TAAHSR) performs screening events including history, ECG and limited echocardiogram (ECHO). Hypothesis: Cardiac abnormalities are identified in athlete screening and challenges exist in long-term follow up. Methods: The TAAHSR database of 4309 participants between 2013-2020 was analyzed and follow up data obtained from phone and electronic medical records. Screening results were classified as: I - no abnormality (abnl) identified, II - abnl identified and further evaluation but no activity restriction recommended, level III - abnl identified and further evaluation with activity restriction recommended if concern for SCD. Results: Of 4309 participants, 218 (5%) screened positive on either ECG, ECHO, or both. ECG abnl were seen in 117/4309 (2.7%) level II and 23/4309 level III (0.5%). ECHO abnl were seen in 73/4309 (1.7%) level II and 13/4307 (0.3%) level III. The most frequent abnl in 218 positive screenings included: ECG - right ventricular hypertrophy (27, 12%), right bundle branch block (26, 12%), T-wave abnormalities (23, 10%), left ventricular hypertrophy (22, 10%), left axis deviation (17, 8%), Wolff-Parkinson-White (8, 4%); ECHO - bicuspid aortic valve (15, 7%), mitral valve prolapse (9, 4%), increased left ventricular trabeculations (9, 4%). The most frequent positive history in the cohort (218) was family history of heart disease (56, 25%), racing or skipped beats (30, 14%), chest pain after exercise (28, 13%), family history of SCD before age 50 (21, 10%). Follow up data was obtained, to date, in 130/218 (60%) positive screening participants and 72/130 (55%) had the suspected diagnosis confirmed. Of 130, 42 (32%) were reached and are alive at median follow up of 5.3 years. Conclusions: Our data shows 3.2% ECG and 2% ECHO positive screening for suspected cardiovascular abnl. Screening results may improve with better utilization of ECG criteria in athletes and lower referral based on ECHO findings that may represent normal pattern in certain populations. Follow up remains a challenge to determine long term outcomes of athlete screening.

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